What Is Complex Trauma Or Cptsd
Complex PTSD or complex trauma is trauma that starts or happens in childhood. Its relational and developmental .
Complex trauma is usually recurring and is inflicted by a caregiver, parent, guardian, or person who has close, repeated contact like a clergy person, neighbor, or family member. Complex trauma can consist of emotional, physical and/or sexual violence.
Every time I use the term trauma survivor, I use it to encompass all types of trauma: complex trauma, single-incident trauma, the list goes on. But in reality, most of my clients are complex trauma survivors those with CPTSD and are the people Im most often talking to and about.
Its so important to take the mystery out of this disorder and make it concrete by talking more openly about CPTSD. Well look at what CPTSD is, what causes it, what it looks like in adulthood, and how we can understand it better and talk about it.
Listening And Good Reactions
One of the best ways to support someone with PTSD is by being a good listener. This is vital for social support, and active listening can be very helpful.
While it may be difficult, it is best not to judge and push a person into talking. It may be hard to understand why a family member or friend can not move on from an event, and it is natural to wish that things can return to normal. But applying pressure or blame, or comparing your feelings or experiences, is not helpful.
When they are ready to talk, it is important to let them know that you are engaged, there to listen, and to acknowledge their spoken feelings. Allowing a person with PTSD to talk at their own pace, and not dismissing or assuming how they felt or are presently feeling is helpful.
Someone living with PTSD may experience triggers of their past trauma even if there is no external danger or threat. They can feel unsafe and like they have lost control, and any statements that may create unfair comparisons, cause them to feel shame, or minimize their feelings are most likely to increase their PTSD symptoms. It is best to avoid statements about overreaction when they are experiencing flashbacks, for example, or telling them that others have it worse when they cry a lot.
Tip : Support Treatment
Despite the importance of your love and support, it isnt always enough. Many people who have been traumatized need professional PTSD therapy. But bringing it up can be touchy. Think about how youd feel if someone suggested that you needed therapy.
Wait for the right time to raise your concerns. Dont bring it up when youre arguing or in the middle of a crisis. Also, be careful with your language. Avoid anything that implies that your loved one is crazy. Frame it in a positive, practical light: treatment is a way to learn new skills that can be used to handle a wide variety of PTSD-related challenges.
Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.
Focus on specific problems. If your loved one shuts down when you talk about PTSD or counseling, focus instead on how treatment can help with specific issues like anger management, anxiety, or concentration and memory problems.
Acknowledge the hassles and limitations of therapy. For example, you could say, I know that therapy isnt a quick or magical cure, and it may take a while to find the right therapist. But even if it helps a little, it will be worth it.
Encourage your loved one to join a support group. Getting involved with others who have gone through similar traumatic experiences can help some people with PTSD feel less damaged and alone.
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Behavior Associated With C
- Substance abuse:Research suggests a strong correlation between substance use disorder and trauma. One of the most common theories is that drugs and alcohol are used to manage numb emotional pain.
- Self-harm: Self-harm may also be called self-injury or self-mutilation and means hurting yourself on purpose due to emotional distress.
- Avoidance:Emotional avoidance means creating distance with unpleasant emotions. Behavioral avoidance is staying away from people, situations, and senses that are reminders of the traumatic event. While this is natural in the short term, extreme avoidance can make it difficult to cope with other areas of life.
- Inability to accept criticism:For those with C-PTSD, criticism can cause severe stress because they are already self-critical or feel shame. They may have also had an abuser who manipulated them with criticism to get an emotional reaction.
What You Need To Know About Complex Ptsd
PTSD and complex PTSD are both anxiety disorders that result from experiences of earlier trauma. C-PTSD typically follows a history of trauma more persistent than that which results in PTSD. Both disorders are extremely distressing, but C-PTSD is characterized by more intense symptoms that intrude on everyday life, including extreme and frequent flashbacks to the source of trauma, unpredictable and upsetting emotions, panic and anxiousness about things that might trigger the stored trauma and pain, nightmares and difficulty sleeping, hypervigilance, and dissociation.
Its important to know that every case of C-PTSD is different and that making assumptions about what your child is going through may lead to more distance and unhelpful gestures, even when your intentions are entirely compassionate. Keep in mind that complex PTSD is a very real and overwhelming disorder, and its not something an individual can just think or reason or relax away. They need your patience. And its possible that when you are patient and willing to listen and support them compassionately, they will be able to develop more patience for themselves and what they are going through.
