Complex PTSD


What is Complex-PTSD
Symptoms & Characteristics

What is Complex-PTSD?

C-PTSD is a variation of Post Traumatic Stress Disorder that has recently gotten some attention from mental health clinicians and researchers . Although they share many symptoms, there are significant differences in how they affect individuals and fundamental differences on how either disorder is acquired. The differences between the two are different enough to peek the interested of mental health professionals but similar enough to cause a lot of controversy to whether to not C-PTSD should be defined on it’s own.

Generally speaking, when we think of someone who was diagnosed with PTSD we imagine of a single event that was traumatic enough to cause the classic “flashbacks” and associated fears that is associated to PTSD. However, Complex-PTSD isn’t the result of a single traumatizing event, but is rather from a chronic history of traumatic events that were inescapable. For example, a soldier returning from a gruesome battle may likely show signs of PTSD. But a prisoner of war (of some number of years) on the other hand is more likely to show signs of C-PTSD. Another example, someone witnessing a loved one’s death is likely to show symptoms of PTSD whereas a child (or even adult in some cases) would show signs of C-PTSD. The causes of C-PTSD generally come from repeated traumatic events that slowly eat away at the psyche. They change our fundamental ways of thinking often causing us to regress into a state that was created only to protect ourselves from whatever the trauma we experienced was. One example of this would be abuse, specifically sexual or emotional abuse, where while we are being assaulted, we are actively (but often not consciously) changing our behavior to defuse our assaulter.  These fundamental differences in origin are a key difference between PTSD and C-PTSD.


Symptoms and Characteristics

Complex PTSD is often considered one of the more difficult mental disorders to classify and diagnose. This is because C-PTSD often mimics other personality disorders. It’s been said that “PTSD is to psychiatry as syphilis was to medicine. At one time or another PTSD may appear to mimic every personality disorder” (Herman, 1992). This is largely because C-PTSD affects the mind in a fundamentally different way than normal PTSD does. While PTSD can often be grown out of, C-PTSD is often something that you carry with you for life because of the profound damage the psyche. That difference is also why C-PTSD can take on so many different symptoms. Some researchers will say that C-PTSD isn’t necessarily a personality disorder, but rather a severe personality disorganization. This is especially true for childhood trauma victims where the normal personality and behavior development process is drastically altered as a means of self-protection and self survival. It is in these cases where you’ll see a larger range of what we’ll call “odd” symptoms.

Considering the huge range of characteristics and symptoms of C-PTSD only the most prominent will be listed:

Avoidance Withdrawing from situations or relationships as a defensive tactic to reduce the risk of rejection, accountability, criticism, etc.
Catastrophizing Automatically assuming the worst case scenario or characterizing minor or moderate problems as catastrophes. Chronic Pessimism.
Dependency An inappropriate and chronic reliance on another individual for personal or emotional well-being.
Dependency, Control A tendency to foster relationships where an individual is controlling or narcissistic.
Disassociation “Escaping to fantasy,” “Extreme daydreaming,” A mild to severe detachment from the self and body.
Depression Overwhelming negative emotions such as sadness that come with out reason.
Fear of Abandonment An irrational fear that an individual is at risk of being abandoned by friends or loved ones. This can also cause the individual to react to minor situations where they “abandon,” most often a canceled plan or a having “no shows.”
General Identity disturbances A psychological term used to describe a distorted or inconsistent self-view.
Interpersonal Hypervigilance An unhealthy level of interested in others behaviors, comments, thoughts, and interests. Can be paired with Dependency and Low Self-Esteem.
Low Self-Esteem Negatively distorted self-view which may or may not be inconsistent with reality.
Panic Attacks Intense and sudden feelings of acute and disabling anxiety



C-PTSD flashbacks have always been very complicated, and often very silent. Unlike a traditional PTSD flashback which have a very visual as well as emotional component, C-PTSD flashbacks rarely have the emotional component. Even within the emotional component, C-PTSD flashbacks are much more subtle for the unknowing onlooker. The emotional flashbacks tend to be large, sudden, unexplainable floods of intense emotion. Generally emotions from a past part of life where you may have been in danger, abandon, or any other traumatic emotion. Often an individual will feel as if they have just been abandoned by someone loved or as if they have just been guilted by abuser. Thus, C-PTSD flashbacks can be more difficult to identify and deal with. It’s often hard to shrug off a feeling of guilt or abandon, or whatever is being felt. After time it becomes easier to recognize these flashbacks as flashbacks.

Actually coping in a flashback is much more difficult than identifying. It’s the sort of process that takes time and consistent practice, even if it doesn’t seem to be helping. It’s important to realize while you’re in a flashback that the emotions you are feeling are from a different time and place. And that it’s more than likely you aren’t in any danger. Whatever triggered the flashback merely brought up a memory which triggered these emotions to venture back into your life. Tools from CBT (Cognitive Behavioral Therapy) can be extremely powerful if practiced. Meditation such as Mindfulness can also be very effective. It’s vital to be able to ground yourself and remind yourself that these emotions don’t really have a place in your current situation.