CPTSD or Complex Post-Traumatic Stress Disorder

There is no such thing as a straightforward trauma and this applies even more when regarding CPTSD. Each and every trauma has its own complexity. 

Being in a (car) accident may seem more straightforward in terms of trauma therapy, but the nervous system's responses are extremely complex and are very dependent on what you have gone through previously.  

You can go through a severe accident and rebound fairly well; or, you can you go through a traumatic event and be absolutely devastated afterward because of an already present history of childhood abuse or neglect.

Having a traumatic history will further impact you, and the traumatic event might be the last drop in the bucket that leads to CPTSD.

CPTSD and its Relationship to Childhood Trauma

Most complex post-traumatic stress disorder is caused by repeated exposure to traumatic events or episodes which often relate to childhood experiences. This kind of trauma might also referred to as developmental trauma disorder.

There is no such thing as a straightforward trauma and this applies even more when regarding Complex PTSD. Each and every trauma has its own complexity. 

Trauma has a certain set of defined reflexes in terms of the nervous system and psychological responses. There is a sense of helplessness and loss of control which is infused with a core emotion of anger, sadness or fear. From there, the surplus of unrestrained energy further dissociates into a coping emotion and coping mechanisms.

When we talk of multiple episodes and traumatic incidents, as in CPTSD, then you also get a variety of set survival reflexes imprinted onto your nervous system and psyche.

How It Can Go from Bad to Worse: CPTSD

Let me highlight this with an example:

Karuna is an unplanned, unwanted child by both parents. Her father is never there for her, and her mother is nagging and overbearing. Karuna has learned that it is best to passively hold still and keep quiet.

Her overwhelming core emotion is deep sadness at not being noticed, loved, nourished, or wanted. Her coping emotion is fear of openly speaking up and being openly vulnerable. With this pattern set in her psyche, she enters adolescence.

She gets into a situation where she is with a man, and although she doesn't consent to have sex with him emotionally, she is unable to speak out and stop him. The experience turns out to be very upsetting for her. Furthermore, this experience really topples her delicate emotional balance, and develops into full-blown CPTSD with severe symptoms of depression, dissociation, and hypervigilance.

CPTSD and The Complexity of Multiple Trauma

When working with CPTSD clients, you have to be aware that there are multiple traumatic incidents or episodes at play. As a therapist, you have to be able to differentiate between what connects with what as the different feelings, emotions, and time periods will often interconnect with one another, making treatment of Complex Trauma or CPTTSD all the more arduous.

You can certainly work through complex post-traumatic disorder and trauma. It is hard work, and it won't be easy, but the payoffs are more than worth.

Do you have CPTSD or complex post-traumatic stress disorder? Leave your comments below.

  • Barbara says:

    Thank you for such an informative post, as a child abuse victim, its always nice to understand the issues that can escalate from the abuse, huge hugs xx.

  • Laoch says:

    I could do with some support. I’ve think I’ve just sabotaged my support group. The story of my life running away, letting know-one close and then regretting it.

    • Roland says:

      Hello Laoch. This sounds familiar in the light of c-ptsd. What is it that sabotage is trying to protect? Is there the fear of being hurt again at some level? Can you learn from your sabotage rather then resist it further and feel/process the emotional layer that is just under it. Hope this helps, Roland

  • Rob says:

    Your posts are always insightful and helpful to me. I’m curious to know what your background is.

  • Pat says:

    I am 66. I have cut contact with both parents. I was adored by my dad as the only girl with 3 brothers. My mom was a conscientious mother but showed me no affection at all. Her constant verbal abuse, accompanied by harsh discipline, and real spitting spite coupled with never-ending favouritism shown to one brother and demands that I be available to serve her 100% of any time at home, tickling her hair for hours on end while she sobbed in bed, despite my dad being an exemplary husband, with years of her dissatisfaction with her life in general were just more than I could stand. I wet the bed until I married. Five years ago my parents instructed me that they expected me to move in to care for my mother when my dad died. It is never going to happen! I was told to stay where I am and continue with the “crap” I am doing. My mother has apparently influenced my eldest so she now refuses to speak to me. This is just awful!

    • janacoyote says:

      Pat, how are you? You & I have similarities. From this 71 y.o. woman in New England…still dealing…but it really is better. For me, I accepted, painfully, that my family didn’t care enough. It was hard. It was painful. It was worth it. I hope you’re well.

      • Pat says:

        Hi Jana. My comment was posted 4 years ago. I am 70 now, so we are about the same age. I am sad to read that you have similar issues in your life. It is tragic and extremely painful.
        But I am doing well thanks. It has been a very difficult time in many ways, but I have no regrets or intentions of going back. I had to do it. I could not bear to continue as it was. Additional issues, such as them in their 90’s; a sibling who managed to get himself into very serious trouble and children who have lashed out, are all heartbreaking, so it has been a case of just trying to live my life quietly. To this day I have never missed my mother, or the extended family, not for one moment, nor do I respect my dad’s decision to remain totally under her control, but that is his choice, nor will I be bullied by my children or held hostage for choices I made 50 years ago. I agree. My family never cared. I was just expected to take over from my dad, should the need arise. Basically as the only daughter, they saw this as my responsibility. It is a huge relief to have shrugged that burden from my shoulders. I would love to chat more to you.

  • Paulette says:

    I am 56 years old and have struggled all my life with what I now know is cptsd. I endured so much violence as a child by being physical abused by my mom and witnessing constant regular violence and abuse because of alcohol. I’ve seen several councilors through the years and I still struggle with severe anxiety that I can’t seem to get rid of. Maybe it’s not anxiety. I’m not sure. I don’t know which book to request first. I’m looking forward to someone really understanding what I’m dealing with and hoping the books help.

