What is Complex Post-Traumatic Stress Disorder?

Pre-warning: This article involves discussions of trauma and mental health conditions.

Most people have heard of Post Traumatic Stress Disorder (PTSD) which is a mental health condition that individuals can develop as a consequence of experiencing a traumatic life event. Veterans of war or individuals who have experienced a life-threatening event such as a car crash or violence are examples of individuals at risk of developing PTSD. Symptoms can include anxiety,

depression, disturbing and intrusive thoughts, feelings, or dreams related to the traumatic events including "flashbacks" where individuals feel they are re-experiencing the trauma and attempts to avoid anything related to the trauma e.g. not wanting to drive after a car accident.

Complex Post-Traumatic Stress Disorder (C-PTSD) is different in that it usually develops as a result of frequent exposure to stressful events in childhood rather than a single life-threatening experience and the symptoms are often much more pervasive.

C-PTSD overlaps with PTSD in that the stressful life events experienced in childhood continue to have a significant influence on an individual afterwards through both re-experiencing (for example as intrusive memories or flashbacks) and avoidance. However, because these experiences occur as we are developing our personalities and understanding of ourselves and the world these traumatic experiences can significantly influence the development of our personalities and belief systems that we live with in adulthood. The fact that these traumas also usually occur within our first relationships and usually with close relationships such as parents or other family members means they often shape our expectations and beliefs about future relationships as they form a kind of template.

It is common that some of the experiences that come up in therapy around C-PTSD may seem to us as adults to not be "traumatic enough". It is normal for us as adults to lose touch with the sense of vulnerability, dependence and needs we have as children which often amplify and compound the impacts of distressing events experienced as children. Babies and young children have virtually no ability to self-regulate their emotions and are designed to out-source their emotion regulation to our care-givers. Thus events that may seem minor to us as adults could cause a great deal of distress in a child especially if they do not have caregivers to help soothe their distress, or as is often the case with C-PTSD that our caregivers are the source of the distress.

As adults we may also intellectually understand why our parents made some of the choices they made even if it was painful and difficult for us as children and feel that this should override any "traumatic" impacts. However, this is not usually something we understood as children when the distressing event occurred and intellectual understandings are often difficult to translate to a felt-sense of security within us.

Connecting these two things, our intellectual understanding that it's over, we survived, we are now ok, we are worthy after traumatic events into a felt sense in our body instead of the fight/flight/freeze response that often accompanies C-PTSD survivors is often in a nutshell the goal of therapy. This is not an easy task, however luckily these days we have some very good therapies that with time and a skilled clinician can help us embody a greater sense of safety and security and a more grounded sense of self. My favourite therapies that work on this include EMDR, Schema-therapy, mindfulness and compassion based therapies, ACT and CBT (yes even CBT can help with this if done well).

Reach out if you would like to find out how these therapies could help you.