cPTSD: What You Need to Know About Complex Trauma
You may have heard the term cPTSD or complex PTSD but have wondered what it is and how it differs from traditional PTSD.
The truth is that while there are certain overlaps between the two terms and diagnoses, complex PTSD - also referred to as complex trauma - is unique in its presentation, symptomatology and treatment.
Let’s dive in and explore more below.
What is cPTSD?
cPTSD stands for complex post traumatic stress disorder. As you have already ascertained from the name, it is a condition that arises as a result of trauma. However unlike traditional PTSD that tends to be more associated with a single incident trauma - such as a car accident, a natural disaster, exposure/participation in war activities - complex PTSD is characterized by repetitive, continuous and unrelenting exposure to events and/or experiences that are perceived, coded and stored by the body and brain as traumatic.
While traditional PTSD can be more short-lived as it tends to be tied to one event, cPTSD stems from chronic and long-term witnessing/experiencing trauma, one where a person has a difficult time imagining a scenario where the circumstances may change. This tends to happen due to intense family dysfunction that can be quite severe, such as abuse, neglect and abandonment.
cPTSD frequently shows up in folks that may look at the above description and say: “That’s not me. I was never abused.” These folks may think of their childhood as “normal” and “ordinary”, where “nothing horrible happened”. Yet when they begin to describe their home environments, there is a palpable feeling of emptiness, lack of attunement and attention from parental figures, lack of emotional intelligence or acknowledgement that emotions are felt and/or exist at all.
The truth is cPTSD comes in many shapes, sizes and colors. And while it may be “easier” to point to a childhood full of abuse and connect it to this diagnosis, it doesn’t make a less abusive family environment less traumatizing for someone who lived in and survived it.
In fact, cPTSD can seem like a big and scary diagnosis for folks who have a hard time describing their past and upbringing as traumatic. Which is why it may be helpful to look at what are the symptoms of cPTSD and see where you may or may not resonate.
Symptoms of cPTSD that overlap with PTSD
Let’s looks at the symptoms cPTSD shares with PTSD and outline some important differences between the two.
Flashbacks as a re-experiencing of trauma.
For traditional PTSD this can show up as memories popping up uninvited - pieces of a movie playing in your head, or triggers directly tied to a traumatic event bringing about the memory (think fireworks for vets, etc.). Traditional PTSD and cPTSD can both experience nightmares and disturbed sleep too.
The distinction here is that cPTSD sufferers experience emotional flashbacks and body flashbacks more often than cognitive ones. This may mean all of a sudden feeling anxious or depressed, or like your body is on guard for no apparent reason. It may also look like getting suddenly irritated, scared or angry as a manifestation of an emotional flashback.
Avoiding reminders of trauma
Both PTSD and cPTSD sufferers go out of their way to avoid places, people and situations that may put them in contact with reminders of what they lived through. This can look like not watching movies or listening to music that reminds you of painful events. Choosing not to go to brunch with friends because of crippling social anxiety that stems from childhood abuse. Or choosing to always be optimistic and relegating your “negative” feelings to the dungeon of your mind.
Sense of persistent alertness and threat
This is also known as hypervigilance - a state where your brain, particularly your amygdala, is constantly and continuously scanning for things being “off”. This may mean reading people’s faces for signs of anger/displeasure, monitoring your environment for loud noises, getting ready to defend yourself/attack the moment anything resembling criticism comes your way.
cPTSD-specific symptoms
With cPTSD there is a core disturbance in the sense of self. Folks who suffer from cPTSD may frequently feel in their bones that there is something wrong with them, like there is a piece of machinery missing inside of them. They frequently feel like the odd one out, the only person in the world who just doesn’t get how others can be happy because they feel so fundamentally out of sync with themselves and their environment.
Difficulty regulating emotions and affect
cPTSD is trauma, and trauma changes our brains and bodies. cPTSD makes it difficult to regulate emotions and affect due to persistent nervous system dysregulation for years and years.
Negative self-image and perception
“I am wrong.” “I am bad.” “There is something fundamentally broken about me.” These are some of the common feelings that arise with cPTSD. Folks can show an external mask of feeling confident and be extremely efficient and good at something (their job, academics, other achievements) and despite this feel like a shame-filled fraud.
Persistent difficulties in relationships
This can look like having profound difficulty trusting people, believing everyone will leave you eventually, experiencing codependent tendencies where your needs are neglected for the sake of the needs of others, and more. Relationship disturbances in cPTSD look different for each person, but the common theme is putting self on the back burner in order to tend to others/manage the external situation.
What to do next?
If you are recognizing yourself in many of the symptoms above, it is incredibly important to remind yourself that you are not wrong. You are not bad. You are not damaged. You have gone through something wrong, bad and damaging. And it has left behind significant scars. You have survived it. And now you may be ready to heal.
Here are a few steps that have helped me personally in my own journey of healing from complex trauma:
Gain information. This can look like reading books that can help educate you on the specifics of trauma and how it functions. Or simply finding online resources that can help underline the fact that you are not alone with this diagnosis, and there is hope for a better life.
Get community support. Find a group you can join to help you make connections with others who are going/have gone through similar experiences. Join an online forum/thread to become part of a community. Healing is not only individual, it is also communal and getting support from others is going to be crucial in your healing journey.
Get individual support. Find a trauma-focused and trauma-trained therapist to work with. Make sure to look for someone you can connect with and someone you can see trusting/building a safe relationship with. Complex trauma occurs in relationship with others, finding a safe relationship is going to be paramount to your healing.
I hope this helps as a start for those who either already know they have cPTSD or may be suspecting it. Know that you are not alone in your pain, and that with support, resources, attention and intention, healing from complex trauma is possible and within reach.