CPTSD
Complex PTSD or ‘CPTSD’ describes the results of ongoing, inescapable, relational trauma. Unlike Post-Traumatic Stress Disorder (PTSD), Complex PTSD always involves being hurt by another person. These hurts are ongoing, repeated, and often involving a betrayal and loss of safety.
It is estimated that 70% of adults or 223.4 million people in the United States have experienced at least one form of trauma in their lifetime, as reported by the National Council for Behavioral Health (NCBH) in 2013. In addition, 90% of childhood sexual abuse victims, 33% of children exposed to community violence, and 77% of children exposed to school shootings develop Post Traumatic Stress Disorder (NCBH).
Humans require safe people, safe places, and safe things during childhood and adolescence in order for healthy brain development to take place. Many adult survivors of complex trauma, having experienced this loss of safety, had no agency over themselves or their environment during critical times in brain development for extended periods of time.
This loss of agency during their early years stunted their growth, depriving them of the opportunity to create the lives they deserved, and has ultimately left many stripped of their sense of worth and sense of self. Without the ability to understand what has happened, young survivors grow up to be adults who live in the same constant state of hypervigilance and suffering, even after escaping physical danger.
Adult survivors of complex trauma often experience amnesia, alienation, chronic mistrust, chronic physical pain, re-victimization, debilitating flashbacks, nightmares, body memories, anxiety, dissociation, trouble with regulating volatile emotions, severe depression, toxic shame, auto-immune disease, along with other deeply distressing and potentially life-altering symptoms.
What is Dissociation?
Dissociation is a process in which a person disconnects from their thoughts, feelings, memories, behaviors, physical sensations, or sense of identity. Dissociation is common among people seeking mental health treatment.
What Causes Dissociation?
Most health professionals believe dissociation is a way the mind copes with too much stress. Many people with a dissociative disorder have had a traumatic event during childhood, although dissociation can also occur with other types of trauma.
This is called Trauma-Related Dissociation. Trauma-Related Dissociation is sometimes described as a ‘mental escape’ when physical escape is not possible, or when a person is so emotionally overwhelmed that they cannot cope any longer. Sometimes dissociation is like ‘switching off’. Some survivors describe it as a way of saying ‘this isn’t happening to me’. These reactions are usually temporary but, in cases of severe or repeated trauma, dissociation may last longer.
Dissociation is known as a common symptom of experiencing trauma and some individuals may vary on a continuum depending on their history. You may be asked to complete questionnaires to assess your degree of dissociation if your therapist warrants that it could be helpful to better understand how to provide the most effective treatment. Your therapist will work at your own pace and assist in providing the ample resources for a tailored treatment approach.
What to expect in treatment for Complex PTSD and Dissociative Disorders?
Complex trauma therapy can also focus more deeply on concerns around identity and self-esteem. People with complex trauma are more likely to have other problems such as substance abuse, dissociation, self-harm and suicidality. These are also dealt with in therapy. Symptoms of complex trauma and dissociation can be a struggle to live with. However, with the correct treatment, you can gain significant relief.
Treatment should:
- Focus firstly on helping you stay safe and manage your feelings.
- Help you understand your symptoms and the causes of them.
- Help you build and improve emotional and relational skills so you can manage your life and your inner experiences more effectively.
- Be respectful of you as person, and respect your goals in therapy.
- Provide a pace that is just right, so you do not get overwhelmed. You and your therapist will discuss your pace and find ways to keep therapy manageable and safe.
- Help you manage and reduce trauma-related symptoms, including dissociation and dissociative parts of self (if this applies to you).
- Work through traumatic memories, when you are ready, and in a way that is manageable for you.
It is normal for many people to feel reluctant about therapy, even scared, and some naturally find it hard to trust a therapist. After all, most people with complex trauma were not safe with care-takers in the past. However, a sensitive therapist will understand that and will support you to take your time and find ways to work in a collaborative way.
Treatment can be lengthy and at first it might seem like progress is slow, but small steps build together to make a big difference over time.