Complex Post Traumatic Stress Disorder (C-PTSD)

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Complex Post-Traumatic Stress Disorder (C-PTSD) – Complex Post-Traumatic Stress Disorder is a psychological injury that results from prolonged exposure to social or interpersonal trauma, disempowerment, captivity or entrapment, with lack or loss of a viable escape route for the victim.

C-PTSD Introduction

Complex Post Traumatic Stress Disorder (C-PTSD) is a condition that results from chronic or long-term exposure to emotional trauma over which a victim has little or no control and from which there is little or no hope of escape, such as in cases of:

  • domestic emotional, physical or sexual abuse
  • childhood emotional, physical or sexual abuse
  • entrapment or kidnapping.
  • slavery or enforced labor.
  • long term imprisonment and torture
  • repeated violations of personal boundaries.
  • long-term objectification.
  • exposure to gaslighting & false accusations
  • long-term exposure to inconsistent, push-pull, splitting or alternating raging & hoovering behaviors.
  • long-term taking care of mentally ill or chronically sick family members.
  • long term exposure to crisis conditions.

When people have been trapped in a situation over which they had little or no control at the beginning, middle or end, they can carry an intense sense of dread even after that situation is removed. This is because they know how bad things can possibly be. And they know that it could possibly happen again. And they know that if it ever does happen again, it might be worse than before.

The degree of C-PTSD trauma cannot be defined purely in terms of the trauma that a person has experienced. It is important to understand that each person is different and has a different tolerance level to trauma. Therefore, what one person may be able to shake off, another person may not. Therefore more or less exposure to trauma does not necessarily make the C-PTSD any more or less severe.

C-PTSD sufferers may “stuff” or suppress their emotional reaction to traumatic events without resolution either because they believe each event by itself doesn’t seem like such a big deal or because they see no satisfactory resolution opportunity available to them. This suppression of “emotional baggage” can continue for a long time either until a “last straw” event occurs, or a safer emotional environment emerges and the damn begins to break.

The “Complex” in Complex Post Traumatic Disorder describes how one layer after another of trauma can interact with one another. Sometimes, it is mistakenly assumed that the most recent traumatic event in a person’s life is the one that brought them to their knees. However, just addressing that single most-recent event may possibly be an invalidating experience for the C-PTSD sufferer. Therefore, it is important to recognize that those who suffer from C-PTSD may be experiencing feelings from all their traumatic exposure, even as they try to address the most recent traumatic event.

This is what differentiates C-PTSD from the classic PTSD diagnosis – which typically describes an emotional response to a single or to a discrete number of traumatic events.

Difference between C-PTSD & PTSD

Although similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.

C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.

Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.

Similarly, a child who witnesses a friend’s death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics shown below:

C-PTSD – What it Feels Like:

People who suffer from C-PTSD may feel un-centered and shaky, as if they are likely to have an embarrassing emotional breakdown or burst into tears at any moment. They may feel unloved – or that nothing they can accomplish is ever going to be “good enough” for others.

People who suffer from C-PTSD may feel compelled to get away from others and be by themselves, so that no-one will witness what may come next. They may feel afraid to form close friendships to prevent possible loss should another catastrophe strike.

People who suffer from C-PTSD may feel that everything is just about to go “out the window” and that they will not be able to handle even the simplest task. They may be too distracted by what is going on at home to focus on being successful at school or in the workplace.

C-PTSD Characteristics

How it can manifest in the victim(s) over time:
Rage turned inward: Eating disorders. Depression. Substance Abuse / Alcoholism. Truancy. Dropping out. Promiscuity. Co-dependence. Doormat syndrome (choosing poor partners, trying to please someone who can never be pleased, trying to resolve the primal relationship)

Rage turned outward: Theft. Destruction of property. Violence. Becoming a control freak.

Other: Learned hyper vigilance. Clouded perception or blinders about others (especially romantic partners) Seeks positions of power and / or control: choosing occupations or recreational outlets which may put oneself in physical danger. Or choosing to become a “fixer” – Therapist, Mediator, etc.

Avoidance – Avoidance is the practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming – Blaming is the practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing – Catastrophizing is the habit of automatically assuming a “worst case scenario” and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

“Control-Me” Syndrome – “Control-Me” Syndrome describes a tendency that some people have to foster relationships with people who have a controlling narcissistic, antisocial or “acting-out” nature.

Denial– Denial is believing or imagining that some factual reality, circumstance, feeling or memory does not exist or did not happen.

Dependency – Dependency is an inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression (Non-PD) -Depression is when you feel sadder than your circumstances dictate, for longer than your circumstances last – but still can’t seem to break out of it.

