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Understanding Complex PTSD (CPTSD) and Its Causes

Let's dive into what Complex PTSD is and what typically leads to its development. First, it's important to note that Complex PTSD, or CPTSD, is not formally recognized in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). However, it is included in the World Health Organization's International Classification of Diseases (ICD-11) manual as of 2018, and many mental health professionals, including myself, consider it a legitimate condition.

While Post-Traumatic Stress Disorder (PTSD) primarily refers to the aftermath of surviving a traumatic event or multiple traumatic events, CPTSD is a term used to describe the unique effects of prolonged, repetitive, and often inescapable exposure to trauma. This type of trauma can be endured for months or even years, and it's the kind of experience that is challenging or impossible to escape from.

CPTSD can result from various circumstances, including living with an alcoholic parent, growing up in a dangerous neighborhood, enduring continuous microaggressions, or surviving human trafficking, among other scenarios. Notably, complex trauma tends to occur during childhood or adolescence, and individuals undergoing it may not immediately recognize it as trauma. This is partly because it is a constant and inescapable part of their lives or because the trauma doesn't stem from one distinct, obvious event. This is a significant difference between CPTSD and PTSD: PTSD is associated with trauma related to specific moments, like a severe car accident, a physical attack, or undergoing treatment for a life-threatening disease, whereas CPTSD arises from subtler, ongoing trauma.

To provide a visual analogy, think of trauma like a boulder and complex trauma like a pebble. A boulder is unmistakable; it's visible to anyone, and there's no doubt about its existence. Complex trauma, on the other hand, is akin to a pebble. It's there, but it might not be immediately obvious. However, if you had to walk on pebbles with every step you took, you'd begin to experience continuous pain that would shape the way you walk and live. Both CPTSD and PTSD can have a profound impact on individuals, but the way we perceive and address them differs significantly.

Understanding Complex PTSD Symptoms

Complex Post-Traumatic Stress Disorder (CPTSD) encompasses a distinctive set of symptoms that go beyond those associated with Post-Traumatic Stress Disorder (PTSD). While PTSD is characterized by re-experiencing trauma, avoidance, and a constant sense of threat, CPTSD introduces a broader array of challenges, including significant impacts on self-worth, relationships, and emotional regulation. Let's explore these symptoms in detail.

Symptoms Shared with PTSD:

In addition to the core symptoms of PTSD, which involve re-experiencing trauma through flashbacks, nightmares, or intrusive thoughts, actively avoiding thoughts and memories associated with the trauma, and a pervasive sense of lurking threat, CPTSD includes the following:

  1. Chronic Emotional Struggles: Individuals with CPTSD often grapple with persistent feelings of defeat, worthlessness, shame, guilt, or a sense of failure. These emotions can color various aspects of their lives for weeks at a time.

  2. Challenges in Multiple Life Areas: CPTSD symptoms can infiltrate nearly every facet of an individual's life. It can lead to difficulties in maintaining relationships, making meaningful connections, and managing emotional responses.

  3. Emphasis on a Shift in Personality: A noticeable shift in personality is a hallmark of CPTSD. This shift can manifest as trouble connecting with others, chronic aggression, frequent feelings of abandonment, anger, confusion, or hopelessness.

  4. Suicidal Thoughts: Persistent suicidal thoughts are a particularly distressing symptom associated with CPTSD. Individuals may find themselves grappling with these thoughts more frequently than in cases of traditional PTSD.

  5. Hypervigilance: Hypervigilance, involving the repeated checking of one's surroundings, is a common symptom of CPTSD.

  6. Memory Loss: Memory difficulties are also observed in CPTSD cases, contributing to the overall challenges in daily life.

  7. Nightmares: Nightmares, akin to those experienced in PTSD, may also be a recurring feature in CPTSD.

Key Distinctions:

There are key differences between CPTSD and other conditions, such as Borderline Personality Disorder, that may present similar symptoms. While these conditions share some features like hopelessness, low self-esteem, fear of abandonment, and difficulty managing emotions, there are notable distinctions:

  1. Trauma as a Common Denominator: Trauma is consistently present in cases of CPTSD, while it is not always the cause of Borderline Personality Disorder.

  2. Normalization of Intense Emotions: Those with CPTSD often normalize or hide their intense and difficult emotions, making it challenging to recognize their struggles. In contrast, individuals with Borderline Personality Disorder may become overwhelmed and seemingly controlled by their intense emotions.

Research into the mechanisms behind chronic trauma and CPTSD symptoms is ongoing. Some studies suggest a correlation between changes in specific brain regions related to memory and emotions and CPTSD. Additionally, genetics and an individual's social support system (or lack thereof) may play a role in the development of CPTSD. It's worth noting that CPTSD is a complex condition with various contributing factors, and our understanding of it continues to evolve with ongoing research.

Understanding Complex PTSD: Do I Have It?

If you're wondering whether you might have Complex Post-Traumatic Stress Disorder (CPTSD), it's essential to remember that a conclusive diagnosis should come from a qualified mental health professional. Since CPTSD is not officially included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), mental health experts often rely on the criteria outlined in the International Classification of Diseases (ICD-11) and various assessment tools to form their professional opinions. Here's how you can begin to explore the possibility of CPTSD:

  1. Consult a Professional: The first and most crucial step is to seek the guidance of a mental health professional. They can assess your condition based on their clinical experience, your responses to specific questions, and your overall well-being.

  2. Assessment Tools: To help in the diagnostic process, therapists may use assessment tools like the International Trauma Questionnaire. This questionnaire includes questions such as, "In the past month, have you felt jumpy or easily startled?" and "Recently, have you had upsetting dreams related to your trauma?" Your responses to these questions offer valuable insights into your emotional state and potential trauma-related symptoms.