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How Is Complex Ptsd Treated
Treatment of complex PTSD can include many of the same strategies that are used for treating PTSD. A doctor may prescribe antidepressants to reduce symptoms of complex PTSD, such as anxiety or depression. But medications tend to work best when combined with trauma-focused psychological treatments.
Psychotherapy is critical for processing the past trauma and learning to cope more adaptively. Therapies that look more promising for treating the symptoms of c-PTSD include:
- Cognitive behavioral therapy focuses on identifying traumatic memories and negative thought patterns and replacing them with more positive ones
- Dialectical behavior therapy helps people better respond to stress and deal with self-harm urges and suicidal thoughts and behaviors
- Eye movement desensitization and reprocessing helps reduce the negative feelings associated with the traumatic memory
Tip : Take Care Of Yourself
Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout and may even lead to secondary traumatization. You can develop your own trauma symptoms from listening to trauma stories or being exposed to disturbing symptoms like flashbacks. The more depleted and overwhelmed you feel, the greater the risk is that you’ll become traumatized.
In order to have the strength to be there for your loved one over the long haul and lower your risk for secondary traumatization, you have to nurture and care for yourself.
Take care of your physical needs: get enough sleep, exercise regularly, eat properly, and look after any medical issues.
Cultivate your own support system. Lean on other family members, trusted friends, your own therapist or support group, or your faith community. Talking about your feelings and what you’re going through can be very cathartic.
Make time for your own life. Don’t give up friends, hobbies, or activities that make you happy. It’s important to have things in your life that you look forward to.
Spread the responsibility. Ask other family members and friends for assistance so you can take a break. You may also want to seek out respite services in your community.
Set boundaries. Be realistic about what you’re capable of giving. Know your limits, communicate them to your family member and others involved, and stick to them.
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The Many Names Of Ptsd
Over the years, PTSD has gained recognition due to its effect on war veterans. It was also called shell shock or combat fatigue.
Complex PTSD is a response to a long-lasting, repeated trauma that lasts for months or years. C-PTSD is most often seen in those who experienced trauma earlier in life and is especially complex when someone was hurt by a caregiver or is still in contact with the abuser.
Ptsd Alive In The Body For Years After Traumatic Events
Our danger detection system, which is also called our autonomic nervous system is the reason why someone with PTSD can get triggered months or years later. Your autonomic nervous system can pick up on perceived threats and gives your body cues that something dangerous is about to happen. This way your body is more prepared to react. Whether that reaction is to fight, run, or freeze in an attempt to survive. With some people, the autonomic system can get stuck into the fight/run/freeze mode in an attempt to survive. The frozen mode is considered immobilization which is a dorsal vagal response within the parasympathetic nervous system.
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What Causes Complex Ptsd
Complex PTSD is caused by a persistent, elevated stress experience. Long-term traumatic events that lead to complex PTSD include:
- Childhood abuse, abandonment, or neglect
- Ongoing domestic violence or abuse
- Repeatedly witnessing violence or abuse
- Being a prisoner of war
- Living in an area of war for long periods of time
- Torture, kidnapping, or slavery
- Being forced or manipulated into prostitution
Such frightening and distressing events in which the perpetrator of the abuse controls the victim lead to traumatic stress that can have a number of effects on the brain. Research showed that trauma is associated with lasting changes in key areas of the brain, including the hippocampus, amygdala, and prefrontal cortex. These areas are responsible for memory and emotions and play an important role in how we respond to stressful situations.
Encourage Us To Express Our Grief And Anger
A lot of trauma-informed therapists will say that survivors have a difficult time grieving the trauma they endured, and sometimes have difficulty expressing anger.
One of the best things a loved one can do is hold the space, then, for survivors to experience these emotions and express them in healthy ways.
Not sure how to do it? Here are some suggestions:
- I noticed that this conversation is bringing up a lot of anger for you. Do you want to share why?
- What happened to you is absolutely unfair and unjust, and Im open to hearing more if you want to talk about it.
- If you need to cry, thats okay. I can stay with you or I can leave if you need privacy. Just let me know.
- Your feelings about this are absolutely valid. I hope you know that youre safe now, and youre allowed to feel those feelings.
The key here is to validate those emotions as real and understandable, and open up a space in which those emotions can be felt and expressed more deeply.
