Complex PTSD
Complex PTSD often occurs when a person has been exposed to chronic trauma (most commonly as a child but also can happen as an adult), in which they lacked power and were unable to escape.
Chronic trauma can include: Physical abuse, sexual abuse, emotional abuse and neglect, and having unstable parenting due to their mental health, drug or alcohol use.
Both PTSD and Complex PTSD share the same core clinical diagnostic criteria that includes:
Experiencing a Sense of Threat - Such as in relationships, trusting people, or in my case feeling trapped in a variety of situations and feeling anxiety.
Avoidance - Withdrawal, avoiding certain places, situations and people in case it triggers anxiety and flashbacks
Re-experiencing - Flashbacks can happen in the form of somatic (body) memories, or may be visual as if the event is being replayed. These can be triggered by noises, smells, sounds, environments, people etc..
They can happen in an instant and cause fight, flight or freeze responses.
CPTSD differs from PTSD as it includes the criteria of:
Interpersonal disturbances - Which means finding it difficult to form and maintain 'healthy' relationships. This could be because of finding it hard to trust others; avoiding the threat of being let down, rejected or even abused again. For me, in the past this has related to a fear of being 'found out' as being a 'bad' person and not allowing myself to get too close to anyone.
Negative Self Concept - Children who are neglected or abused can be brought up to feel blamed and shamed by parents who have not dealt with their own psychological baggage. Children are passed the intergenerational hot potato containing the issues that the family and individuals refuse to deal with or take responsibility for.
Children are especially prone to taking on the identity of being not good enough, 'bad'; the scapegoat or black sheep. They need to see their parents as being 'good' or 'right', as they are trapped with them, and will do anything to excuse their behaviour to keep the relationship. This can be as serious as blocking off memories of abuse, taking the blame for a parent's actions and assuming responsibility for the emotions and behaviours of mum and dad. Children become 'bad' so they can stay attached to their parents.
Affect (emotional) dysregulation - This means difficulties with managing or processing emotional responses in a healthy way. If you have grown up in an unsafe household your focus is on survival and getting through the day in whatever way you can. Because you have likely not been shown how to deal with emotions healthily by your parents or even being allowed to talk about them, you either find ways to suppress them or let them out in damaging ways. Stressed children who have undergone repeated traumas have to develop ways to cope with their overwhelm on their own, often without any support and whilst still living with and relying on the causes of their trauma to care for them. Signs of affect dysregulation include:
Difficulty calming down from anxiety/anger/stress
Being intensely triggered by people/situations that remind you of the past, and reacting out of proportion to the here and now.
Self-harming to relieve feelings (as a punishment or distraction)
Dissociating - zoning out, losing time
Risk taking/impulsive actions
Outbursts of anger or tearfulness
Running away/dissapearing
Using drink and drugs to manage and cope with emotions
If you resonate with this, there are many places you can get support for CPTSD. You don't need to do it on your own anymore.
If you are in crisis you can google your local crisis team for their details and if it is an emergency call 999 or go to A and E.
https://cptsdfoundation.org/ The CPTSD Foundation is a support website and a good source of information.
https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/
The NHS also has an information page on CPTSD.
ICD: 11 Diagnostic criteria for PTSD and CPTSD