How it begins
The term Complex-Post Traumatic Stress Disorder (also known as C-PTSD and “disorders of extreme stress not otherwise specified”) is still relatively new. Some mental health practitioners would like C-PTSD to have its own diagnostic criteria, separate from those of PTSD. This change may actually be forthcoming. I think a possible indicator is that PTSD was removed from the “anxiety disorders” category and added to a brand new section called “trauma and stress-related disorders” in the DSM-5 (Gattuso, R. 2018).
PTSD symptoms are stress-related coping mechanisms called “triggers” that are associated with hypervigilance. (Lanius et al. 2010). They’re often seen combined with non-anxiety symptoms like angry outbursts, self-destructive behavior, flashbacks, and nightmares, and they include physiological sensations like nausea or a sudden rapid heartbeat.
People who have C-PTSD experience the same symptoms of PTSD, but they also suffer from additional symptoms such as:
- feelings of shame or guilt
- feelings of responsibility for the abuse
- difficulty controlling emotions
- episodes of losing attention and focus (dissociation)
- physical symptoms like headaches, dizziness, chest pains, and stomach aches
- isolation from friends and family
- relationship difficulties
- destructive or risky behavior, such as alcohol or drug abuse
- suicidal thoughts
In addition to the C-PTSD symptoms above, there are some additional ones to be aware of:
- unnecessary worrying
- adrenal burnout
- chronic inflammatory disorders
- mental exhaustion
- various forms of anxiety
- depression/ or loss of pleasure
- black-and-white thinking
- digestive disturbances
- weight loss or weight gain
- self-gaslighting: a form of self-doubt that contributes to codependency. The consequence of living in a hostile environment and lacking adequate emotional support.
Traumatic experiences are not stored linearly as stories, but as fragments of sensory input: smells, sights, sounds, touches, tastes. These stored fragments can become the “triggers” that alert us to recurring danger or threats. Triggers are highly sensitive and reactive emotions that are activated by our environment or another person’s behavior or words. When we become triggered, we automatically react without any thought. There is often a sense of losing control of ourselves. When we become triggered because of C-PTSD, it becomes challenging to navigate our daily lives and relationships.
If we’re triggered, we may quietly emotionally withdraw, or we may react rather intensely and aggressively. Either way, it’s because we’re defending ourselves against a perceived threat, whether it’s a real threat or just feels like one.
Our emotional triggers are wounds that still need to heal. For example, a friend makes a casual remark, and for some reason, you suddenly and without warning, hear yourself snap back with a cutting and intentionally hurtful remark. You don’t know what came over you. You weren’t in a bad mood or feeling angry, but immediately as the comment was made, you instinctively reacted swiftly and defensively to shut them down and protect yourself. You intuitively understand that you wounded and confused your friend, but you don’t know why. Later, after you’ve taken the necessary time to reflect on and process what happened, you realize that at the moment you heard the comment, you instantly felt distraught, confused, and full of self-doubt. In effect, you felt instantly inferior. It was as if a “switch” had been flipped.
You also recognize that the remark was not said to intentionally hurt you, and yet you deliberately reacted viciously, with a desire to inflict pain. So you decide to apologize to your friend. You understood now that the remark activated one of your triggers, and your triggers are your responsibility.
Get to know your triggers. We can never know all of our triggers because we’re usually not aware of them until they happen. Triggers are created by consistency and repetition. We develop new ones throughout life because we’re continually partaking in new life experiences. Once you have an idea of what your triggers are, you can form appropriate responses to them and have them ready for the next time. You can also replace your triggers by questioning their validity. Whether it is or isn’t, get rid of unrealistic expectations and cut yourself some slack. You are not perfect. There is no such thing as perfection. You’re a human being who doesn’t know everything and never will, but you’re learning and growing every day. Is that not enough?
Survivors of complex trauma often have difficulty forming attachments to other people. An unfulfilled longing for connection can be a cause of deep-seated loneliness, which may further contribute to developing other symptoms. Depression and risky or self-destructive behaviors are often attributed to a lack of emotional connection. It makes sense that the treatment process for C-PTSD includes learning ways to strengthen the ability to feel attached to others while at the same time feeling safe, secure, and loved. It is “an extremely difficult process” but not impossible. (Franco, F. 2018).
Conscious awareness: Be aware and make conscious choices before acting. Self-awareness releases us from making impulsive and potentially damaging decisions. Learn about setting boundaries
Self-care: We can only choose to focus on and be responsible for ourselves, our own thoughts, actions, and behavior. The good news is that we can change ourselves with patience, persistence, and practice. We can take responsibility for getting our needs met, instead of waiting for someone to change or meet our needs for us. We are in control of ourselves and no one is responsible for us but us.
Learn about codependency and maladaptive coping skills
Take the Adverse Childhood Experiences quiz
Learn to recognize the Cycle of Abuse
About the author
Diane Metcalf earned her Bachelor of Arts degree in Psychology in 1982 and a Master of Science in Information Technology in 2013.
She has held Social Worker, Counselor and Managerial Positions in the fields of Domestic Violence and Abuse, Geriatric Healthcare, Developmental Disabilities, and Reproductive Health. She is an experienced Advocate and Speaker on the topics of Domestic Violence and Abuse and has been a guest on Lockport Community Television (LCTV), sharing her knowledge and experience regarding Domestic Abuse with the local community. In addition, she experienced Maternal Narcissistic Abuse and has been involved in other toxic relationships. She purposefully learned (and continues to learn) appropriate coping skills and strategies to live happily. She shares those insights here.
Her books and articles are the results of her education, knowledge, and personal insight regarding her own abusive experiences and subsequent recovery work. She is no longer a practicing Social Worker, Counselor, Program Manager or Advocate, nor is she or has she ever been a licensed psychologist.
Currently, Diane runs her own website design company, Image and Aspect, and writes articles and tutorials for Tips and Snips, her inspirational blog for creative people. She continues to learn and write about Emotional Healing.
This website is intended for informational purposes only and is not a substitute for professional therapy.