Escape To Fantasy – Escape to Fantasy is sometimes practiced by people who present a facade to friends, partners and family members. Their true identity and feelings are commonly expressed privately in an alternate fantasy world.

Fear of Abandonment – Fear of abandonment and irrational jealousy is a phobia, sometimes exhibited by people with personality disorders, that they are in imminent danger of being rejected, discarded or replaced at the whim of a person who is close to them.

Hyper Vigilance – Hyper Vigilance is the practice of maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Identity Disturbance – Identity disturbance is a psychological term used to describe a distorted or inconsistent self-view.

Learned Helplessness– Learned helplessness is when a person begins to believe that they have no control over a situation, even when they do.

Low Self-Esteem – Low Self-Esteem is a common name for a negatively-distorted self-view which is inconsistent with reality. People who have low self-esteem often see themselves as unworthy of being successful in personal and professional settings and in social relationships. They may view their successes and their strengths in a negative light and believe that others see them in the same way. As a result, they may develop an avoidance strategy to protect themselves from criticism.

Panic Attacks – Panic Attacks are short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as shaking, sweats, chills and hyperventilating.

Perfectionism – Perfectionism is the practice of holding oneself or others to an unrealistic, unsustainable or unattainable standard of organization, order or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in others.

Selective Memory and Selective Amnesia – Selective Memory and Selective Amnesia is the use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Self-Loathing – Self-Loathing is an extreme self-hatred of one’s own self, actions or one’s ethnic or demographic background.

Tunnel Vision – Tunnel Vision is the habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

C-PTSD Causes

C-PTSD is caused by a prolonged or sustained exposure to emotional trauma or abuse from which no short-term means of escape is available or apparent to the victim.

The precise neurological damage that exists in C-PTSD victims is not well understood.

C-PTSD Treatment

Little has been done in clinical studies of treatment of C-PTSD. However, in general the following is recommended:

  1. Removal of and protection from the source of the trauma and/or abuse.
  2. Acknowledgement of the trauma as real, important and undeserved.
  3. Acknowledge that the trauma came from something that was stronger than the victim and therefore could not be avoided.
  4. Acknowledgement of the “complex” nature of C-PTSD – that responses to earlier traumas may have led to decisions that brought on additional, undeserved trauma.
  5. Acknowledgement that recovery from the trauma is not trivial and will require significant time and effort.
  6. Separation of residual problems into those that the victim can resolve (such as personal improvement goals) and those that the victim cannot resolve (such as the behavior of a disordered family member)
  7. Mourning for what has been lost and cannot be recovered.
  8. Identification of what has been lost and can be recovered.
  9. Program of recovery with focus on what can be improved in an individuals life that is under their own control.
  10. Placement in a supportive environment where the victim can discover they are not alone and can receive validation for their successes and support through their struggles.
  11. As necessary, personal therapy to promote self discovery.
  12. As required, prescription of antidepressant medications.

What to do about C-PTSD if you’ve got it:

Remove yourself from the primary or situation or secondary situations stemming from the primary abuse. Seek therapy. Talk about it. Write about it. Meditation. Medication if needed. Physical Exercise. Rewrite the script of your life.

What not to do about it:

Stay. Hold it in. Bottle it up. Act out. Isolate. Self-abuse. Perpetuate the cycle.

What to do about it if you know somebody else who has C-PTSD:

Offer sympathy, support, a shoulder to cry on, lend an ear. Speak from experience. Assist with practical resolution when appropriate (guidance towards escape, therapy, etc.) Be patient.

What not to do about it if you know somebody else who has it:

Do not push your own agenda: proselytize, moralize, speak in absolutes, tell them to “get over it”, or try to force reconciliation with the perpetrator or offer “sure fire” cures.

  1. My narcissist abuser is my older sister, and it has been a long and VERY terrible road. A shaky and curvy road that I had been on for 29 years. Finally, when she tried to ruin my wedding I decided I had enough. I have not spoken to my sister in over six months and I have never been so proud. Each month I feel prouder. Today, she sent me another text message, and, of course, like narcissist always tend to do: never really say they are sorry. My sister drinks a great deal of alcohol, as many narcissists do, and that is when she always contacts me. The messages don’t really make a whole lot of sense and are always sent to me late at night. I almost gave in tonight and responded to her text, and thank god my husband came in the room and caught me. He has seen me go into very dark depressions over her and feels very strongly that I should avoid contact with her. I feel that way too, but sometimes it is hard. What do I do about Christmas? What do I do when her daughter has a birthday? Do I just forget about the pain? Do I just tell myself that I can handle it? If I told my dad or my younger sister that I think I have c-ptsd from my older sister they would probably just think I was being dramatic. My younger sister has suffered from my older sister’s abuse, but I was her most prominent and favorite victim. But, I think about how happy I have been in the past six months, and, guess what? the only time I feel down is when I remember her. All these horrible flashbacks enter my mind. But, now, these flashbacks actually work for me, and not against me. They remind me why I continue to keep her out of my life. I hope there is somewhere out there that can relate to this, in fact, I know there is. Stay strong!!!


