Complex PTSD (C-PTSD) is a term first coined in 1999 by Judith Herman in her groundbreaking book Trauma and Recovery. It’s a designation that’s finally making its way into the mainstream of mental health. Though it is not considered an official diagnosis, there are groups trying to make that happen. It's a phrase I’m hearing more from clients these days than ever before, which just speaks to how many people can relate to the experience of complex trauma.

Post Traumatic Stress Disorder: The Basics

When thinking about complex PTSD it’s helpful to start with understanding PTSD (Post Traumatic Stress Disorder) in a more general way. People experiencing PTSD have survived or witnessed an event that posed a threat to their physical or psychological safety or that of a loved one. Sometimes the event could have been a one time experience like a random assault or a car accident. Sometimes it could have been a series of events like being in a war zone, experiencing domestic violence or systemic oppression. Some people will naturally recover from these experiences, but sometimes, through no fault of their own, these events can get locked in the mind, resulting in PTSD. People with a PTSD diagnosis likely experience some of the following:

• Intrusive memories of the event or events, flashbacks or nightmares

• Feeling physically or emotionally activated, similar to a panic attack when reminded of the event(s)

• Avoiding people, places, or situations that remind them of the event(s)

• Feeling cut-off or distant from other people

• Increased anger or irritability

• Feeling watchful or on-guard

• Easily startled

• Difficulty sleeping

• Believe that the world or others are unsafe

• Feeling responsible for the event(s)

• Feelings of worthlessness

For it to be considered PTSD it needs to have been more than three months after the event or events and the person still finds themselves struggling. It’s as though what we went through has become stuck in the brain. In spite of our best efforts to move on, its always there.

So What About Complex PTSD?

C-PTSD is just like it sounds: PTSD, but more, well, complicated. Complex PTSD can result when someone has experienced a series of events such as the war zone or domestic violence described above. It tends to surface after multiple traumas of an interpersonal nature, often at the hands of someone we trusted and cared for, someone who we believed cared for us. I most commonly see complex PTSD in my clients who are survivors of domestic violence or childhood abuse, neglect or maltreatment though it can happen with other pro-longed adversities as well.

The experiences of those with complex PTSD mirror those of PTSD but also can include:

• Difficulty with intense emotions

• Struggles with forming healthy relationships

• Feelings of guilt/shame related to the trauma

• Dissociation, or losing touch with the present moment

• Using impulsive, risky or unhealthy behaviors to cope

• Difficulty trusting one’s own judgement

If you think about people as social beings it’s easy to see how pro-longed, interpersonal trauma can result in these additional struggles. People need each other to help regulate emotions, give us feedback that helps us feel good about who we are, and create meaning in our lives. If we go without that those things for a long time while being hurt by someone we love, especially during those critical childhood years, everything feels more difficult.

But that doesn’t mean things have to stay this way forever. I’m inspired everyday by human’s incredible capacity for healing. There is hope, there is recovery, there is resiliency and you don’t have to do it alone.

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