What Is Complex Post Traumatic Stress Disorder (C-PTSD)?

Unresolved trauma is one of the most common reasons people seek therapy, and the effects of childhood trauma can explain why you're struggling right now.

Childhood is a time when we need to experience a sense of security and being loved and wanted, and to know that our needs matter. But when childhood is complicated by abuse (physical abuse, sexual abuse, emotional abuse), neglect, and other types of traumas (large and small), the ability to trust and connect to others can be compromised. Life and relationships are approached as needing to be “survived”. Childhood trauma can result in feelings of shame, guilt, and low self-esteem, create feelings of disconnectedness and alienation, and increase your risk for anxiety, depression and of course, Complex Post Traumatic Stress Disorder (C-PTSD).

When children grow up with caregivers who they can't trust, this can naturally lead to relationship struggles in adulthood, including negative or distorted beliefs about oneself. Ruptures caused by complex trauma can lead to experiencing relationships as unsafe, chaotic and unpredictable. Relationships can be confusing and disorienting---even with your own children and people you love. And coping strategies (such as dissociation, guardedness or trying to dismiss or minimize needs) that were once adaptive and helped survive a traumatic childhood can cause a greater sense of disconnection.

Strong connections exist between childhood trauma and challenges in adulthood

Adults who find themselves once again dealing with the past often make comments like “I'm a grownup. This shouldn't still be bothering me”. However, study after study has shown that adverse events in our younger years can be linked to problems in adulthood. One longitudinal study found that women who experience adverse events during their formative years (abuse, neglect or family dysfunction) are more likely to experience depression during midlife when compared to women who did not experience these kinds of stressors. (Read the study here: https://www.eurekalert.org/pub_releases/2017-03/uops-tas032717.php). Another important longitudinal study, The Adverse Childhood Experiences Study (ACE Study) showed important connections between childhood abuse and neglect and a person's health and well-being later in life, including being at risk for C-PTSD.

Understanding C-PTSD

Complex Trauma is often referred to interchangeably as "attachment trauma", "childhood trauma", "developmental trauma" and "relational trauma". Complex Post Traumatic Stress Disorder(C-PTSD) results from "interpersonal traumas", traumas that occur within relationships---commonly in parent-child relationships. Because children are developmentally/physically vulnerable and completely dependent on parents/caregivers, these traumas create ruptures in the ability to form secure attachments to others.

Judith Herman, author of Trauma and Healing, was the first to distinguish Complex PTSD as a separate form of posttraumatic stress disorder (PTSD). In addition to symptoms of PTSD, Complex-PTSD includes:

• difficulty regulating emotions

• disturbances in relationships

• altered attention/conciousness (dissociation)

• adversely affected belief symptoms(about self and others)

• somatic(physical) distress/disorganization or somatization resulting in many doctor's visits

• efforts to cope that are self destructive

While complex traumas can occur within any relationship where the power differential prevents escape or makes managing boundaries or creating safety impossible,(for example domestic violence, intimate partner abuse, dependent adults and their caregivers), this type of trauma most often occurs between children and their adult caregivers.

“Childhood traumas can range from having faced extreme violence and neglect to having confronted feelings of not belonging, not being wanted, or being chronically misunderstood.”

~Arielle Schwartz

Arielle Schwartz outlines the kinds of experiences that can result in C-PTSD in her book The Complex PTSD Workbook (page 20):

• childhood relationships with caregivers who are frightening, unpredictable, overwhelming

• onging/repeated neglect and/or abuse (physical, sexual, emotional)

• being expose to domestic violence

• being raised by an addicted or mentally ill caregiver

• abuse that occurs at especially vulnerable times of development (early childhood or adolescence)

• facing severe social stress such as bullying, disability or exposure to traumatic events in the absence of a supportive/protective caregiver

Overcoming Childhood Trauma

While childhood trauma can make your life more challenging at times, it doesn't have to define you and how you live your life.

As painful as it is to live with C-PTSD and unresolved childhood trauma, the good news is that you can heal. If you're reading this, be comforted by the fact that learning about C-PTSD and how it's showing up in your life now—-understanding your symptoms and how you're reacting to your world--- is something you're doing to support your healing.

Therapy can help you establish a sense of safety and develop the tools and understanding of yourself you need in order to free yourself from the grip that trauma can have on you. So that you can enjoy your life and the people you care about. And if you're ready to take the step to find a therapist, here are a few helpful therapist directories:

EMDRIA.org

Postpartum Support International (for birthing people/parents)

Therapy Den

Sources:

Judith Herman, Trauma and Healing (1992)

Areille Schwartz, The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control & Becoming Whole (2016)