  2. The worst part for me is that I was dumb enough to believe him. A self-assured woman was drug into the con and I was powerless against it. No matter how badly he treated me, I loved him. I twisted myself into a pretzel to please him and failed continuously. And the weird things he did, like I’d fall asleep on the couch and wake up to see him staring directly into my eyes. I’d scream and he’d laugh insanely. I eventually couldn’t determine fact from fiction. He had me convinced I was the problem. He would tell me things I knew I hadn’t said and somehow have me believing I actually had said them. He was a monster. I finally escaped and moved 2000 miles. I’ve been free a year, yet his taunting continues in my mind. I haven’t heard him say one word in a year, yet he never ever shuts up. One day at a time…


    • I know how you feel. I don’t speak to my abuser but I hear him all the time, when I get up, when I get dressed, when I see friends I wasn’t allowed to see. He controlled my every move and I don’t know how to get him out. I’m sorry for what you went through but its helpful to know others understand this feeling. You’re not alone.


  3. My narcissistic husband of 15 years is divorcing me. With two children and having MS, my stress level is off the charts. He stayed living with us for 2 months to try to get some dirt on me to use to get custody. And I now have a civil protection order because of domestic violence. I am having a hard time with all the premeditation he’s been doing to me for the past two years. How do I cope?


    • I have the similar situatuon. My husband/partner of 12 years spent three years crazy making premeditated plans to divorce me. He would record our conversations and I thought I was losing my mind, he would say I didn’t hear things, or my mind was illogical, or that I said things I never said. In the audios he has one I found where he actually talks into the recording while I am not in the room and speaks about how he will “pretend to be asleep” while I am left crying and confused so that “all hell will break lose”.

      He gave me psychedelic drugs to “cure” me of my supposed prescription drug addiction. He then would make records of me and confuse me mentally and gaslight me. He would take me out to party then when we got home he would take pictures and make notes sayin (“she was out all night again, passed out and she is no longer herself I have lost her. I am so afraid for her life”). He would threaten to call my family if or when I left the house after an “episode”.

      All of this was done very intermittent with him being very loving and kind, taking me to the best places/dinners, New Zealand and South America etx. he suprise trip and renews our wedding vows in Vegas, then out of nowhere the pity party plays, the testing of me and my love or support (I wasn’t supportive enough or normal), follows with public displays of how I am the “best ever” can’t live without me. The other abuse was financial, leaving me months on end then returns, sales our primary business behind my back, sends me out of the state for “rehabilitation” while filing and lying the the courts that he doesn’t know where I am. All this while telling me he is busy with work and “let’s keep talking. I love you and I am so scared for your life. Your in a safe place right now.” He would define my reality and say…I am “always angry” and I am “never happy” enough. I “want to be unhappy”…then me trying to prove constanly that I am not unhappy or unhealthy. After four years finally in woth a therapist that specializes in sociopath/narcissistic abuse she says it is the worst case she has ever seen.

      He has gone on in a very public way with a smear campaign. I was court order of protection and could not even go to the home I personally own (it’s empty…he doesn’t even live in it). I could not call a single friends because I am “dangerous unstable and want to murder him”. He took my messages out of context over years and pulled off such a con with the court. It is hard for me to even imagine the mind involved in premeditated actions to hurt me, make me craxy, make me react. I was suicidal and now diagnosed with Complex PTSD. I have spent four months institution and almost a year in solitude. I had no idea how unhealthy I was. I lost myself completely. Humiliated and trauma bonded just in hopes of his return of kindness.

      The most difficult part is the premeditated actions. Things that made no sense for years now make sense, but I have lost years of my life and he just left on as if nothing happened. He was able to justify taking everything. In fact he has sympathy from others because I was labeled a “drug addict”, “bipolar/crazy” and abusive.

      The scariest episodes were the psychedelic “cures” the one recording I actualky have he is brainwashing me and telling me literally “you are no longer you…the old you is gone.” And saying that he can’t connect to me because I am a stranger in my body. I have no recall of the events.

      This has been my life sorting out memory’s and madness for 2 years. The divorce is still not finalized and I am out of money.

      He is so good and able to convince everyone because to look and talk to him no one would ever believe that this is possible. We had 10 stronger years where publicly I was normal and appear very happy with him.

      We have no children so it makes it seem I am just after his money.

      I have 2 friends and parents who believe me, and to the rest they either have no idea where I went.

