My Mental Health: Complex Post Traumatic Stress Disorder

Hello, Readers! Welcome to my blog series, The My Mental Health Series. My hope with the series is to educate, advocate, and to let people know that they are not alone. For 38 years, I did not know or understand myself because I didn't have the knowledge that I needed. I decided that I wanted to share what I've learned in the hopes that maybe I can help someone else recognize themselves in my words. Today, I will focus on Post-Traumatic Stress Disorder.

Be sure to check out the last installment, My Mental Health: Obsessive Compulsive Disorder and stay tuned every Tuesday for a new installment. Also, you can reference My Mental Health: A Glossary and the My Mental Health: Busting ADHD Myths for more information. Thanks for stopping by!

Before receiving a long list of diagnoses last year, my therapist had said something that puzzled me on several occasions. After telling her about a specific behavior or quirk or line of thought that I seem to struggle with, she would say, “Oh, that’s the PTSD.” I would always just shake my head in agreement (ever the agreeable…also a C-PTSD trait), though I never quite understood why she was chalking so much up to PTSD. Though I have lived through more than my share of trauma, I had never had PTSD-level trauma. Right? I didn’t have flashbacks and I’ve never been to war or been the victim of a violent attack.

It wasn’t long before I was researching to figure out just what are PTSD and C-PTSD? What I found was surprising and undeniable. I have C-PTSD and I have had it since childhood. Much like my other disorders, I only understood a surface-level view of PTSD; what the media and pop culture portray. What I learned is that PTSD is complicated and much more than what we can observe from the outside. The symptoms of PTSD can be scary, distressing, and widely varied in what they entail.

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder is a mental health condition that is triggered by a terrifying or severely traumatic event, either experiencing it or witnessing it, and can cause significant impairment. It is estimated that 1 in 11 people will be diagnosed with a form of PTSD in their lifetimes. Some events that cause PTSD can include witnessing or being a part of war, assault, or disaster. For example, a natural disaster, a serious accident, a terrorist attack, living through a war, and rape could all trigger PTSD.

Symptoms of Post Traumatic Stress Disorder are generally grouped into 4 types:

1. Intrusive memories
   • recurrent, unwanted, distressing memories of the event
   • flashbacks (reliving the event as though it were happening again
   • dreams or nightmares about the traumatic event
   • having certain triggers that remind of the event
2. Avoidance
   • trying to avoid thinking or talking about the traumatic event
   • avoiding triggering people, places, or activities surrounding the event
3. Negative thought pattern and mood changes
   • having negative thoughts about yourself, others, or the world
   • hopelessness
   • memory issues
   • difficulty maintaining relationships
   • feeling detached from the people closest to you
   • lack of interest in the things you used to love
   • difficulty experiencing positive emotion
   • feeling emotionally numb
4. Changes to your physical and emotional reactions
   • easily startled or scared
   • cringes away from confrontation
   • people-pleasing
   • always on guard
   • self-destructive behaviors
   • sleep issues
   • concentration issues
   • angry or aggressive behavior
   • overwhelming guilt or shame

The symptoms of PTSD can vary in intensity over time; sometimes things are really bad, but sometimes it is manageable.

Complicated Post Traumatic Stress Disorder

There are several types of Post Traumatic Stress Disorder, but I won’t get into all of them in detail. The one type that I would like to discuss is Complicated Post Traumatic Stress Disorder (C-PTSD) because this is what I have. C-PTSD is caused due to relentless, repeated trauma. When the trauma is prolonged and on-going for months and, more likely, years, it can cause a person to lose hope. They see no end in sight; no one to come to their rescue.

The causes of C-PTSD can include on-going physical, emotional, or sexual abuse; being a prisoner of war; living in a war zone; on-going childhood neglect, etc. It is important to note that childhood neglect includes emotional neglect. Children have vast and varied emotional needs and, if these needs are denied or not met, the effects can be long-lasting and devastating.

While C-PTSD can develop in adults, it is most often seen when the trauma was experienced in childhood. This is a period when we have little to no control over our lives, as we are under the complete control of other people. In a lot of cases, the people who control our lives are also our abusers. This prolonged trauma with little to no way out can disrupt the entire course of a child’s psychological and neurological growth, resulting in C-PTSD.

The symptoms of C-PTSD can include but are by no means limited to:

1. Any or all symptoms of Post Traumatic Stress Disorder
2. Lack of emotional regulation
   • this can include excessive anger or on-going and uncontrollable sadness
3. Dissociation/Interruptions in consciousness
   • feeling detached from your emotions or even from your body; a feeling of watching yourself from the outside
4. Difficulty with self-perception/Extreme guilt or shame
   • self-blame, self-doubt, self-hatred; you develop a severe “inner critic”
5. Difficulty cultivating and maintaining relationships
6. Developing a distorted view of an abuser
   • this can include giving up total control of yourself to them, but also can include hatred or obsession with revenge
7. Loss of systems of meaning
   • systems of meaning are closely-held beliefs about religion, spirituality, or how the world works

C-PTSD and me

I would like to look at each of these more thoroughly and through the lens of my own life experience. Please keep in mind that I have only known about my Complex Post Traumatic Stress Disorder for 5 months, so I am still learning about all of the symptoms and behaviors that can, and do, affect me.

