To briefly explain what it is, complex post-traumatic stress disorder cn develop because of trauma experienced as a child whether it is emotional, physical, spiritual or sexual abuse. It is ongoing trauma where you as a child believes that there is no way out for you. You then adopt behaviours, beliefs and values to help you to survive your difficulties.
These behaviours, beliefs and values helped you to survive as children but when you still have them as an adult, they can often cause problems for you.
The symptoms as the title suggests, is complex and varies quite widely between individuals. Also, some people have stronger symptoms than others.
Symptoms of Complex PTSD
Officially, the main symptoms of CPTSD could be Emotional Flashbacks, Toxic Shame, Social Anxiety, Inner Critic, Outer Critic or very low self esteem
In other words, you may find that you:
- might find it difficult managing your emotions. You could have a bad temper, or you are frightened of showing how you really feel, you suppress your emotions and seem emotion less or you find your emotions very overwhelming.
- are very critical of your self and / or other people
- often find that when you have emotional outbursts, they are not in keeping with the situation you are upset about. You may find that you tend to over or under react.
- may be fixed with one or two ways of dealing with stress, relationships. You may fight (aggressive, passive aggressive, controlling etc) Flight (perfectionist, worry a lot, workaholic) Freeze (disconnected, detached) Fawn (people pleaser, doormat)
- have Emotional issues which could also include low mood, panic attacks, feelings of anxiety, depression sometimes suicidal thoughts.
- Find it difficult to trust people, so you find it difficult forming deep and meaningful friendships and partnerships
- Constantly feel empty or hopeless sometimes even despair
- avoid friendships and relationships as you find them difficult
- have very little self-worth. No matter how successful you are, you feel that you just don’t measure up.
- feel totally inadequate
- use substances such as alcohol, food, drugs, work, sex etc to manage or avoid how you really feel.
- find that no matter how much support you have tried to manage your addictions, you often struggle to stay ‘clean’ or you often go from one addiction to another.
- feel different from other people, but you don’t know why
- may feel like nobody would understand what happened to you as a lot of the time emotional abuse is difficult to explain to others. Especially if to the outside world your family seems great
One other symptom of CPTSD is that you know that your childhood was not great, but you are not sure why it was so bad. You find it difficult to put your experiences into words
I will explain Emotional Flashbacks and Toxic Shame using the example of a guy called Patrick who experiences CPTSD, who I have totally made up as I don’t know anyone called Patrick.
With normal PTSD, the flashbacks affects your senses where you often see visually, hear, smell or even touch things that triggers you back to when you were traumatised.
They can be quite powerful and overwhelming where you can think that you are actually there in the situation. It can often seen like a movie playing in your head.
What happens with Emotional Flashbacks is, something in the present day triggers you back to something you experienced as a child. However, the flashbacks are emotional and it affects your feelings.
For example, Patrick got really angry at his drug worker because he did not get his methadone prescription on time. He started shouting and swearing at his drug worker on how incompetent she was etc. She started to cry.
The drug worker quite naturally couldn’t understand why he reacted so badly as it is something that could be sorted out easily. Shouting and swearing won’t speed things up.
However, Patrick experienced trauma where his parents were often verbally abusive. There was no love or kindness in his home. As a child he didn’t feel loved, so to cope with all of that he took all his anger and frustrations out on his siblings and school friends as that helped him to feel in control.
His parents were controlling and aggressive towards Patrick all his life. From when he was born, they would leave him crying for hours.
He emotionally flashed back to this time as he felt his drug worker was controlling what he needed, like his parents did. Like most people he could not remember when his parents left him to cry for hours not feeding or comforting. But emotionally those old woulds feeling of being forgotten and left alone was remembered when his drug worker did not help him as he needed.
Patrick clearly did not make the connection that those feelings of being out of control and helplessness with his drug worker was the same that he experienced as a child.
In other situations when Patrick feels powerless and out of control, he may react the same way. With emotional flashbacks, current situations often trigger and hurt old wounds. So not only he is upset about what is happening now, because his old wound has been hurt, without knowing, Patrick is upset about that as well as the situation with his drug worker which reminds him of his bad experiences.
A clear sign of someone having an emotional flashback is when the reaction to the current situation is over the top and is not in keeping with what has happened.
Toxic shame is a big topic in itself
If I could just describe it very briefly – Shame is a good thing to have. We all need to have shame as it can act as a moral compass in how we treat ourselves and other people. The problem with Toxic shame is that instead of saying sorry I’ve made a mistake, with Toxic shame, feeling ashamed constantly becomes part of who you are. You then feel that you are “shameful” and see yourself as a mistake or wrong.
With Patrick, underlying his anger with the worker is his own lack of self-worth and self-hatred. Even though he comes across as confident, underneath his swagger, he has self-loathing. He really hates himself and believes he is treated the way he is because he is not loveable. Because of his anger, it’s really hard to get to the fact that Patrick really is in a lot of emotional pain.
This feeling of toxic shame could also leave Patrick feeling helpless and hopeless – instead of asking for help he would be flashing back to his childhood when he was abandoned and would be feeling that way. As his parents left him and did not give him what he needed, he now feels that everyone would do the same.
The problem with clients like Patrick is that they generally tend to stay in services for a very long time. Unless his underlying trauma is dealt with, he would continue to find life difficult. That’s why when you treat someone with CPTSD just for some of the symptoms they present, it doesn’t work and you find that people keep one going back to different counsellors, therapists etc. but unless you get to the root of the trauma, it won’t work and it’s not sustainable.
Also, as you could imagine, some people who have CPTSD get misdiagnosed with other things which doesn’t help. CPTSD is a learned behaviour which can be unlearned over time. You are not crazy, Patrick isn’t crazy, he is just responding to behaviours that he learned in childhood that at the time he needed it to survive.
Those behaviours are not serving him at the moment as he is stuck but he can, with the right support and over a period of time, can be unstuck or at the very least things can improve for him a lot.
I am a Therapist based in Sutton Coldfield, UK also available online.
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