Complex PTSD Symptoms

Trauma and complex PTSD are sometimes difficult to diagnose.  The symptoms can develop over many years and during that time it is not uncommon to be given an incorrect diagnosis of depression or anxiety disorder.  This means that a sufferer, rather than having the origin and context of their problems understood, may have had to endure unhelpful treatments, including prescription medicines.

When we speak of psychological issues relating to complex PTSD symptoms we are referring to traumatic events that have been experienced repeatedly such as;

  • disturbances in childhood at the hands of an unpredictable or unstable parent
  • someone who has suffered repeated bullying at school at home or at work
  • someone who has suffered domestic violence
  • repeated exposure to combat
  • repeated exposure to emergency accident scenes

Complex PTSD symptoms include:

  • feelings of anxiety, shame, depression, difficulties controlling emotions
  • difficulties with concentration (dissociation)
  • feeling you cannot follow through on your good ideas
  • unexplained physical symptoms, pains in the body
  • disturbing dreams and nightmares
  • being particularly startled by sudden noises
  • self-destructive behaviour
  • isolating yourself
  • problems trusting others

It is the repetition of traumatic experience that leads to the destructive on going experience of complex PTSD symptoms

The sufferer develops a particular sensitivity to anything that triggers a connection with the original traumatic experience without necessarily knowing what happened in the original events.

Complex PTSD Symptoms – what does it mean?

Trauma can feel like a rather vague term, it indicates, from the Greek word: trauma, that there has been a wound or damage. An event has occurred that has overwhelmed our defences. In every case the traumatic wound will be unique.

One of the consequences of suffering complex PTSD symptoms is that often, when the traumatic events happened, part of the individual’s sense of themselves becomes cut off from awareness, this is referred to as dissociation.

A person who has gone through complex PTSD is likely to have cut themselves off from the impact and severity of the original experiences in an attempt to survive them.

If this has happened to you then you may experience some or all of the symptoms listed above, but not have a sense of what your symptoms actually refer to.

Psychotherapy provides an opportunity to understand your complex PTSD experiences and how it is impacting on your life.

People who suffer from complex PTSD symptoms may come to psychotherapy reporting that they feel depressed, anxious or over sensitive, but not have a sense of what the depression relates to.

This is why talking things through is important.  It provides an opportunity to build up a useful working understanding of what happened and what you have gone through.

Most of the symptoms that someone suffering complex PTSD experiences relate to things that have happened in the past

In cases of complex PTSD one of the problems is that the cause, the thing that the symptoms relate to has been dissociated, cut off from our awareness.

Complex PTSD why is it can be so hard to investigate – some historical context

‘‘…trauma is a subject that is periodically investigated and then drops from public consciousness.  …it drops out of public mind because it is subject that provokes intense controversy.’ Trauma and Recovery, (Herman 1992)

Judith Herman’s excellent book, ‘Trauma and Recovery’ begins by exploring the question of how it is that the subject of trauma drops out of the public mind.  Herman shows that trauma has had a very patchy existence as subject throughout the last 150 years.  Trauma gets attention from the psychiatrists Charcot and Janet in Paris, Jung in Switzerland, and Freud in Vienna, but interestingly throughout the twentieth century trauma struggled to keep its place in public consciousness.

It is war, particularly western wars and interventions that did much to keep the subject in mind. It is particularly with the fallout from the Vietnam war, when USA GI veterans started speaking about their experience of battle, that complex PTSD symptoms gained a foothold in the public mind.  Previously in relation to combat stress it was referred to as shell shock. In these historical medical interpretations, we don’t hear about the psychological impact of the war on the Vietnamese or, more recently, the Iraqi population. It seems it’s hard to include a broader picture of the impact or existence of complex ptsd.

Traumatic events, be they a sudden unexplained bereavement, or a war, very often leave a complicated mark on all of the participants.