Sometimes these conversations will happen when the trauma is referenced directly. Other times, a seemingly unrelated event can trigger a flashback. In both cases, its important to give survivors the space to navigate their feelings without judgment.
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A More Complex Look At Complex Ptsd
The traumatic stress field has adopted the term Complex Trauma to describe the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature and early-life onset. These exposures often occur within the childs caregiving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood.
Dont Practice Toxic Positivity
While people being overly positive have good intentions, toxic positivity invalidates peoples experience and communicates to the person with PTSD that their trauma is not bad enough, or that their symptoms are irrational now that they are out of immediate danger. Any comment that engages in suffering olympics and compares one persons trauma to the suffering of another is not helpful. Instead, acknowledge their perspective, suffering, and hurt, and thank them for trusting you to hold something so heavy and personal.
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Give Us Permission To Be Imperfect
For a lot of us with complex trauma, we struggle with perfectionism. Pete Walker calls this the inner critic, which so many survivors grapple with in recovery.
For some of us, perfectionism was a coping mechanism run amok, in which we desperately tried to better ourselves to earn the love or attachment that we lacked by correcting our supposed shortcomings .
This inner critic can also be the voice we internalized, like when youre a bad child suddenly becomes Im a bad child. The external criticisms or neglect we endured suddenly became the mantras we took on as we were further and further traumatized.
Which is to say, a lot of survivors who are dealing with complex trauma really struggle with being imperfect.
For me personally, I believed for a long time that if people truly got to know me, they wouldnt be able to love me. So I spent a good amount of time trying to make myself better, with the hopes that I would someday be good enough for the people in my life.
I think this is why its powerful when our loved ones give us permission to be imperfect. Some examples:
- You dont have to be perfect for me or for anyone else. Im going to be in your corner no matter what.
- Its true that you make mistakes. But you always work hard to make things right, and thats what matters.
- In my eyes, youre already lovable and youre already worthy.
- Trust me. If somethings wrong, Im going to tell you, and I promise well work through it.
Eye Movement Desensitization And Reprocessing
Eye movement desensitization and reprocessing is a technique that may help people with PTSD or complex PTSD.
After preparation and practice, the therapist will ask the person to recall the traumatic memory. The therapist will move a finger from side to side, and the person will follow the movement with their eyes.
When effective, this process helps to desensitize the person to the trauma so that they can eventually recall the memory without having a strong adverse reaction to it.
EMDR is controversial because the exact mechanism by which it works is unclear.
However, several guidelines, including those of the American Psychological Association, recommend EMDR as a treatment for PTSD under certain conditions.
They caution that confirming the effectiveness of EMDR for trauma will require more research.
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Recognize That We Dont Always Know Our Triggers Either
Whenever I disclose to someone that I have C-PTSD, they often try to support me by asking, What are the triggers I should know about? I think this is a great question to ask if a survivor is aware of what can cause a flashback, but the reality is that many of us can be triggered on a level we arent even aware of.
Thats why its good to not only ask what triggers us but to ask what you can do if we find ourselves triggered.
What does your loved one find helpful? Is there something you can say, a kind of safe touch they want from you, or something else thats comforting?
I use this guide to manage my flashbacks, and I think its a good point of reference for anyone who wants to help someone work through a particular episode. Give it a read, and invite your loved one to share whats useful to them and what isnt assuming that this person is ready and able to have the conversation with you.
What Are The Symptoms Of Complex Ptsd/complex Trauma
Complex trauma is a condition that develops due to experiencing multiple and repeated traumas when you were young. The effect of this continued exposure to trauma as a child can have significant ramifications- even into adulthood.
Being exposed to complex trauma causes changes in brain development. There are learned experiences that influence how you perceive and interact with the world as an adult.
Thus, complex trauma often leads to complex PTSD and its far-reaching symptoms.
Unlike someone who has experienced a traumatic event in adulthood and developed symptoms of PTSD, complex trauma stemming from childhood has taken years or even decades to take root. And that is what makes it and its symptoms so hard to deal with.
So, what are some of the symptoms of complex PTSD and complex trauma?
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Tip : Be A Good Listener
While you shouldn’t push a person with PTSD to talk, if they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. It’s the act of listening attentively that is helpful to your loved one, not what you say.
A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as they need.
Some of the things your loved one tells you might be very hard to listen to. Its okay to dislike what you hear, but its important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.