I experience or have experienced symptoms from all 4 of the main groups for PTSD.

Intrusive Memories

Intrusive Memories – I am often plagued by intrusive memories. Generally, they come in the form of intense daydreams or “spacing out.” When I have them, they often cause me to become extremely emotionally disturbed, if only on the inside, and they sometimes make me outwardly cry. Until a few weeks ago, I didn’t realize that these memories were abnormal; I thought everyone remembered things that way. I realize now that I only remember bad or painful memories in such a vivid and effective way.

Avoidance

Avoidance – I am the queen of avoidance. It turns out avoidance is my “answer” in EMDR, which we will talk about in another post. Avoidance is the main coping mechanism that I have fostered since a young age and have used the most to protect myself during times of trauma, but also when I perceive there to be danger where there is none. I cower at the thought of confrontation and I can’t hold to outward anger, which means I can’t stay angry for long…even if I’m angry for good reason. This causes me to get walked on a lot.

Negative Thought/Mood Changes

Negative changes in thought or mood – Negative thought patterns have become my jam over the years. Hopelessness is a near-constant companion in my life; I regularly feel like there is no escape from the pain and the anger. Negative thoughts of myself and the world that I live in are sometimes like a plague on my brain.

When things get particularly bad with my brain health, I get to a point where I feel emotionally numb; unable to feel real joy, excitement, or even pain. Positive emotions elude me. During these times, I know when I am expected to feel joyous or excited and I play the part well, but I don’t feel them. If things are really bad, I even have problems feeling love except in regard to the few people that I trust to my core. There aren’t many of them, these days.

Physical/Emotional Reaction Changes

Changes to physical and emotional reactions – I’m still learning how C-PTSD has affected my physical and emotional reactions, but the most glaring example is my inability to handle confrontation. I cannot quite describe how I feel when I know that negative confrontation is inevitable. It terrifies me and I will do absolutely anything to avoid it, including doing nothing. If I have to make a decision and the right decision requires a confrontation, even if there is only a small chance it will devolve into anything other than rationale, I will choose the wrong decision every time. It is perplexing and distressing and I’m not sure how to stop doing it but, as I said before, I’m still learning.

Emotional Regulation

Emotional Regulation – This can be anything from explosive rage to debilitating sadness and even suicidal ideation. My rage is not explosive, but I do have rage. I can regulate it; call it up with one memory and smash it back down by will; it’s probably not healthy, honestly. That said…the sadness…it knows me well. I can’t tell you how much of my life I have spent just so sad. I had no reason, most of the time. Even in my youngest memories. Also, I’ve had suicidal ideations since I was a pre-teen. L’appel du vide, the French call it. The call of the void. I think that romanticizes Hell. Thoughts of death; a gift, from my abuser.

Self Perception

Difficulty with self-perception – It can be hard for people with C-PTSD to see themselves as they are or as other people see them. We often have a negative and doubtful view of ourselves, fueled by self-blame, self-doubt, and self-hate. A lot of people have a harsh inner critic, but mine is an entire boardroom full of people who hate me. I know I am not perfect, so my inner board meeting tells me there is no point in trying. Anything. Ever. No matter how many people tell me that I’m a good writer, a good friend, or a good parent (3 things that are insanely important to me), my inner critic tells me they are lying. I can’t possibly be good at anything important.

There’s a CEO in the boardroom; it’s the person that started telling me I would never be anything good in life when I was a child and she doesn’t even have to work anymore. She just sits back and lets the rest of the gang wear me down. I’m working hard on this in therapy, though. Dr. W has my back on this one.

Dissociation

Dissociation/Interruptions in consciousness – Dissociation can be as minor as intense daydreaming or “spacing out,” or as intense as feeling disconnected with your body or your thoughts, not feeling real or like what is happening isn’t real, or losing time. It can also include visual and emotional flashbacks. I just recently learned what dissociation was, why it happens, and that your therapist will not lock you up and throw away the key if you tell her about it. In all seriousness, I have experienced this severely, on 2 separate occasions, and it can be really scary…once you’ve realized it happened. I’ll explain.