    • Roland says:

      Hi Paulette. Anxiety is often a front and is directly related to suppressed anger. When anger is owned anxiety often reduces dramatically. As to the ebooks, you might want to consider buying all 4 as a package. Regards

    • Pete says:

      Exactly the same life I had. im 49 and only just been told i have cptsd. ‘after demanding answers for the last 30 years’

  • Sue says:

    I completely identify with the young girl in your example & instead of feeling the anxiety,shame & guilt,catapulting me back to my childhood & the trauma, your posts have enabled me to recognize it & stop!
    I have been able to face the fear & I am, going through it, even paying to get a diagnosis of dissociative identify disorder & CPTSD. Just knowing why & what is wrong with me,has completely altered my perception & I am able to see a way forward. I have general anxiety disorder, social anxiety, panic attacks, etc, but just knowing that, that, is what it is, is beyond a relief. No-one in my family or extended family really cares to understand & most of my friends have disappeared, I don’t want them back & the very fact that my family don’t care, is why, I ended up with this,in the first place.
    But the one thing I have, that I never knew before, is Me + all the others, too. Together, we are each others’ friends.
    Your posts have changed my life, Thank you,Roland.

  • Leah says:

    Can C-PTSD be imprinted on an infant birthed to an individual with C-PTSD like traumas of the Holocaust survivors reportedly have. I have C-PTSD, had a difficult traumatic time during my pregnancy so my child may have suffered intrauterine trauma, and a very difficult birth on top of it so she may even have suffered birth trauma. How damaged might she be?

    • Pat says:

      I would understand that as a spirit of fear, rejection, hate for your abuser (instead of what your abuser did), to name just a few possibilities, which are transferred down the bloodline. As a Christian, I would ask Jesus to protect your child, and you.

  • Claire says:

    Hi Roland,
    Thank you for this article, it helps me to understand how precious traumas Impact my thought process and why I make the decisions I do. Thankfully, I know I’m not strong enough to drink alcohol at the moment (never had a problem, but know I could easily slip into one as an escape method), but as I work in a pub, it’s tempting. 15 months without any alcohol isn’t bad I reckon (loads of chocolate and sweets instead though – i guess this is my addiction now)

  • Sue says:

    I have complex PTSD, currently working with a therapist. I have trauma from childhood neglect and witnessing the emotional abuse of my brother by my father. A serious car accident (nearly 20 years ago) and trauma from the loss of my daughter to suicide 9 years ago. So much to work through! I’m very interested in your books.

  • Vikki says:

    Yes , yes and yes I believe I have both . Huge trigger / flashbacks last week , neighbor came screaming for help after partner assaulted and threatened to kill her . We were out on the road . I was terrified ( maybe sane response , not sure ) but my response to her was not what I would have expected from myself . I’m feeling guilty because I got cross with her and had zilch empathy . She told me they’d been drinking and taking drugs, that they both had psych issues & jail time etc . He’d thrown her at a wall and tried to run over her with lawnmower . There is also a teenager in the house . I just wanted her to get away from me , my stranger danger alert told me I was in a very dangerous situation. He came out of the house and I went to that “ fawn & please “ response again , I managed that situation like I use to manage my own . That constant anticipating and assessing of the situation , moderating responses , non threatening behaviour, and basically talking shit omg it was horrible . Anyway , I’m physically ok but have been left with a horrid feeling of uneasiness that revs up to terror in the evenings when I’m alone
    Thanks for reading , I obviously needed to get that out Cheers

  • Kristin says:

    What is your opinion on therapeutic usage of MDMA for CPTSD?

  • CT says:

    What is your perspective of EMDR, somatic experiencing and prolonged exposure therapy? I feel like talk therapy is just not working for me.

  • Leah says:

    My scientifically based question was not answered adequately. I asked about inherited trauma. I was given a religious answer of no use to me.

    Yes, a mother’s trauma, and even a grandmother’s trauma (and so on but less and less), since a woman is born with as many eggs as she’ll ever have, meaning your mother’s egg experienced the trauma that her grandmother experienced, and so a child can be born with much a mother experienced.

    To say “As a Christian, I would ask Jesus to protect you and your child.” is absolutely no solution and simply wrong as there are many faiths other than Christianity and none even are scientifically based to provide a traumatized individual with trauma experienced.

    It takes a trained medical, psychological, physical and emotional approach to address that which has affected an individual’s issues attained through the early developmental phases of life.

  • KKT says:

    Thank you Roland for your work and your devotion.
    Is self-harm/cutting common to C-PTSD? What unmet need(s) in particular be demonstrated by self-harm/cutting? How does one be of functional help to a relative who self-harms/cuts? Any additional educational insight/commentary you could provide is well appreciated. Thank you.

    • Roland says:

      Self-harm is or becomes a form of addiction where you are releasing (emotional) pressure. Addiction, in relation to CPTSD/CPTSD, is a form of dissociation to try to manage feeling emotionally overwhelmed. For some that addiction is drugs, drink, meds, social media, mobile phone, sex, obsessive behavior and so forth and so on. Whatever the addiction, the purpose is the same.

  • Pat says:

    I have hadmore than one client who was a cutter. One in particular was appalling. I was shocked to see the multitude of scars on her body. There was barely a centimeter of her skin that was not scarred.
    A huge diagonal cut across each thigh was stomach-turning. It was bone deep.
    I asked when it started. She said her parents had divorced. A deaf teenager who lived next door had begun raping her when she was 14. Her mother had had to go to work.
    She was afraid of him and who he would tell.
    Some cuts were life threatening, yet her mother only found out years later.

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