      I am scared and I have nightmares, I don’t know that I can ever work a job like normal, I have severe emotional attacks or panic out of the blue and it’s unpredictable. I over react to slights and my startle response is massive. It is taking a lot of EMDR, therapy and drugs to help and I still feel hopeless.

      Before I was bright and quick mind, full of love and hope, always believed in the best. I, had a great career (supported him actually he was in debt), I was very social, great health and nutrition, wanted to go back to school for a master’s degree.

      Now I am just getting through the days hoping I can get to the store and back without dissociation where I keep driving my car and get lost…going on 2 years of the symptoms that bad.

      I know how bad it can get.

      I want to get well and devote my life to helping others. I am at the very beginning of a long road back.


  4. Michelle Skeen

    i just lost my husband to whom I was his caregiver for the last 5yrs. I couldn’t leave the house due to his illness and if I was able to leave it was for food,pharmacy,doctor and then hurry home. He had Jeckyl/Hyde syndrome which is what I called it especially after dialysis then the hospital stays, and lifting and all the other stuff and I love him dearly. Now that he’s gone I still can’t leave the house and I can’t feel happy anymore. I fake it in front of ppl that visit just so they will leave quickly so I can be alone again. I’m tired all the time quick to get angry or enraged at nothing. I just can’t seem to pull myself together to who I know I use to be. I’m forgetful not able to organize anything even my thoughts. I feel horrible. Thank you for posting this article. I hv sought out counseling to begin in June, I feel crazier when friends I hv 1 that thinks I should snap out of it now that he’s gone and automatically be HAPPY….NOT!!!!!
    I just want to laugh again.
    Thank you.


  5. I have been in a relationship with a strongly narcissistic person. I did not realize until after the damage was done, and now I feel the creeps by the thought of this person.

    Sometimes I find myself having very special nightmares where I am trapped in a feeling of being frightened and paralyzed. This is probably the feeling I mostly felt when being around him, although unable to recognize or act upon it.

    I completely let him control me and put me down in the search of wanting to feel safe. I went through a major illness because of this highly damaging situation, and I have been on the recovery from it since last summer.

    With hopes for a better future, with love, action and responsibility-seeking behavior.

    All the best.

    Liked by 1 person

  6. I have experienced everything that is known as CPTSD. It is so amazing how emotionally draining it can be. I also feel after reading more into this, I almost get ashamed or want to denies certain personality traits. Not because they are not true, but maybe i am unable to control the complex and hopelessness of the trauma. On the other hand what to me makes it so complex is not wanting to open up about painful or preventable problems i know still exist and yes i can learn to cope, teach and express traumatic events it is a learning process that is always going to be complex, my traumatic issue is post a stress i endured, It has to be recognized and treated to the worth and re-parenting process that is so worth every souls worth to practice honesty to stand up and feel safe and not let stress from past make your future complex. It is growth and proper regulations that complicate, We can control our on destiny not create it.


  7. I have recently, within the last year or so left my narcissistic ex-boyfriend. I am having a hard time expressing myself emotionally. I blew up at my current fiancee last night because of my suppression of all my stresses and worries. I didn’t know I had this condition.I used to do the same thing as a child. My mother was a narcissist. I just thought suppression was a normal thing. I don’t know what is “normal” emotional behavior.


    • This is really common Lindsay. You’ll learn proper emotional regulation and expression, now that you (Im assuming) :) have a HEALTHY fiancée that is open to listening to and responding to your emotions. Keep practicing your emotional honesty with safe people and you’ll begin to teach yourself how to express yourself and stand up for yourself. Hang in there, this is a reparenting and learning process that is so worth it in the long run. :)


  8. Thanks for posting this. I have been struggling with this all my life


  9. This article IS NOT about PTSD. This is C-PTSD, they are two different critters, from different causes with different, treatments.


  10. I just got out of a very abusive relationship and I am going through almost all of the above symptoms. I am seeing a therapist and taking Wellbutrin. I am currently not working because I am so anxiety ridden some days I cannot even work. When does it get better and this awful pain go away. I feel at time I am loosing my mind. I have been away from him for 2 months.


  11. Good god. Thank you. This is very validating and am glad to know I’m moving in the right direction.

    Liked by 1 person

  12. I know I have suffered this 4 years ago (doesn’t time fly) and I was lucky enough to have a doctor who diagnosed me with PTSD!


  13. Thankyou f.or posting this succinct explanation of what is such a complex condition. It is frightening but also a relief to finally be able to give a name to something that effects me on so many levels.


  14. PTSD can take a very long time to heal. You will need some professional help to manage it. “:’*:

    My very own website


  15. This is exactly what I have been dealing with. Thank you for posting this!


  1. Pingback: Narcissistic Abuse Part I: When The Right Fit Is All Wrong - HolyVegGYogi!

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