Complex Post Traumatic Stress Disorder (CPTSD): An Introduction

In a previous post I explored the negative effects that some adults can experience as a result of being emotionally neglected by their parents or primary caregivers in their childhood, such symptoms included depression, anxiety, and feelings of emptiness. These symptoms arise from not having received emotional learning and compassion from their parents, even if their parents had the best intentions.

But what happens if on top of the emotional neglect, you add a toxic and critical parent to the equation? The type of parent who always shames and belittles their child in a non-stop tirade of emotional abuse.

The answer could be that the child develops what is known as Complex Post Traumatic Stress Disorder (CPTSD).

The concept of CPTSD is relatively new, and at the time of writing is not even recognised as a genuine diagnosis by health practitioners. A lot of victims, however, are waking up to the idea that CPTSD is a very real condition and are finding comfort that a lot of their behaviour and adult experiences have an explanation.

Since it is a new idea, there isn’t an authority piece of work on CPTSD, however the work by Pete Walker is well respected and it is from his book that I did most of my research. My post will largely be based on his findings and what he has discovered from helping patients to recover from CPTSD, and from his experiences of having the condition himself.

5 Main Symptoms of CPTSD

CPSTD doesn’t seem to have one symptom that is at its core, but rather it’s a cluster of symptoms.

The main features of CPSTD are:

  1. Emotional flashbacks
  2. Toxic shame
  3. Self-abandonment
  4. Vicious inner critic
  5. Social anxiety

The emotional flashbacks that accompany CPSTD is the feature which separates it most from other disorders.

What are Emotional flashbacks?

  • Emotional flashbacks are sudden and often prolonged regressions to the overwhelming feeling states of being an abused/abandoned child.
  • These feelings states can include overwhelming fear, shame, addiction, rage, grief and depression.
  • They also include unnecessary triggering of our fight/flight instincts.
  • Flashbacks can range in intensity from subtle to horrific. They can also vary in duration from moments to weeks (regression).
  • Emotional flashbacks are accompanied by intense arousals of the fight/flight instincts along with hyperarousal of the sympathetic nervous system, the half of the nervous system that controls arousal and activation.
  • If fear is the dominant emotion the person feels extremely anxious, panicky or even suicidal. If despair is dominant – numbness, paralysis and desperation to hide may occur. A sense of feeling small, young, fragile, powerless and helpless is also commonly experienced including humiliation and toxic shame.

Emotional flashbacks are somewhat comparable to what war veterans suffer (Post-Traumatic Stress disorder) when they see flashbacks of traumatic events that they experienced at war, the difference is that CPTSD does not necessarily have images during a flashback, but rather emotional feelings only.

Origins of CPTSD & Further Symptoms

 While CPTSD is most often associated with physical and sexual abuse it is also caused by ongoing verbal and emotional abuse. As we discussed earlier it is also a result of emotional neglect.

Parents who consistently ignore or turn their backs on their own child’s call for attention will cause the child to fall into a bottomless hole of fear, depression and death like feelings of helplessness and hopelessness. The child will also develop a sense of shame through their parents’ rejection, and over time the fear and shame will blend into the development of a toxic inner critic that continuously blames the child for his parents’ abandonment.

A CPTSD survivor will have an overwhelming sense that he is loathsome, ugly, stupid or fatally flawed and develop toxic shame. Without knowing the neglected child becomes his own worst enemy and develops CPTSD.

Getting Stuck in Trauma

If a child is constantly emotionally abused, trauma will set into the child’s life when an attack of abandonment triggers a fight/flight response so intensely that he cannot turn it off once the threat is over. It is at this point that the child would need a compassionate adult to help him grieve the incident through verbally venting, angering or crying about it, allowing him to relax back into parasympathetic nervous system functioning. If he does not receive such care, the child becomes stuck an adrenalized state and cannot revert back into a relaxed state. If the child experiences attack after attack, the child may become frozen in the trauma and the symptoms of Post Traumatic Stress Disorder set in.

