Complex Post Traumatic Stress Disorder (C-PTSD)
By Dana Morningstar
C-PTSD is similar to PTSD in that the person experiences much of the same symptoms but for different reasons. PTSD tends to happen after a specific event or situation like war or a car accident, whereas C-PTSD is more “complex” because it’s often the result of ongoing traumatic events, many of which can be difficult to pinpoint. This is especially the case if a person grew up in a den of dysfunction, and the traumatizing behavior was considered normal.
Some degree of C-PTSD symptoms is common after an abusive or neglectful relationship of any kind, whether in childhood or as an adult (or both). C-PTSD is currently not in the DSM-V (Diagnostic and Statistical Manual of Mental Health, Fifth Edition), which is why so many mental health clinicians are not familiar with the term. They may diagnose a person with PTSD, or they might not diagnose what a person went through at all as any form of PTSD, as emotional and verbal abuse tends to fly under the radar of what is worthy of being a traumatic issue—especially by those who haven’t been on the receiving end of it.
The term C-PTSD is much more commonly used among those who specialize in emotional trauma. Having a PTSD (or C-PTSD) type response is a normal reaction to an abnormal situation and is part of the healing process, as the brain attempts to piece together everything that happened into a cohesive narrative. If your symptoms are negatively impacting your life, and especially if they go on for longer than a year, it might be worth a trip to a mental health provider, ideally one who specializes in abuse, trauma, and ideally EMDR or EFT treatment.
The four main types of C-PTSD symptoms:
1. Reliving or re-experiencing the event.
Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:
- You may have nightmares.
- You may feel like you are going through the event again. This is called an emotional flashback.
- You may see, hear, or smell something that causes you to relive the event. This is called a trigger, and triggers “trigger” an emotional flashback. For example, if a person has been in battle, hearing news reports, seeing an accident, hearing fireworks go off, being startled, or hearing a car backfire are common triggers for PTSD. Triggers for C-PTSD might include feeling flashes of intense emotion (fear, rage, anxiety, crying/depression) that are disproportionate to what is going on—but you may or may not be able to connect a trigger to your intense feelings.
An example of a more direct connection would be if a person had an abusive ex who drove a red Mustang, and every time they see a red Mustang (even if it doesn’t belong to their ex), they feel intense anxiety, rage, or sadness, which might put them in a bad mood lasting hours, days, or weeks.
An example of a less direct connection would be if a person finds themselves feeling angry, defensive, and tense whenever they walk into their weekly therapy appointment, but they don’t know why. They may later come to realize that they are feeling this way because as a child, their parents emotionally neglected and abused them, and they reached out to a school counselor who not only didn’t believe them, but who told their parents everything that was said which ended up making the abuse at home much worse.
2. Avoiding situations that remind you of the event.
- You may find yourself avoiding talking or thinking about the event, or avoiding situations or people who trigger memories or painful feelings. For example:
- You may avoid meeting new people (or even spending time with friends and family), because you are fearful of being hurt again.
- You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
- You may find yourself with changes in eating or sleeping patterns (which can be ways of numbing out and avoiding).
- You may find yourself really upset by certain music, certain restaurants, or by people who have certain features of the abusive person.
3. Negative changes in beliefs and feelings.
- You may find that the way you think about yourself and others changes because of the trauma.
- You may not have positive or loving feelings toward other people and may stay away from relationships or find yourself wanting to isolate and stay away from people in general.
- You may forget about parts of the traumatic event or not be able to talk about them.
- You may think the world is completely dangerous, and that no one can be trusted.
4. Feeling anxious or on “high alert” (also called hyper-arousal or hyper-vigilance).
- You may be jittery or always alert and on the lookout for danger. You might suddenly become angry or irritable. For example:
- You may have a hard time sleeping, and find yourself having really vivid nightmares.
- You may have trouble concentrating.
- You may be startled by loud noises or sudden movements.
- You might have a hard time trusting others—even people you previously trusted that have done you no wrong.
C-PTSD (or PTSD) can make a person feel like they are losing their mind, because they are acting in ways that seem out of character for them, and they don’t know how to go back to the way they were. Please know that if you are experiencing this, you are not alone; these symptoms do tend to lessen in time, and joining a support group for narcissistic abuse can really help to better understand what you are going through.
Dana Morningstar is a former psychiatric nurse turned domestic violence educator who specializes in abuse awareness and prevention. Her passion is working with survivors of abuse to reclaim and rebuild their self-esteem, boundaries, confidence, and identity. She is an author of multiple books on the subject, and also has a blog, podcast, and YouTube channel, as well as several online support groups, all of which you can find under the name “Thrive After Abuse.”