If you want to know more about this cycle within Complex-PTSD take a gander at this post.
Definition of C-PTSD
Honestly, I can’t remember if these are my words or not. Please tell me if they are yours.
Complex post – traumatic stress disorder
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. Other resources will explain C-PTSD 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 C-PTSD. 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 C-PTSD. Anyone who has suffered trauma was not in a situation to escape – but where PTSD is an instance, C-PTSD 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 C-PTSD 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 C-PTSD 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 C-PTSD 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 C-PTSD 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 C-PTSD.
Core Beliefs of CPTSD
The manner in which the other major symptoms of C-PTSD can manifest are as varied as the people who suffer with this condition. One core belief that many people with C-PTSD 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 C-PTSD have created defenses to keep them safe from their early environments. Most of the people who live with C-PTSD 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 C-PTSD 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 C-PTSD 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.
I have a question for my readers – Would you be interested in a book about the journey of recovery from Complex-PTSD?
What I have in mind is an exploration of the healing process from three distinct perspectives. The view of the person trying to overcome CPTSD would be one. I have a therapist who is willing to work with my to provide the therapeutic aspects that are encountered and how to work through them. And I have a person who is willing to author at least a part of the ‘how to support someone’ in recovery.
If you have some interest or ideas, please share them in the comments.
I didn’t have a migraine last night.
Read that sentence again because I’m going to explain WHY? that is a big deal. Ready?
One of the symptoms of my Complex PTSD, since I was 12 perhaps, has been debilitating blinding headaches. I could expect expect 3-4 nights out of the year that I would spend sleeping on the bathroom floor. The tile floor was cool and I could close the door and be alone with my pain. Pain that was so bad I saw auras, I suffered muscle contractions that twisted me involuntarily, I would bang my head on the walls to find some focus away from the lancing pain through my skull. The pain was so severe there was the added insult of nausea and puking.
When my parents finally witnessed one these headaches, (huh, I can’t remember how that happened), they took me to the doctor. A neurologist. There was a long day of many tests. At the end of the appointment, the doctor sent my parents home with the knowledge that there was nothing physically wrong with me.
In retrospect, I think I really hate that he did that. Because, of course, for my parents if there was nothing physically wrong then there was nothing to treat. End of story.
Only it wasn’t. I have spent another forty years living in fear of one of these ‘headaches’. For a long time, I had no idea of where these came from and what triggered them. In my 20s when I was in grad-school the general practitioner I was seeing prescribed massage for me as a way to lower my anxiety. Best three months I had experienced in a long time. And that lead me to one of the ways to alleviate these events, touch. A person who would hold me as I writhed, or better before it got that bad. could usually halt or at least soften the episode.
I knew nothing of the sympathetic nervous system or the role it plays in cptsd. This was, like so many of the coping mechanisms we find hard won out of brutal experience. After nearly a decade in and out of therapy I put another pair of pieces together. I found I could predict when I might experience a headache. That knowledge allowed me to attempt to stop it.
Not all of those attempts were wisely chosen. Most of the time I cut to let my demons out. Only once or twice did I turn to alcohol. I still can’t stand the smell of most alcohol. Never chose drugs because my central need is to be able to control myself. With alcohol and drugs I might have been able to stop the pain or blunt it, but I would lose control and that wasn’t acceptable. So I chose to bleed instead. Most of the time it worked. But, not always.
The trigger I found that most commonly lead to this reaction was a case where I felt I had failed or where I had been rejected. If you have cptsd you’ll understand how fundamental those triggers are and how far ripples can travel even decades later.
Over time I discovered the most effective method for me to handle an event that might trigger one of these episodes was to talk to myself. Yeup, I still think it sounds corny – and I know it works. As I started to learn about cptsd, the sympathetic nervous system, triggers, dissociation, integrated family systems I was learning how to better manage those events in my life that at one time would have produced a migraine. (Technically I don’t know if it was migraine, but you get the idea, right?)
I am making progress. Huzzah!
Yesterday one of those events of life happened that would have had me out of commission on the bathroom floor last night. But, it didn’t. I processed that F*er. Ok, probably still processing it, but the major danger of having a reaction headache as some type of punishment that my psyche thinks I believe is low. Perhaps, I would even go so far as to say – very low.
And that feels like a miracle. Feels like. I know it isn’t. The ability to deal with yesterday’s ‘thunk’ was decades of practice and finally understanding my brain.
So here is to recovery and the many little victories it brings.
May you have many, many little victories.
Speak to me
Inside my head.
They travel in a troop
Like a cloud
One is shame,
discarded, and yet
loudest of them all,
One cries ‘look at me’,
she wears a red dress
and high, high heels.
One slips by invisible, almost.
made of cellophane.
Wanting to be held.
My angry girl,
Walks a silent old woman
Dressed in dark oil skin.
Always prepared for disaster
She follows them
in silent solitude.
Slung across her back
In a rucksack twice her size
The colossal collection of
My lost memories.
I stood upon a road facing a divide,
I trembled knowing that on one path
Without premonition, sign or guide
Both branches were equally eyed.
Filled with doubt I must choose to pass.
On both roads stood dread unknown
Faceless fears and boogie men
Childhood monsters though I’m grown
Follow me far from home
And try to draw me back again.
I was caged safe and sound
My hands could span from wall to wall
In silence I sat making myself small
Blinded to the bars that did surround
For if I did not rise then I could not fall.
When I saw the cage I had designed
Silver bars and barbed wire fence
About myself for fear I did wind
I was prisoner in my own mind
And that has made all the difference.
