Complex post-traumatic stress disorder, or CPTSD is not a formal mental health diagnosis, but this term describes a mental health condition related to the exposure of repeated and chronic traumatic experiences. “Complex PTSD comes in response to chronic traumatization over the course of months or, more often, years. This includes emotional, physical, and/or sexual abuses, domestic violence, living in a war zone, being held captive, human trafficking and other organized rings of abuse, and more. While there are exceptional circumstances where adults develop C-PTSD, it is most often seen in those whose trauma occurred in childhood.” Definition retrieved from https://www.beautyafterbruises.org/what-is-cptsd.
The difference between PTSD and CPTSD
When we think of trauma, we think of physical abuse, sexual abuse, witnessing death, experiencing a natural disaster, or being in a life-threatening situation. These are “big traumas”, or “big T’s”. Post-traumatic Stress Disorder, or PTSD is a formal diagnosis that describes the distressing symptoms and impacts of big T traumas. While more rare, a chronic or repeated exposure to big T traumas would fit the CPTSD criteria. These big T experiences of trauma are often recognizable as a root cause of distress, as opposed to emotional or psychological trauma. These types of trauma are “little traumas”, or “little t’s”. The main difference between PTSD and CPTSD is the recurring exposure to trauma for a long period of time that is associated with CPTSD.
Little traumas are distressing experiences that aren’t in the big T category, and can be more challenging to see. These include, but are not limited to: being insulted, invalidated, humiliated, shamed, made to feel unsafe, made to feel incapable, made to feel less than or unworthy, neglected, violated, etc… Often, CPTSD develops when children experience repeated and chronic little t’s by caregivers or other prominent individuals in their lives.
What this looks like in childhood
Here’s an example of complex trauma in childhood from little t’s: A 10-year-old boy works hard at school to get good grades because he was told for years by his parents that he won’t amount to anything unless he’s a straight-A student. He starts struggling with test anxiety, and even though he studies for hours every day, he gets B’s and C’s. When his grades come in, his parents often say things like: “This isn’t hard, why aren’t you getting this?” “You’re not trying hard enough.” “You’re lazy.” “You must be dumb if you can’t do any better.” Eventually, the boy stops trying to get good grades and starts spending his time doing other things besides his school work. He starts to believe that he won’t amount to anything and feel that life is pointless.
Children who experience repeated insults, shame, or humiliation, such as in the example above, start to believe what they are told about themselves. More so, the mind and body start to try and cope with the trauma by disconnecting from the experience and body, which can lead to chronic psychological, physiological, and emotional issues and difficulties. These difficulties can impair a person’s overall functioning in childhood and adulthood.
What this looks like in adulthood
If we continue with the example above, how this person functions as an adult could look like this: he’s now 25 and works part-time at a tech store and lives alone. He wants a long-term committed relationship, but has a dating pattern of frequent short-term relationships. His relationships often end with him screaming at his partner after he’s asked what he wants to do with his life, which triggers the trauma of his parents saying that he wouldn’t amount to anything. After his break-ups, he secludes himself in his bedroom for days, sometimes missing work because he can’t get out of bed. He struggles with depression, anxiety, low self-esteem, and emotional regulation issues.
Adults who experience CPTSD may not be aware they have experienced trauma. They may feel something is wrong or “off”, but not know what is making them feel that way. Even more so, the way they feel may be so long-standing, that it’s their “normal”, making it difficult to recognize and address.
Common signs of CPTSD:
- Difficulty managing anger
- Low self-esteem
- Suicidal ideation
- Feelings of hopelessness
- Impulse issues
- Quick mood changes
- Difficulty maintaining relationships
Recovering from CPTSD
While CPTSD can be difficult to uncover, there are ways to recover. Different types of therapies, such as EMDR, somatic experiencing, trauma-focused cognitive behavioral therapy (TF-CBT), trauma-focused emotion-focused therapy (TF-EFT), brainspotting, and others specifically address and help people work through their trauma. For more information on different types of trauma-focused therapies, visit the links in Resources below.
What if this is you?
If you’ve experienced the impacts of CPTSD, there is hope and help for recovery. The therapists at Fuller Life Family Therapy are qualified and trained to help you heal. To schedule an appointment, call (855) 245-5433 or email firstname.lastname@example.org.
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Contributed by Lindsay Perry, LPC Associate
Clinical supervision by Amy Fuller, PhD, LMFT-S, LPC-S