In our time, we can see the profound problems that the traumatised families of the Hillsborough football stadium disaster have gone though since 1991 trying to get the case reviewed so that the label of hooligans can be shaken off and the victims’ traumatic testimony be heard.

Since the painful and upsetting revelations of the Savile case, we have witnessed the struggle that has been involved setting up the Independent Inquiry into Child Sexual Abuse (IICSA).  As that inquiry develops, it becomes clearer that there are too many cases of people in positions of authority who have been able to abuse and repeatedly traumatise people with impunity.  It has been all too easy for trauma victims to be disbelieved.

Complex PTSD cuts people off from other people and it cuts them off from their own experience.

With complex PTSD it is likely the individual will have lost their trust in people

Someone who has gone through complex PTSD is likely to have lost their trust in people.  This means that developing a trusting relationship in counselling and psychotherapy can take time.  Try to be patient, it is possible, it just takes time.

In some cases the repeated trauma will have been inflicted by a loved one, a family member, or a person in authority such as a teacher who the individual will have felt they could or should have been able to trust.

They might feel that there were people who could have stepped in and stopped things and who didn’t.

This is part of what makes treating complex PTSD symptoms difficult.

Psychotherapy and complex PTSD symptoms

In psychotherapy the first and often the hardest part of the work is in repairing the injury to trust.

The sufferer needs time to develop the sense that they can trust the psychotherapist or counsellor.  This kind of trust cannot be invented or assumed.  It has to be built up over time.  Frequently the sufferer will need to test the therapist and the therapy again and again.  The sufferer knows that the last time they trusted someone things went very wrong and they are not going to make that mistake again.

Gradually, as it becomes possible to develop a sense of trust in the therapist it becomes more possible to build up a sense of the complex PTSD that was suffered.

In therapy it becomes possible to work with your therapist to build up a new understanding of what happened.  To start to develop confidence that the complex PTSD symptoms you experience are a consequence of events that happened to you.  As this happens, the part of the personality that have been cut off, dissociated, start to become available again.  Gradually the sufferer starts to reintegrate the parts of themselves and their experiences that have been in hiding since the events occured.

DW Winnicott’s (psychoanalyst and paediatrician) work is valuable.  His seminal paper ‘The Use of an object and Relating through Identifications” (1971) gives great insight into the client’s need to test and re-test the therapist.

There is no denying that complex PTSD symptoms are difficult, upsetting and confusing, particularly when there may have been unhelpful and inaccurate diagnoses along the way.  But if given time these symptoms can be worked with and repair made possible.

Why the traumas of the past feel like they are still happening

It is often part of the clinical picture that the sufferer is experiencing complex PTSD symptoms in the present based upon repeated traumatic events that happened in the past.

When the original traumatic events happened the mind was overwhelmed.  The events were shocking and unpredictable in a way which meant that they could not be taken in. So although they happened in the past it is like they are still going on.  Until the experience has been processed they cannot become part of the past.

You might say it is a bit like laying a ghost to rest.  The trauma has not yet become something of the past and the sufferer is still experiencing the emotional fallout as though it were going on now in the present.  The sufferer has been living an anxious life as they have been haunted by the past.  This is why psychotherapy and counselling can be helpful, because they help the sufferer see that the events do belong in the past.

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Having the chance to speak in a confidential setting is often the key to developing a clearer understanding of Rebecca Syndrome or Retroactive Jealousy.

By giving yourself a safe space to look at these things you may start to discover a greater sense of possibilities, and this may be the beginning of developing a greater sense of understanding how to relate to yourself and others, how to start living more fully again, and how to start to have healthy relationships with yourself and other people.

The chance to reflect on ourselves, our feelings and experience can be powerful and transformative. Out of this, you may be able to develop a clearer understanding of how you and your sense of your problems have developed, and what you can change.

I have been working with people on issues such like this for more than twenty years.  My work is built around helping you to develop greater insight into who you are, and how you live. 

Contact me to arrange a free telephone consultation to discuss how my approach might help you.