Ok. I did something extravagant last year. I made myself a T-shirt. This is it. I was planning to wear it on a family trip – but that went bust. Maybe next year?
I’m so excited every time I wear it. It starts conversations on #cptsd – and that is exactly what it is designed to do.
This is the back
Change your spots for no one.
A patch of leopard spots
Complex Post Traumatic Stress Disorder
is a bitch.
I was trying for something more academic sounding, but let’s face it, I’m not on that plane today. Nope, today is one of those days where I’m just trying to figure out where I put my sh*t. Or, more accurately, where I lost it.
I know when. That much I am certain of. But, where all my bits scattered to after that I have no bloody idea. I’m off the rails, ground to a halt and trying to find a way to right myself and start moving again.
I hate this.
A cornerstone of my CPTSD
And yet, I know this process very well. This is a cornerstone of my CPTSD. This cycle repeats itself ad nauseum. Every time through this process these days I’m better at being able to identify which part of the cycle I am in. That, although it sounds trivial is a huge step.
It used to be that I didn’t know what was happening. My CPTSD manifests in many ways. The aspect being activated here is my emotional dysregulation. The cycle goes something like this.
It almost seems like nothing’s wrong.
Calm, cool, collected. Moving forward with life tasks and goals.
Small emotional moments are managed by either listening to the emotion or ignoring.
The sum of the emotion is no change in my equilibrium.
CPTSD : Normal or Intensely dangerous? From the inside I really can’t tell.
An event of intense emotion.
The event can be almost anything and can trigger almost any emotion possible. The track-record is more to the negative, but positive emotional events have also kicked the cycle into motion.
In the event there is a sharp dichotomy about expressing or not expressing what I am feeling. More often than not I fall to the side of repression. Which, as loved ones have told me, can feel deceptively normal – or intensely dangerous. I’ll admit, from the inside I can’t tell the difference.
On the upside, I am at least getting better at acknowledging that I am feeling ‘something’. Even if I cannot always identify the emotion, these days I am at least aware that I am feeling. It may sound inconsequential, but for someone who has lived with emotional paralysis for 40+ years, this is a huge step.
CPTSD : Believe me when I call it work.
Working my way out of ‘the moment.’ Because of the confusion surrounding my emotions, their muted state and sometimes just the delay in determining what is happening, the ‘moment’ of emotion can last. It is like sitting down and teasing apart lines of rope that have been coated in tar. Laboriously I peel apart the strands of what I am thinking from what I am feeling. At the end of the process I need to sit with that feeling and try to not only understand it in a rational manner, but to also process it at an emotional level. That processing is another intense period of labor as the creaking and stunted machinery of my inner emotional self is prodded into motion.
Previous patterns of attempting to ignore or stuff the feelings away results in anger, depression and intense self-loathing. Enough of that and I will begin to start longing for ‘out’.
So, these days I work through it. Believe me when I call it work. It is.
CPTSD : The aftermath is all encompassing.
The aftermath of one of these events is all encompassing. Every system of myself suffers under the impact of such an event. Physically there might be muscle spasms, stomach upset, migraines, exhaustion. Emotionally the rawness caused by this unprepared for intensity leaves me in one of two states; hyper-aroused or depressed. Periods of hyper-arousal are followed by emotional numbness.
There is another feature in all this backwash. The question inevitably comes up of “Why am I doing this again?” Why am I spending time and effort and money on trying to connect with these emotions when I was doing well-enough as an automaton?
All those storylines where an android wants to ‘become a real boy’ – wow, I’m pretty sure I could talk them out of it. Because, seriously – why am I doing this?
CPTSD : Recovering my balance.
Much as I wish that recovery from such an event was as simple as recognizing that I am in the midst of one, it isn’t. Recovery takes time. Time to process the emotions. Time to process the event that caused it. Time to herd the physical and mental processes back on-line. Time to pour it all out onto a page in an effort to move past the wreckage. Time to reflect, but not to fall into an old pattern of over analysis.
That is where I am, right now.
I’m trying to feel my jaw unknot. I’m coaxing my shoulders to relax. Telling my stomach that this too shall pass and to try to stop cannibalizing itself. Above all reminding myself to breathe.
I will end with a couple of quotes from Winston Churchill:
First “When going through Hell, keep walking,” and the second – “Success is never permanent, and failure is not fatal.”
So – here’s me, walking.
Duane Robert Stewart
October 16, 1964 – January 18, 2021
My brother died today and I wept for him, for us.
For all the warm words we never exchanged,
For all the jealousy we held for each other,
For all the times pain was our only contact,
For the words of hurt,
For the thefts,
For the bruises,
For the silence,
And for the little boy
At the bottom of the stairs
Who screamed in panic
As I fled upward
And father raged below.
You deserved better,
And so did I.
Well, January 2021 certainly led off with a bang. I still see things on the horizon of concern. I’m trying very hard NOT to focus on those.
Instead, I am head-down in editing my second novel while waiting somewhat patiently for my first novel to have a pre-order date. I’m also trying to remind myself that even though things seem overwhelming at the moment there is the slow, steady process of just taking one breath after another.
One thing I did learn from CPTSD is that some days just getting to the end of the day was enough. Those days, sometimes, are the hardest. Remember, it can be done.
There are some behind the scenes ‘shenanigans’ going on which I am not yet in a position to relate. I hope it will be a funny story with a good ending – but, until then, everyone buckle up.
With any luck, I will be able to write next week about a very boring and uneventful Inauguration. Let’s keep hoping for that.