What is C-PTSD?

PTSD stands for Post Traumatic Stress Disorder. It’s associated with people who’ve experienced traumatic events. The condition causes high anxiety around the traumatic event which can manifest in intrusive thoughts, flashbacks, or nightmares (among many others). However, the lesser known condition is called C-PTSD. C-PTSD stands for Complex Post Traumatic Stress Disorder. While there are certain aspects that are similar to PTSD, it’s a completely separate condition.

The main difference between the two is the duration of the traumatic event. PTSD is typically caused by a specific series of events in a short period of time (or one specific event, it’s different from person to person), while C-PTSD is caused by a series of traumatic events over a long period of time. That can mean several months or several years. You can develop PTSD from a car crash, sexual assault, or a house fire. You can develop C-PTSD from being abused as a child/growing up in a war torn country, going to an abusive program like the one I’ve talked about, or being deployed to a warzone

Like PTSD, C-PTSD can lead to other issues/mental health conditions like addiction, depression, anxiety, and changes in personality (among others). Below I will make certain lists to make it easier for one to understand what one can go through without it getting personal.

C-PTSD symptoms often include:

• Flashbacks

• Nightmares

• Triggers to things that remind one of their experience

• Difficulty dealing with emotions

• Diminished sense of worth

• Excessive shame and guilt

• Difficulty sustaining relationships

• Difficulty feeling connected to others/getting attached easily

• Avoidance

• Self blame

• Hyper Arousal (anxiety surrounding the traumatic event and anything related to it)

• Detachment (derealization and depersonalization)

• Substance abuse

• Overeating

• Overworking

• Self harm

• Anxiety

• Difficulty sleeping

• Physical pain (can manifest in back pain, stiff joints, muscle soreness, migraines, etc)

• Hypervigilance (to an unhealthy degree)

• Becoming a “People Pleaser”

• Re-experiencing (different than flashbacks)

Trauma Response: A trauma response is how a person deals with what happened. It has to do with how they think, behave, feel, act, and physically respond to what happened to them. For a lot of people, it’s unconscious, but we’ll get more into that later.

• Social Withdrawal– Trauma harms its victims self esteem and negatively impacts their world view. These people can see the world as a dangerous and unsafe place, people as malicious and untrustworthy, and themselves as damaged and unworthy. This response may manifest as:

  • Spending less time with loved ones

  • Making less of an effort to stay in touch

  • Not wanting to go out or have people over

  • Getting nervous when someone gets too close (emotionally)

  • Overthinks when someone has a slight change in tone or demeanor.

• Lashing Out– Besides withdrawing socially, sometimes we push people away by lashing out at them. Anger is a common reaction to trauma. When one is unable to make sense of it all, this anger is often accompanied by sadness, fear, and anxiety, All of which can make someone incredibly emotionally volatile. People may be angry at:

  • Themselves for what happened

  • Others for not seeing it or helping them sooner

  • The world in general

  • Religion as a whole

• Overworking– Sometimes people will feel a strong need to keep themselves busy, others will have difficulty relaxing or enjoying themselves, and some will feel anxious when they have nothing to do. People like this use their work as a way to keep themselves occupied to avoid difficult thoughts or emotions like those related to their unhealed trauma. People will overwork themselves to:

  • Avoid thinking about what happened

  • Avoid confronting how they feel

  • Pretend it didn’t happen

• Freezing up– Freezing up is a common trauma response, especially when the nature of the trauma has led the victim to believe that they’re better off making themselves as non threatening as possible. A long term “freeze response” can become a mask one uses to protect themselves when they can’t identify any means of fighting back or escaping. People with this trauma response may use fantasy or imagination to escape, hide their true feelings, or mentally check out from stressful or painful situations. The “freeze response” can manifest by:

  • Dissociating

  • Becoming emotionally numb

  • Having great difficulty making decisions or taking action

  • Getting this paralyzing fear of trying new things

• Fawning– Fawning is often overlooked as a trauma response. Fawning refers to behaviors that aim to please, appease, or pacify others in an effort to avoid conflict, harm, or stress. Survivors of childhood abuse and trauma would often learn to please the person threatening them and keep them happy as a way of making themselves feel safe. Some ways people do this are by:

  • Doing things for others they don't want/need to do

  • Over apologizing

  • Struggle to say “no”

  • Struggle to tell the truth if it has a slight chance of hurting someone's feelings

  • Having difficulty expressing their own needs and feelings

  • Struggle to tell someone when their wrong

  • Feeling guilty about receiving help from others

In order to explain what this means, I’ll give some personal examples.