Perfectionism Sets In

If a child is raised in such a toxic family, perfectionism will often set in, as her subconscious tries to achieve the impossible; the acceptance and love of her parents. She develops a subconscious strategy of trying to become smart, pretty, helpful and flawless enough to make her parents less dangerous.

Since it is a task that is impossible, she will fail to achieve her goal and her only conclusion will be that there is something wrong with her, that she is herself fatally flawed in some way.

As Walker puts it, she learns that she is loveless not because of her mistakes, but because she is a mistake. She begins to only see what is wrong with her, and anything she does in her life is torn apart by the toxic critic installed within her. She sadly, descends down into an abyss of fear and toxic shame, with a full-blown trauma inducing critic who won’t leave. Self-criticism then runs non-stop in a desperate attempt to avoid rejection inducing mistakes. Perfection is demanded no matter what.

For this process to stop, a child would need someone to offer self-compassion and self-protection. However, the parent will not allow this and instead shames the child further by shaming or intimidating whenever a child has sympathy for themselves or makes an attempt to stand up to the parent. As a result, the instinct to have self-compassion and to protect themselves from unfairness becomes dormant.

Social anxiety, relationships and CPTSD

A child who grows up in a toxic home will become socially anxious as extensive childhood abuse installs a message that people are dangerous. This message becomes deeply ingrained in the mind of the child. With no reliable source of love, support and protection he will adopt counter-dependence/self-sufficiency as asking for help or needing anything from someone can seem dangerous.

  • Some survivors learn to function adequately such as in structural situations (i.e. job with clear and common goals) where everyone around them is focusing on a specific task at hand. Unstructured social situations however, like attending parties or just hanging out can be more triggering. Spontaneous self-expression feels like the sure setup for disaster that was in childhood.

People with CPTSD may approach everyone with caution and will often overlook that in reality a lot of people may actually quite like them.

Not only will a survivor of CPTSD struggle with meeting new people but they are likely to struggle with developing healthy relationships and intimacy with others. Since CPTSD is an attachment disorder the child grew up without a safe adult to bond with, which means they will lack the knowledge of the relational skills to create intimacy. Typically the survivor will struggle to maintain healthy supportive relationships in their adult lives.

CPTSD and the Inability to Understand & Feel Emotions

In life, it is important to experience and understand that emotions vary all the time. It is a part of being a healthy human to experience a variety of emotions along the continuum and shift between one and the other frequently – between happiness and sadness, loving and angry, trusting and suspicious, enthused and depressed.

It is not surprising that an adult raised by CPSTD inducing parents will be greatly lacking in this area, since his parents are likely to attack any hint of the child expressing his own emotions.

This can even be the case where the child expresses happiness and the parent responds with a scowling, “What are you so happy about!?”

Such situations can arise where any hint of emotional expression from a child can be so assaulted with disgust from a parent that any time the child experiences any emotions he falls into a hole of toxic shame.

The child will respond by repressing his emotions in an effort not to upset his parents.

There are some problems if emotions are repressed:

  • It forces the child’s healthy grieving into developmental arrest.
  • Continuous repression causes a person to get stuck in a feeling he is trying to avoid and does great damage to himself.
  • Repression of one end of the emotional continuum often leads to a regression of the whole continuum and the person becomes emotionally deadened, bland and lifeless. This is the same when someone tries to hold onto a preferred feeling longer than its actual tenure.

The ability to feel all emotions is paramount. Without it, we will experience loneliness, emptiness and stray into addictive distraction to escape from these feelings, which is why so many people in today’s society are struggling.

In the case of someone with CPTSD, their inability to access their emotions will cause them to be unable to detect when something is wrong, unfair or a situation is causing harm. They will feel like something is missing in their lives until they learn to begin to start accepting all their emotions. This means showing self-compassion and self-love even in unhappy and depressive moments.

For the CPSTD survivor (and emotional neglected people), they will need to recover their emotional intelligence.  Without emotional intelligence, a person will struggle to know their wants and struggle with decision making.