  3. Adverse Childhood Experience (ACE) Questionnaire: Another useful resource is the Adverse Childhood Experience questionnaire. This questionnaire delves into your background and asks questions like, "Did a parent or adult in your home ever swear at you, insult you, or put you down?" and "Were your parents ever separated or divorced?" These inquiries aim to provide a comprehensive understanding of your childhood experiences and any potential traumas.

It's important to note that experiencing difficult times or having a challenging childhood doesn't automatically indicate CPTSD. As stated in the ICD-11, you must meet specific diagnostic criteria to receive a CPTSD diagnosis. These criteria typically involve a combination of symptoms related to emotional struggles, challenges in self-worth, and difficulties in various life areas.

When seeking professional help, it's crucial to share your experiences and symptoms openly. By combining your responses to assessment tools, your therapist's clinical expertise, and your personal history, a mental health expert can form a comprehensive understanding of your situation and how past experiences may be impacting your current well-being. Remember that seeking help is a proactive step towards better understanding and addressing your mental health concerns.

Treating Complex PTSD: A Personalized Journey to Healing

Healing from Complex Post-Traumatic Stress Disorder (CPTSD) is a deeply personal and often complex process. Each individual's treatment journey is unique, and it's essential to work with a trusted mental health professional who can create a tailored, long-term plan for recovery. Here's an overview of the diverse treatment options available for CPTSD:

  1. Talk Therapy: While the idea of having to relive every traumatic memory may be daunting, not all therapies require this. Effective talk therapies aim to provide a safe space for individuals to discuss their experiences, emotions, and challenges. The topics to explore will become clear as you and your therapist progress through the process, allowing you to address specific issues when you're ready.

  2. Trauma-Informed Talk Therapy: Trauma-informed talk therapy is a well-established approach for treating PTSD and shows promise for those with CPTSD. It involves discussing your experiences, emotions, and triggers in a supportive and empathetic therapeutic environment.

  3. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is another proven therapy for PTSD that involves specific eye movements. It can help individuals process distressing memories and reframe distorted beliefs about themselves.

  4. Somatic Therapies: Somatic or body-focused therapies help individuals identify and release physical tension linked to painful memories. These therapies explore the connection between the body and the mind in the healing process.

  5. Brainspotting: Brainspotting utilizes your visual field to tap into long-term memory, allowing you to access and work through unresolved trauma.

  6. Cognitive Processing Therapy: This therapy helps you question and change unhelpful beliefs related to your trauma. It provides techniques for challenging and reframing negative thought patterns.

  7. Neurofeedback: Neurofeedback involves measuring brain waves and teaching individuals to control their responses to triggers. It aims to enhance self-regulation and emotional stability.

  8. Psychodrama: Psychodrama encourages individuals to tap into their inner thespian and act out moments from their past. It offers a unique approach to revisiting and retelling the stories that have shaped their lives. This engaging exercise helps work through emotions, regain a sense of self, autonomy, and strength.

  9. Educational Resources: Complementing therapy, reading books on trauma can offer valuable insights and support in your healing journey. Some recommended resources include "Try Softer" and "Strong Like Water" by therapist Audi Kobler, LPC; "Why Am I Like This?" (author not specified); "Trauma & Addiction" by psychologist Tiyan Dayton, PhD; and "The Boy Who Was Raised As a Dog" by children's mental health researcher and clinician Bruce Perry, MD, PhD.

Complex PTSD gets its name for a reason, and attempting to heal it without professional assistance can be like trying to perform surgery on yourself—it may not work and could lead to unnecessary pain. The most valuable gift you can give yourself as someone dealing with CPTSD symptoms is to be honest about your story and let a qualified professional guide you through the healing journey. Remember, healing is possible, and you don't have to navigate it alone.


Need Help Developing A Plan For Self-Care

Do you want help developing a self-care plan that works for your busy schedule? Do you want accountability in implementing a self-care plan? If you or someone you love is struggling to maintain optimal mental and emotional health, consider reaching out to Spiced Life Conversation Art Wellness Studio and Botanica. We are a Metro Atlanta, Conyers Georgia area. We are a coaching and counseling practice with empathetic, skilled counselors and recovery coaches who can help you set goals, develop a self-care routine, and move forward to build a more fulfilling life. Our team would be happy to work with you either just for a couple of sessions to develop and implement a Self-care plan or longer term to work toward overall better mental health within our membership site or other programs.

Dr. Nikki LeToya White

About The Author:

Dr. Nikki LeToya White MSEd-TL, Ph.D. RHN is the founder, director, and full-time board-certified trauma-informed nutritionist, folk herbalist, and wellness consultant at Spiced Life Conversation Art Wellness Studio and Botanica. She created Spiced Life Conversation, LLC Art Wellness Studio and Botanica to provide the Metro Atlanta area with counseling and coaching services where clients are carefully matched with the right program for healing abandonment and childhood emotional neglect trauma that cause codependency, emotional eating, financial stress, and imposter syndrome as it relates to fear of success and being abandon. We help you begin your emotional healing journey with ease. Recently, we have expanded to include an online membership site so we now provide support to people living all over the world. All of our recovery coaches provide at least one evidence-based treatment to assist in your recovery. Dr. White is a big proponent of self-care and helping people live a fulfilling life! She has been in full remission with both codependency and emotional binge eating disorder since 2016. In living a life in recovery from sugar addiction. Loving her low-sugar balance lifestyle.

Warm Regards

Dr. Nikki LeToya White


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