Identifying and Understanding C-PTSD
When you hear the term “Post-Traumatic Stress Disorder,” you probably think of life’s biggest disasters. Explosions, hurricanes, school shootings, violent combat, sexual assault… Those are the kinds of things that give people PTSD, right? But back in 1988 Judith Herman, a Harvard Professor in clinical psychology, suggested that there be a new term for a subclass of PTSD called complex PTSD (or C-PTSD) to cover patients whose trauma happened over the course of several more frequent events over a longer period of time rather than the result of one or more major, isolated incidents. Since then, the term hasn’t gotten nearly as much attention in research and media as PTSD, but lately it’s gained a little visibility in conversations about trauma-informed counseling and emotional abuse. Society is now more open to discussing how traumatic experiences like systemic oppression, narcissistic parenting, emotionally abusive relationships, and bullying at school or in the workplace can leave lasting marks on a victim’s mental health. C-PTSD is one way that prolonged, often subtle trauma can manifest.
How is C-PTSD different from “regular” PTSD?
C-PTSD shares a lot of symptoms with PTSD. For instance, both can cause flashbacks, nightmares, insomnia, and hypervigilance, but C-PTSD brings a few other fun challenges into the mix. Because of the long term, frequent occurrences of trauma that can develop C-PTSD, a patient may often have an extremely negative worldview and self-view, struggle to engage in healthy relationships, engage in self-destructive behaviors, and experience derealization or depersonalization in order to detach from feeling or remembering the pain they’ve experienced. It’s important to note that these can also be symptoms of a number of other mental illnesses, such as Borderline Personality Disorder (BPD), so never self-diagnose! If you or someone you know is experiencing symptoms like these or having memories of unresolved trauma, the best thing to do is talk with a mental health professional who can help you figure out exactly what you’re dealing with.
A Day in the Life of Someone With C-PTSD
Popular media and TV shows like Grey’s Anatomy and Criminal Minds have made PTSD a familiar, household term. Though it’s important to do your own research and make sure you understand the context of the versions of PTSD you see in the media, it’s true that a lot of us are at least familiar with how the disease can manifest. But what does living with C-PTSD look like?
Imagine waking up in the morning, turning on the shower, sticking your hand into the stream of water to test the temperature, and being instantly thrown into a vivid memory of a time when you were humiliated in the school locker room, standing naked or half-dressed by the shower as a coach or classmate belittled you. The memory is so vivid that you actually relive it. A few seconds pass, maybe even a few minutes, before you jolt back into the present moment and realize you’re still standing there with your hand in the water. You shake your head, swallow the bile that’s gotten stuck in your throat, get in the shower and go about your day.
Next, you eat a bowl of cereal for breakfast. At first, your cereal is delicious, but in the next moment, it turns to sawdust in your mouth as the taste unexpectedly reminds you of the morning your mom found another failed quiz crumpled up in the bottom of your backpack. As you try to swallow, you forget where you are because you’re back in that kitchen, on that morning, hearing the yelling, seeing the paper being shoved and waved in your face, and feeling the shame all over again. You feel small. You snap yourself out of it, dump the rest of today’s cereal down the drain, and leave for work hungry.
When you arrive at work, you check your email as you normally would. Everything seems fine, and there’s a message from your boss. You click on it, and it says, “Swing by for a chat when you have a chance.” Short and sweet, right? Nothing to worry about. No problem. But instead of staying centered in the present and waiting until you have more information before you make assumptions about what your boss needs, you’re catapulted into the past again. It’s suddenly not a normal morning at work anymore—it’s 5 years ago, and you’re staring at your phone screen reading the text that came just before the breakup, the divorce, the arrest, the accident, the huge fight, etc. You try to get focused and take your best self into your boss’s office, but you can’t help feeling nervous, shaky, suspicious, and defensive as you knock on the door to have what could have been a casual, forgettable conversation with a coworker.
And that’s just the morning! This goes on all afternoon, all evening, sometimes in your dreams, and then continues the next day for those who struggle with C-PTSD. It’s no wonder that living with the constant burden of these destabilizing moments can manifest in the symptoms we talked about earlier and lead to depression, destructive behaviors, eating disorders, and even self-harm. While none of the intrusive memories above were the classic “explosive” moments of trauma that we normally associate with PTSD, for people who struggle with C-PTSD, these flashbacks are causing very similar chemical reactions in the brain, triggering a shift into survival mode multiple times a day. Over time, that kind of stress can become debilitating, no matter how “strong” or “resilient” you are.
Do You Have C-PTSD?
As stated above, never self-diagnose. Many mental health problems look alike on the surface, especially when it comes to symptoms like insomnia, anxiety, and destructive coping mechanisms. If you feel like the above description of C-PTSD sounds similar to your experience, the first thing to do is seek help. Though it may seem normal to you, you actually shouldn’t have to be pulling yourself out of multiple flashbacks or intrusive memories per day. If you’re stuck reliving the past over and over, it doesn’t have to be that way, and there is hope! Tell a professional about what you’re experiencing and ask whether C-PTSD or another diagnosis could shed more light on your day-to-day experience. If you have access to free counseling in your school or on your campus, that’s a great place to start. You can also reach out to TheHopeLine, where we can help connect you with great resources either online or in your area.
There are a number of ways to cope with the symptoms of C-PTSD as you work on your healing journey. While “try to live in the present” can be a really annoying and flat-out disrespectful platitude to offer someone with any form of PTSD, the intention behind it is valid. Your brain is often incapable of truly staying “in the moment,” but do some experimenting to see if you can find a few activities that help bring your mind back to the here and now. For some people, starting a small garden or doing some arts & crafts or another tactile activity can help them reconnect to where and when they are. Starting an exercise routine, practicing breathing and meditation, or calling a friend could work for you, as long as it helps, even a little bit and in a healthy way, to pull you out of your brief visit to the past and situate you in reality.
It can be hard to imagine living without the ever-present symptoms of a mental illness like C-PTSD, and while there may not be a real “cure,” healing is indeed possible. There is light at the end of this tunnel, and you can find a way to live joyfully and freely in the present, rather than in fear and confusion. Trust that a loving God actually wants that for you, and seek the counseling, therapy and healing you deserve. You are loved. You are not alone. You are worthy of abundant life.
Some relationships leave us with very deep scars from trauma. Click here for help and resources for PTSD from an abusive relationship.