As emotional recovery progresses, mindfulness begins to get in touch with their emotions and helps us stop automatically dissociating from our feelings. We then learn to identify our feelings and choose healthy ways to respond to them. Grieving is the key process for reconnecting with our repressed emotional intelligence, and is discussed in another post.

Healing from CPTSD

Despite all the terrible things that may have happened to such a helpless and innocent child the effects of CPTSD can be healed or at least lessened. CPTSD is not caused by genetics or DNA, nor is it a part of their personality, it is caused by the environment that they happened to find themselves in. As Walker puts it:

  • CPTSD is a disorder caused by nurture (or lack of) not nature.

If you are a sufferer of CPTSD the healing process lies in ensuring that you provide yourself now, with what was not provided by your parents in your childhood. Insufficient self-compassion, is the worst development arrest of, and restored self-compassion is the keystone of all effective recovery.

Deep level recovery is also accelerated by connecting to safe people during emotional flashbacks. A qualified therapist may be able to act as this safe person, however a person such as a close friend or partner where the survivor can truly be themselves can also work well.

Although relational healing through interacting with safe people is best, some sufferers have experienced so much emotional abuse that they no longer trust people. The idea of seeking help from another would be far too risky. In this case, close bonds with pets, helpful books, and simply learning about CPTSD can work well.

Some victims may need a ‘Parentdectomy’

Whilst it was recommended that some people may need to develop relationships to ignite the healing process, many may need to do the opposite and sever relationships, particularly if they are still in contact with their abusive parent. Some survivors can be triggered into an emotional flashback through simply hearing the voice of their parents. For some, the idea of a ‘parentdectomy’ may be required to heal sufficiently.

Healing from CPTSD as a Lifelong process

It is important for a CPTSD survivor to be realistic over the length of the recovery process. As one can guess, recovery will not take place in a few weeks, or months but most likely will be a lifelong process. They must also not create the false expectation that they will never have another emotional flashback, by doing so they could self-sabotage their own progress.

CPTSD sufferers often think in an all or nothing way. They are either doing well, or not doing well. They are either healed or not healed. If they see that they have a slight set-back it is not uncommon for them to slide back into anxiousness and the deadened feeling of hopelessness from the abandonment melange. Pete Walker calls this the surviving-thriving continuum. At the survival end, every little task can seem like trying to climb Mount Everest. This is a feeling state flashback to their childhood when everything felt so overwhelmingly difficult and it was hard to imagine that there was any possible escape from the everlasting present.

It is at this point that a recoveree will need to use effective flashback management to avoid getting stuck in this depressive feeling, otherwise the feeling could go on for days.

The Pitfall of Happiness as the Goal

As a part of their all or nothing thinking, the CPTSD recoveree will commonly adopt a way of judging their own emotional tone and mood as either good or bad. As a result, if they are not feeling good or happy, they immediately judge this as bad and will dump more shame on themselves for not being happy enough.

This kind of thinking is a trap. The idea that someone should be happy all the time, is not even a realistic goal for someone who does not suffer from CPTSD, let alone a sufferer of CPTSD. In this respect, their feelings of feeling bad becomes more prominent than is necessary. A better goal would be to change their goal of happiness to one of peace or serenity.

Unfortunately, we are promoted happiness all the time from the media, adverts and now from social media channels where people throw up the best versions of themselves. Whether we suffer from CPTSD or not, we all need to have more reasonable expectations of happiness, and realise that trying to be happy all the time actually has the effect of making us unhappier.

For the CPTSD sufferer letting go of the idea of permanent happiness is critical for recovery because at any time they are not feeling happy enough, the critic will begin to blast them with shame for not being happy.

The healing process for anyone with CPTSD can appear tough but it is doable. For a closer look at the healing process make sure to look at Part II of this research into Complex Post Traumatic Stress Disorder.

If you want to learn more on CPTSD I’d recommend reading Pete Walkers book Complex PTSD: From Surviving to Thriving. It provides an in depth look into his experiences helping people overcome CPTSD as well as his own personal struggles with CPTSD.

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