What is Complex PTSD?
You’ve heard of Post-Traumatic Stress Disorder (PTSD), which in short is a mental health condition that can develop after a person experiences or witnesses a traumatic event. Symptoms may include intrusive memories or nightmares of the traumatic event, avoidance of triggers that remind them of the event, hypervigilance, and emotional numbness. But what if you’ve been through multiple or ongoing traumatic experiences? Some people may not be able to single out one specific traumatic event that they have been through, and don’t feel like they qualify for a PTSD diagnosis because of this wording.
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However, this type of trauma has been identified and discussed more in recent years. It is referred to as Complex PTSD, or C-PTSD for short. C-PTSD is a type of PTSD that results from prolonged and repeated exposure to traumatic events. It is similar to PTSD in that it can cause symptoms such as intrusive thoughts, avoidance behaviors, hypervigilance, and emotional dysregulation. However, C-PTSD can also cause additional symptoms such as difficulties with self-esteem, interpersonal relationships, and overall sense of identity. This traumatic stress reaction can form in response to repeated traumas such as childhood abuse/neglect, domestic and sexual abuse, human trafficking, being a prisoner of war, and other long-term traumas. C-PTSD is not included in the DSM-5 yet, but it has been recognized by the World Health Organization’s International Classification of Diseases, and its use as a clinical term is helpful in creating specific treatment plans for people with this disorder.
Abuse in childhood is a major risk factor for developing C-PTSD.
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Your brain has more plasticity (meaning flexibility in patterns of learning and growing) the younger you are, and adverse childhood experiences can impact your development. If you grew up in a home where your safety was never guaranteed and the people responsible for caring for you were often cruel, violent, or manipulative, your brain adapted the best way it knew how in order to weather the storm - to become passive and compliant to prevent conflict, to fight back and use your anger as a weapon, or to separate body from mind to escape mentally. C-PTSD can develop in adulthood as well, and it is a real and valid response to experiencing multiple terrible things.
When you have been exposed to extremely distressing and dangerous events over and over again, your brain gets stuck in the fight-or-flight response, even when there is no real threat to your safety. The ability to respond appropriately and regulate your emotions in stressful situations is called being within your window of tolerance. With PTSD or C-PTSD, your window of tolerance gets smaller, and this can trigger a trauma response at harmless stimuli, like hearing a loud noise, smelling a certain scent, or seeing a person that looks like your abuser. When people can’t fight back or flee, your body goes into a freeze state, shutting down all higher functions in order to reserve energy to simply survive. This is why many people with post-traumatic stress blame themselves for freezing up, feeling numb, or dissociating during a traumatic event, and feel that they should have fought back instead. The freeze response is a completely normal and common response to danger, and is in no way an indicator that something terrible that happened to you was your fault. Experiencing this biological response over and over again literally alters your brain chemistry, which is why people with C-PTSD have trouble regulating emotions and feeling connected to other people. It is simply a long-term habit your brain has picked up to try and help you survive.
But this doesn’t mean that you can never recover.
Seeking psychotherapy from a counselor/therapist/social worker/etc that is trained and qualified in trauma treatment can be extremely beneficial, as well as mindfulness, medication, meditation, exercise, creative writing… there is not a one-size-fits-all approach, and different things work for different people. We have several therapists that treat trauma and PTSD at Aspire Counseling. There are many scientifically proven treatments for PTSD that can easily be applied to C-PTSD as well. These potential treatments include:
Cognitive Processing Therapy (CPT), a form of therapy that has been found very effective for treating PTSD and involves challenging “stuck points”, or long-standing negative beliefs about yourself, others, or the world, and restructuring your thinking patterns.
Prolonged Exposure (PE) involves gradually approaching and confronting the traumatic event by recounting it in detail and exposing yourself to trauma reminders/triggers, repeatedly and in a structured way, until it no longer causes significant distress.
Eye Movement Desensitization and Reprocessing (EMDR) is a method that uses bilateral stimulation (activating both sides of the brain alternately) to reprocess the traumatic memory in a more adaptive way. This allows the person to access and process it in a different way than they were able to before.
Narrative Therapy emphasizes the stories we tell ourselves and others about our experiences, and how they shape our understanding of ourselves, our relationships, and the world around us. This therapy aims to help people rewrite these stories in a way that is more empowering and positive.
In addition to these structured treatments, there are things you can do by yourself to cope with C-PTSD.
Mindfulness techniques can be helpful for individuals with PTSD to manage symptoms such as anxiety, hypervigilance, and intrusive thoughts. Here are some mindfulness techniques that may be helpful:
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Deep breathing: Taking slow, deep breaths can help reduce feelings of anxiety and promote relaxation. Focus on taking long, slow breaths, inhaling through the nose and exhaling through the mouth.
Body scan: This involves lying down or sitting in a comfortable position and focusing on different parts of the body, one at a time, while releasing any tension in those areas. Start at the top of the head and move down to the toes, paying attention to any sensations in each area.
Grounding: This technique involves focusing on the present moment and the environment around you to reduce feelings of disconnection and dissociation. Try naming five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
Mindful walking: Walking slowly and deliberately, paying attention to the physical sensations of each step, can be a grounding and calming activity. Focus on the sensations in your feet as they touch the ground, and the movement of your body as you walk.
Mindful meditation: This involves sitting quietly and focusing on the present moment, paying attention to the breath and any thoughts or feelings that arise without judgment. You can use guided meditations or simply sit quietly and focus on the breath.
It's important to note that mindfulness techniques should not be used as a substitute for professional treatment for PTSD. If you are struggling with PTSD, it's important to seek out the guidance of a trained therapist or healthcare professional.
C-PTSD, or Complex Post Traumatic Stress Disorder, can occur in individuals who have experienced prolonged or repeated trauma, particularly in the context of interpersonal relationships, such as childhood abuse or neglect, domestic violence, or ongoing combat situations. It can make the lives of trauma survivors difficult, but there is hope for everyone, no matter how extreme the trauma can be. Trauma therapy is a commitment and can be intimidating, but there are several approaches that have helped those with complex trauma recover and live fulfilling, promising lives. In addition to starting trauma therapy at Aspire Counseling, here are some other resources you can use when you are struggling with the effects of complex trauma:
Trauma Therapy in Missouri
At Aspire Counseling one of our passions is working with trauma, and many of our therapists are trained in evidence-based treatments that help with trauma. Along with providing trauma therapy, we also provide therapy for those struggling with depression, anxiety, grief, life transitions, OCD, Disordered Eating, and much more. We provide a safe environment for each of our clients, and also provide affirming and LGBTQ+ support. Reach out to our Client Care Coordinator to begin your journey with healing, and with therapy.
About the Author
Ozzie Dinwiddie is an intern at Aspire Counseling. Ozzie is passionate about working with those experiencing trauma, depression, and LGBTQ+ issues. When Ozzie isn’t interning here at Aspire, he loves to hang out with his adorable cat, and write!
