Complex Post-Traumatic Stress Disorder

Complex PTSD can be differentiated from traditional PTSD by the length of time and the severity of the situation the person is subjected to trauma and/or abuse.

C-PTSD happens over many months, but more typically occurs for years, especially in homes where children grow up in an authoritatian atmosphere with a parent who is abusive.  A non-functioning adult or a parent/caregiver who is neglectful can also trigger C-PTSD. Authoritarian parents typically raise children with all types of psychological problems, the most likely being C-PTSD.  A comorbid condition of C-PTSD may be  social anxiety disorder.

What causes C-PTSD?

Researchers are still trying to figure out exactly how traumatic stress affects the brain and leads to conditions like C-PTSD. Studies on animals suggest that trauma can have lasting effects on the amygdala, hippocampus, and prefrontal cortex. These areas play a big role in both our memory function and how we respond to stressful situations.

Any type of long-term trauma, over several months or years, can lead to C-PTSD. However, it seems to appear frequently in people who’ve been abused by someone who was supposed to be their caregiver or protector. Examples include ongoing childhood sexual abuse  or long-term emotional abuse by a family member. It has been documented that ongoing emotional abuse over a period of years can be worse than the stress of one physical incident.   

Other examples of long-term trauma include:

  • ongoing physical, emotional, or sexual abuse
  • being a prisoner of war
  • living in an area of civil unrest or war for long periods of time
  • ongoing childhood neglect and abandonment
  • authoritarian parents (who have 18 years to belittle their sons or daughters)

Are there any risk factors?

While anyone can develop C-PTSD, some people may be more likely to develop it than others.  Risk factors include:

  • underlying mental illness, such as anxiety or depression, or a family history of it
  • inherited personality traits, a predispositation to emotional factors
  • how the brain regulates hormones and neurochemicals, especially in response to stress
  • lifestyle factors, such as not having a support system, a severely dysfunctional family, or having a dangerous job

An Example of C-PTSD

"My father was an extremely authoritarian man who had to be in charge of his family. This meant no one in the family was allowed to have opinions but him. If you expressed an idea or opinion contrary to what he thought, he immediately grew irate and loudly condemned the family member who got out of line.  One time I was called to dinner and was enjoying a great rock hit.  This made him very mad because he hated rock music and only listened to polka and old country music.  So, with his voice raised, he went on for twenty minutes, all throughout dinner, screaming about rock and roll and how evil it was.  His way was always right, and when you expressed any kind of idea that diverged from his beliefs, he found a way to punish you.

I never understood why all the other boys in grade school looked up to their fathers. I was afraid of my father and knew he was there to hurt me in any way he could. Even my first memories of him supported those emotions, so he must have done something to me at an early age before my brain acheived awareness.  Appeals to my mother were futile as she almost gloried in her role as the typical abused wife wrapped in a conservative upbringing that said marriage was for life, and after messy blow ups that could last for days or weeks, she would eventually get a kiss. This is what she lived for.   

Although we kids encouraged her to divorce him, she always chose his side and never supported us.  Later, she refused attempts to comfort her when my father  trashed her publicly or ridiculed her (which was a daily event in our house).  He belittled her constantly, called her "woman" derisively, and counted the seconds she stayed on the phone until she finally gave up calling or answering, crying she could get no peace.  

His ridicule of me was persistent and it took all the strength I could muster just to stay alive as a person most days. He knew what words would hurt me the most and he used them. He cut me down in every way he could, but he only did it in the confines of our own home. Publicly, he deliberately gave the impression that he was a warm, loving husband and father.

This only added to the aggravation and frustration I felt. There was nowhere I could turn for any kind of help or support. The counselors at school were guidance counselors, not therapists. Anyone I tried to tell about what it was like at home, could  not understand the depth of despair I was in because they had never lived through this themselves.  

 This made me withdraw even further and encouraged the rage he felt inside and he made me his #1 target. In order for him to feel good about himself, he had to traumatize me. And he did. For eighteen years, there was no rationality in our household. It was all a lesson in how to quiet down and avoid confrontation with a monster. I never have felt a shred of love for my father. He never gave me room to do so. He just wanted me know he hated me, he disliked everything I ever did, and his pronouncements about me amounting to nothing would come true.

I could write another thousand pages about my home life as a child and still not come close to the terror and horror he inflicted on me and my mother. When I left home, I had no self-esteem, no positive belief system concerning myself, and a strong urge to fulfill his prophecy for me, as irrational as this was.

No person should ever be allowed to treat their children in this manner. But he did it, got away with it, and never had an iota of concern for anyone else but himself. Later on, it was clear that he had paranoid personality disorder, which is a severe emotional disorder that persists throughout the life-span. Knowing this, however, did not change the trauma and horror he put us through, and the many years it took of thinking things through rationally before I could ever come close to being "normal" and participating in typical human interactions.

I was 40 years old, and finally ready for my childhood to begin."

This is the typical life of a person that has lived through complex PTSD.   

What Can C-PTSD Cause?

Most commonly, one of the recognized anxiety disorders, such as

social anxiety disorder

panic disorder

generalized anxiety disorder

It also leads to depression. Everyone who has symptoms of complex post-traumatic stress disorder, is depressed. How could you not be?

Complex PTSD may also lead to other psychological impairments. The study of complex PTSD, which is one of the most common psychiatric illnesses, has been woefully neglected. Cognitive-behavioral therapy, which changes the brain when used therapeutically, should be encouraged as the treatment of choice in helping people with C-PTSD.  Only a therapy that literally changes the brain will be permanently effective.

  Luckily, this is now verifiable through the use of MRI scans.  Research has demonstrated changes in the brain after cognitive-behavioral therapy for both PTSD and C-PTSD.  As expected, cognitive-behavioral therapy also works for the anxiety disorders and most forms of depression.