What is Complex-PTSD?
Definition of CPTSD
Complex post traumatic stress disorderHonestly, I can’t remember if these are my words or not. Please tell me if they are yours.
is a psychological disorder that can develop in response to prolonged, repeated experience of trauma in a context where the individual has little or no chance of escape.
That is the clinical definition of Complex-PTSD (CPTSD). Other resources will explain CPTSD as a form of PTSD that has other overlying factors. The two can be easily confused if you don’t start with the definition. The definition above holds some key phrases.
The first is “prolonged, repeated experience of trauma.” Most instances of PTSD are traced back to a single horrific event. Not so with CPTSD. Someone who has this form of mental wound has experienced not one instance of trauma, but multiple instances, even possibly their entire life.
The second phrase to take note of is “little or no chance to escape”. I would add the words ‘over time’ to that phrase, because that is a key part of CPTSD. Anyone who has suffered trauma was not in a situation to escape – but where PTSD is an instance, CPTSD plays out over a long period of time. The person who is being traumatized has no means to escape their situation.
There is another central issue when differentiating PTSD from CPTSD and that is the mind that experiences the trauma. The initial group of the population where PTSD was observed was military veterans. In this group, the men and women were all over 18 years of age when they experienced trauma. This is important because most of their cerebral development was done. They knew who they were, and they knew who they wanted to return to being after the trauma.
When we talk about CPTSD the trauma can start as early as infancy. That is perhaps the most important difference. In PTSD the individual, usually an adult, has a point before the trauma to return to. People with CPTSD have no previous to return to in many cases because they were shaped from their earliest moments by their traumatic environment.
Symptoms of PTSD and CPTSD
Complex PTSD builds on the already accepted symptoms associated with PTSD. So, while someone with PTSD will experience symptoms from the list on the left, someone with CPTSD will experience symptoms from both lists.
- Memories of the trauma.
- Flashbacks – Reliving the trauma.
- Dreams or nightmares
- Emotional or physical reactions to reminders
- Trying to avoid thinking or talking about the event
- Avoiding anything that reminds you of the event.
Negative thoughts about damn near everything.
- Hopelessness about the future
- Memory problems
- Difficulty maintaining close relationships
- Feeling detached from family and friends
- Feeling emotionally numb
Being easily startled or frightened
- Always being on alert
- Self-destructive behavior
- Trouble sleeping
- Trouble concentrating
- Irritability, angry outbursts or aggressive behavior
- Overwhelming guilt or shame
- difficulty controlling your emotions
- feeling very angry or distrustful towards the world
- constant feelings of emptiness or hopelessness
- feeling as if you are permanently damaged or worthless
- feeling as if you are completely different to other people
- feeling like nobody can understand what happened
- avoiding friendships and relationships, or finding them very difficult
depersonalisation or derealisation
physical symptoms: headaches, dizziness, chest pains and stomach aches
regular suicidal feelings.
Emotional Flashbacks vs. Flashbacks
You would think that there wouldn’t be a dividing line between these two terms. After all, both are moments when the brain is hijacked by the past and trauma is reexperienced. The difference lies in the brain. A flashback is a full sensory being there re-experiencing of the trauma. The person can see, feel, even smell and taste all the details of the event. Those details are stored in their memory. They reexperience every part of that trauma.
The concept of the emotional flashback extends this to include periods of early childhood where the ability of the brain to form, store and retrieve memories is still developing. Particularly in the area of the visual cortex. What that means is that the memories of the event are stored complete with all the associated emotions, but there is no visual context. So when you encounter something that triggers a memory of that trauma – you are instantly swept back to the emotions of that time. And, you have nothing to correlate it with.
This being flung into emotions that are overpowering, without knowing why, or being able to point to any specific memory is one of the most disorienting, and in my opinion frightening aspects of CPTSD.
Core Beliefs of CPTSD
The manner in which the other major symptoms of CPTSD can manifest are as varied as the people who suffer with this condition. One core belief that many people with CPTSD have is that they are essentially fatally flawed. And because of their own brokenness, they are undeserving – of anything.
This is the core belief that tells us we are not worth ‘the bother’. This is the core belief that makes us accept the least. This is the core belief that makes it difficult, at the least, to face conflict. The script in our head says we are not worthy of our parents love, therefore we are not worthy. It is the core belief that we are worthless, completely without value.
CPTSD: Survival before growth
Most of the people with CPTSD have created defenses to keep them safe from their early environments. Most of the people who live with CPTSD are fiercely independent. We are also likely to be stoic. But many of these traits come from the need as a young child to be ‘easy’. Many people report a similar scenario of not asking for anything, because asking was dangerous. Others report that they abandoned things they enjoyed for the sake of peace. Many of the strategies we developed as children were not to explore our world, but instead to survive our world.
Where are we now
Post Traumatic Stress Disorder (PTSD) is more widely known in the public. Efforts to educate about this mental wound, typically found in soldiers but also victims of violence, have been ongoing since the 1980s. In contrast the study of CPTSD is relatively new. So new, that it is not yet included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
But, European sources are starting to recognize that CPTSD is a disorder that should be recognized as a unique set of symptoms, behaviors and challenges. Hopefully, one day the DSM will follow.
There is a great deal more to convey but, for now, to sum it all up, Complex-PTSD is a bitch. Really.