Social Withdrawal– If there is any change in tone, I start to curl up inside and do anything to either get out of the situation or fix it. If someone’s tone is even slightly different than it usually is, I start to panic and it feels like I’m walking on thin ice. Another reason it’s so hard for me to reach out, I can’t tell how someone truly feels over the phone. I feel like falling apart. I get so paranoid I can start crying.

Lashing out– In my case, I’m mad at Religion and the world. They forced religion onto the students there. I respect you and your religion as long as you don’t push it onto me, but they did. I am angry at religion because why would I pray to a god that’s letting me be abused? I’m angry at the world for being so sensitive about hard topics. Bad shit happens. I’m angry that people condone certain behaviors. In my head, I think “Why did I get sent away? Look at him!” or “why is he allowed to talk to you like that?” because I was reprimanded every time I opened my mouth, and NLA blamed it on me or god.

Overworking– This is complicated. C-PTSD can affect how one handles future events as well. I don’t overwork to avoid the trauma from NLA, I overwork to avoid the sadness of something that happened after. That’s actually one of the reasons I started working on this document. I’m trying so hard to push the feelings of heartbreak away by working on something that needs my full attention.

Freezing up– Before NLA I was able to take the subway/train, walk to school (when I went), and go into small restaurants and convenient stores. Now, even 5 years later, I can only go a few blocks on a good day (or to the end of my driveway on a bad one), I am terrified of public transportation, and I can’t order for myself/walk into crowded stores/restaurants without nearly breaking down. I need to have my mom with me in order for me to feel safe. Until recently I thought it was because I lived in a safer place before NLA (My family moved during my stay), but in reality it’s the fear of losing sight of my mom and never seeing her again. At NLA she was there one second, and gone for the next for 15 months. There are times where I dissociate and stare into space, sometimes it’s caused by something that reminds me of NLA, but NLA has had such an impact on me that it just happens. Multiple times a day my head is just blank and I can't think or talk. Unless someone notices and snaps me out of it I can be like that for up to 5-7 minutes. There’s a lot of different ways one can “freeze up”, these are just 2.

Fawning– I am the definition of fawning. I’m a chronic people pleaser. We had to tiptoe around everything at NLA, and when I mentioned getting in trouble for opening my mouth I wasn't joking. If I didn’t finish my meal because I didn’t like it I’d get a lecture and the staff would look at you with this expression that just made students want to cry. So I never tell my mom when I don’t like a certain dish. Even when she asks, I panic to find an acceptable answer that isn't a lie, but doesn’t let her know I don’t like it. If she wants me to go shopping with her I say yes because when you said “no” at NLA after someone asked you something, you’d get in alot of trouble. I do things I don’t need to do, but I feel like if I don’t my mom will hate me because of how staff reacted at NLA when I couldn’t finish/do something.

There is something that has affected me immensely that is completely separate to the trauma responses written. I was abused by women. Psychological abuse is just as harmful as physical abuse. Something that’s been hard is seeing that not all women are like that. I go by he/him because going by she/her makes me feel gross after what I’ve been through. Pronouns don’t mean very much to me, but when it comes to my loved ones and people who know what I’ve been through, it means alot. I’m a very feminine person, yet it’s the pronouns that frustrate me. I don’t know exactly why it’s the pronouns, I don’t think I’ll ever know. Feminine compliments are fine, referring to me as “girl” in a fun slang way is fine, and I don't care if people mess up (Cuz it’s really not really a big deal) because mistakes happen. What I do know is that I automatically feel safer with a man than I do a woman, and that's fine. People can’t really control what makes them feel safe or not. I’m adding this because It shows that C-PTSD can affect people in crazy, unthinkable ways.

If you’re a friend or family member of someone with C-PTSD, read into these. These are all personal, but now that you’ve read how certain trauma responses can manifest in certain ways, think about things that your person does/doesn’t do that doesn’t make any sense/seems “lazy”. People with C-PTSD have irrational fears, but knowing that their fears are irrational doesn't help. I know that my mom won't abandon me at a grocery store, she loves me very much, but that doesn’t make me any less paranoid.

You aren’t responsible for other people's trauma and reactions, but it also doesn’t take much to be kind and lenient. You don’t have to understand, you just gotta go along with it sometimes.