In 2014, I went through a severe trauma that I’m not ready to talk about publicly yet. It was really bad. As soon as I found out about it, my brain just…broke. I dissociated and, for 2 full weeks, it was like I was watching myself move through life from the outside of my body. I was one vaguely aware of it while it was happening; too busy focusing on surviving and I was barely doing that. I was still going to work every day, taking care of my kid, keeping up my home. I assure you, though, there was no one home. At the end of the 2 weeks, my brain was ready to absorb the truth of what had happened and I started processing the emotions of it. I’d like to think that dissociating was my brain’s way of absorbing the shock more slowly; protecting me from shattering into a million pieces.

It happened again a few years later, but for a much shorter period. Things at work had gotten bad for me. I got a new manager who was hell-bent on making our jobs much more micro-manageable. She started pulling production reports and my numbers were low. She kept asking me why and I kept telling her I didn’t know. I did know, sort of; my mental health was struggling and ALL of my disorders were on full display. Of course, I didn’t know about my disorders then, so my answer was, “I don’t know.” Most people with ADHD can tell you that neurotypical people hate that answer. They believe that you do know so you must be lying.

Things got worse and worse until the new boss and one other employee were constantly bullying and harassing me about anything and everything they could possibly find. They used my poor production to make me seem untrustworthy and unintelligent. They even lied or told half truths about me and I had to prove them wrong (luckily, I had proof), more than once. My stress levels were off the charts; I couldn’t sleep, my anxiety was through the roof. It all culminated in me having to go into the office for a face-to-face meeting. I had already decided to stand up for myself in the meeting, and I did, but I dissociated on the drive there and I stayed that way until several hours after I left. Throughout the entire meeting, I felt like I was watching it happen from the outside. Maybe it was the reason that I stood my ground and asserted myself. Either way, my boss backed off of me after that, though I would always find myself a nervous wreck at work from that point forward.

Relationships

Difficulty with relationships – With C-PTSD, difficulty with relationships goes well beyond the quality and richness; how fruitful the relationship is. It can include feeling isolated from your peers, so not knowing how to interact with them, a refusal to trust anyone, trusting anyone way too easily, always seeking rescuer/rescued relationships, and inadvertently seeking out abusive friends and partners because the abuse feels like “home.” I have felt all of these at some time or another, especially trusting the wrong people too easily and seeking someone to rescue. Those two the behaviors that have led me to a point where I now have real trouble trusting anyone.

Perception Of Perpetrators

Perception of perpetrators – Your perception of your abuser can change over time, many times over. Feelings can range from submitting and letting the abuser have total control over you, having extreme guilt for leaving the situation, craving love and approval from them even well after you are gone from the environment, or obsessing angrily; having hatred and disdain to the point of bitterness and/or revenge. I fall into the last category. My abuser is still in my life and has relationships with people that I love, so I stuff my rage deep down. Just the thought of her name can make my heart pound with contempt. Honestly, writing this has been difficult because the anger keeps creeping up. My only revenge is living the best life I can; a life she wanted me to believe I would never have.

Systems Of Meaning

Systems of meaning – The struggle to hold on to a faith or belief that ethical and moral justice will ever be served is a common one amongst childhood abuse survivors. I was raised in a family full of Christians. When I was in elementary school, just an innocent little girl, I used to beg God to save me. Every night, as tears streamed down my cheeks, I would beg him to get me out of there and save me. He never did. It killed any hope inside of me that there was a God and I have struggled to find a system of meaning since then. A couple of years ago, I realized that I was missing something spiritual in my life, so I started to do research (me, doing research?!) and try to figure out where my heart was. I’m closer today to having a meaningful belief system than I ever have been. But I will never again pray to a god to save me. I’m the only one that does the saving around here.

My story isn’t over yet…

My story was re-written by someone else, almost from the very beginning. I have been the recipient of severe emotional, mental, and verbal abuse and neglect, several times over throughout my life. It’s scary to be so honest about it and it might cause me a lot of problems down the road, but I deserve to tell my truth. There’s probably a reason why I buried it in a 2500 word document, but that’s for another therapy appointment. I was abused and that abuse rewired my brain; I am not the person I was meant to be because someone else thought it was their right to intervene.

Complex trauma is often compounded into adulthood, and so it was for me. My history is littered with chronic trauma; often feeling held captive by one perpetrator or another. But my story is not over yet. I have taken control for the first time in my life; working through childhood trauma in therapy. I will no longer allow her to have control of the boardroom. I’m putting in the hard, emotional work for the first time in my life. I’m learning for the first time how these things have affected me and, more importantly, what I can do to get past them. The truth is, I win. I get my revenge. I am on my way to my very best life; working on the very best version of myself. As I see it, I’m damn-near unstoppable.

Thanks for sticking in there with me! Stay tuned for next Tuesday with, My Mental Health: ADHD 2. I hope to see you there!

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Love and light. Keep fighting the good fight.💜💜