Complex PTSD is more than just a response to trauma. It’s a response to trauma that is repeated again and again.
What is c-PTSD?
c-PTSD develops from ongoing abuse or neglect, often during childhood. It happens when a person has repeated exposure to intense fear-inducing situations coupled with the feeling they cannot escape. Most c-PTSD occurs as a result of childhood trauma, but it people can also develop it as adults in situations such as in domestic violence relationships later in life.
PTSD vs. c-PTSD
While PTSD often stems from a single traumatic event, c-PTSD is the result of trauma that was repeated, ongoing and interpersonal. The threat wasn’t a moment in time. It was the daily reality of your childhood.
It was the pervasive lack of safety you felt in your own home. It was a person – a parent, a caregiver, a partner – someone you should be able trust, but that was actually the biggest survival threat you faced.
c-PTSD is what happens when your nervous system exists in permanent fight, flight, freeze fawn mode because you never feel safe to let your guard down. Why? Because you live every day with the danger you most want to avoid..
Complex PTSD symptoms are well… complex
They include:
- deep feelings of shame or guilt
- emotional flashbacks (feelings that seem to come from nowhere and feel asintense as if you are back in an experience from your past
- chronic anxiety or hypervigilance
- intense emotions and mood swings
- trouble with relationships and trust
- feeling disconnected or numb
- challenges with concentration and decision-making
negative self-image and feelings of worthlessness
- difficulty with self-perception
How c-PTSD Affects Daily Life
C-PTSD impacts almost every aspect of life because it changes the structure and function of our brains. We might struggle with concentration at school or work, emotional regulation, intimacy, relationships, an ongoing feeling we are in trouble, that people hate us. We worry we will be abandoned once people know who we really are. We might find it hard to relax because we never feel safe in our own bodies.
Low self-worth can make self-care challenging. We may look for respite from the war of turbulent feelings raging inside of us in unhealthy ways. We are more likely than others to struggle with addiction. These are not personal flaws.
They’re survival responses from long-term trauma.
These responses are also able to be changed and improved with intervention and effort.
Complex PTSD and the body
C-PTSD doesn’t just affect your mind. It lives in the body. The constant physical toll of long-term nervous system dysregulation that accompanies C-PTSD weakens the immune system and increases the risk of developing physical health problems.
It can lead to increased rates of muscle tension, insomnia, chronic pain, fatigue, elevated heart rate, heart palpitations, shallow breathing, trembling, high blood pressure, high cholesterol, obesity or stomach issues.
These physical symptoms are very real, but they don’t have to be permanent, and can be reversed or improved with support and intervention.
C-PTSD and Relationships
C-PTSD can make relationships difficult. Because people were meant to be able to trust were the cause of your original childhood trauma, when you become an adult, people can still feel unsafe or confusing.
You might struggle with trust and vulnerability, fear abandonment, struggle to ask for what you need, feel unsafe to be yourself with others or be stuck in a pattern of chronic people pleasing to avoid conflict.
These patterns can be unlearned and healthier strategies developed that allow you to feel more open, authentic and connected to others.
Can you treat c-PTSD?
You can absolutely make the symptoms of c-PTSD more manageable and stop them from interfering so much in your daily life. But for me, despite the eye-watering amount of money I have spent on therapies of all persuasions, c-PTSD still rears its ugly head from time to time, especially the stupid emotional flashbacks, feelings of worthlessness and shame. Boo! You need to have self compassion in these moments (note to self : ).
The process for treatment of c-PTSD is more complex than many other conditions because the trauma is so deeply embedded into our brains and bodies. It sucks. I know. All that childhood trauma and now all this extra work. But at least there is a way forward. These are the approaches I have found most helpful.
Nervous system support
Building safety back into your nervous system so you can switch off your permanent fight, flight, freeze, fawn response you may have been living in since you were a child, is step number one for me. Nervous system practices are really gentle and simple and they have had a really profound impact on my capacity to more quickly regulate my emotions and return to calm after I have been triggered. Also, they have helped me feel more alive, present, grateful and joyful, which is pretty darned excellent.
My book Beyond Fight, Flight, Freeze and Fawn distills many years of research as well as the practical strategies that I have found most helpful if supporting your nervous system is something that appeals to you.
Therapy that incorporates body / imagination / creativity
I haven’t found cognitive-only therapy approaches particularly helpful and often find them very annoying. Also, I find that doing regular exercise every time I feel that charge in my system and getting enough sleep really helps. And Yes. I have done a truckload of therapy. Thanks for noticing.
These are some of the therapies and practices I have found most effective
- meditation
- grounding practices
- emotion-focused therapy
- soul-centred psychotherapy
- somatic therapy
- bilateral stimulation e.g. EMDR
- EFT tapping
- art therapy
- inner child work
- yoga
- breathwork
- body scanning and reconnection
Reclaim your lost sense of self
Most people with c-PTSD are expert at tuning into the emotions of others (chronic people pleasing or “fawning” to avoid trouble), but they do not have a clear sense of self.
Because their needs have been constantly neglected and they didn’t receive adequate attunement from caregivers, they haven’t formed a clear identity. Who am I? What do I like? What do I need? What do I want from life? These are questions they may never have asked themselves because they were so busy just surviving.
But the good news is, you can do this at any age, and it is fun! I highly recommend the book The Artist’s Way as a great starting point. But I have also explored psychological testing, human design, astrology, as well as many other woo woo and weird ways of looking at myself, because who the hell actually am I???
I still don’t really know. But trying to figure it out is quite entertaining.
Build capacity for relationships
Ugh. Relationships. People suck, don’t they? Okay, not everyone. But some people. They’re just dicks.
If you have c-PTSD, it is especially important to build your capacity for healthy relationships because your first model for relationships was so damaging. Building relationship skills allows you to not repeat the unhealthy patterns of your past in the present. It’s how we break the cycle, baby!
Key relationship skills/ practices for people with c-PTSD
Nervous system work so you can learn how to feel safe co-regulating with others.
Strengthen awareness of red flags and trusting your gut through self-awareness and self-trust building
Learn to set boundaries
Learn to stay in your body and overcome the impulse to fawn in the face of conflict.
Learn to advocate for your own needs.
Learn healthier ways of expressing feelings e.g. l statements, effective and respectful argument techniques
Learn how to repair and apologize without needing to annihilate yourself for making.
You are worth it
The process of c-PTSD recovery is complex because the trauma you experienced was complex.
Is it worth doing? Absolutely.
Are you worth the effort? 1,000,000% yes
