CPTS(D): The Missing Diagnosis in Trauma

Complex post-traumatic stress can develop from pain and stress that began at an early age. Your perspective of yourself and the world around you have been shaped from these experiences.

Complex post-traumatic stress (Disorder)

Your world circumnavigates around threat, fear, and survival. You feel confused as to what constitutes a loving supportive relationship. You struggle to feel safe and are constantly and involuntarily taking a pulse of the environment, internally and externally. 

You cope through unhealthy behaviors that you may or may not be conscious too. You feel bombarded by self-criticism, emotional turbulence, and toxic relationships. You learned a belief system, world view, and behaviors that have proven to be ineffective as an adult.

You may be suffering from complex post-traumatic stress (disorder). C-PTS(D) occurs when you have been exposed to long term traumatic stress. Sometimes we don’t even know we are living in a traumatized state. It just feels like confusion because the traumatic stress has been repetitive and ongoing and often began during childhood. 

If you lived in fear as a child, the consequences are negative adaptions to your thoughts, emotions, and physical development. This type of traumatic stress and pain develops into an identifiable set of symptoms.

The good news is that it was learned and can be unlearned. The symptoms can be messengers, not permanent landings. 

It begins with knowledge and changes through a commitment to self-care and a commitment to slowing down. Let’s explore CPTS(D).

Complex post-traumatic stress can develop from pain and stress that began at an early age. Your perspective of yourself and the world around you have been shaped from these experiences. 

 Some examples of experiences that can precede the onset of CPTS(D). 

• Relationships with primary caregiver that are filled with fear, overwhelm, and inconsistency

• Experiences of neglect, physical, sexual, emotions, or verbal abuse

• Witnessing domestic violence at home

• Growing up with a primary caregiver who is mentally unstable or struggling with an addiction

• Being a victim of bullying

• Experiencing a traumatic event without a safe person to support, care, and protect you

• Struggling with a disability or discrimination without someone to advocate for your needs

To work through CPST(D) we need to lean into the past, with the goal being to relinquish the past from the present. 

Understanding the past also helps to determine if you are struggling with CPST(D), as it is not a recognizable “disorder” by the DSM standards, and often people become victims to labels that do not capture the entire person and their history. 

CPST(D) doesn’t feel like it even begs the title of disorder to me. It is lingering traumatic stress that needs to be resolved. Rest easy, as there is nothing wrong with you and it makes perfect sense why you are suffering now. Identifying this traumatic stress will be a breakthrough to your healing. 

Factors that contribute to cpts(d)

It is true, two people could experience the same unfolding of events, and one can walk away relatively unaffected, while the other is traumatized. There are factors that contribute to being traumatized and the expression of CPTSD has many faces. 

A factor that plays into the susceptibility of being traumatized is age. The younger you are, especially the first three years of your life, and at specific developmental growth periods, the more likely you are to be traumatized. 

The duration, intensity, and repetitiveness of the stressor(s) has a huge influence on how easily you move through the trauma. 

Trauma also runs in families. Generational trauma says that if your primary caregivers suffer with addiction, have experienced abuse and or neglect, and are mentally unstable, you are at a greater risk of being traumatized. 

Caregivers who have had these experiences often are overprotective, over-reactive, and unpredictable, leaving a child to feel overwhelmed, intruded upon, and abandoned simultaneously. 

Children also learn what is modeled for them. They may see a caregiver engaged in substance abuse, a high-risk behavior that they themselves may take up. The care-giver may not model self-care, or hygiene, or healthy behavior such as exercising. Abusive homes tend to model many dangers behaviors to children that make them more susceptible to trauma and traumatic stress.

Without the support of a primary caregiver, or a safe adult, after exposure to an overwhelming negative event, a child is more prone to being traumatized. Participating in sports or having positive peer relationships can act as protective resources for the child.

Age, duration, intensity, generational trauma, emotional stability and consistency of primary caregiver, modeling behaviors, and resiliency factors are all determining variables if a child will go on to develop CPTS(D) later in life. 

The symptoms of CPTS(D) very often show up as:

• Irritable

• Self-harm or injury

• Disorder eating

• Social anxiety

• Impulsiveness 

• Risk taking

• Promiscuity

• Addiction

• Rage

• Trouble focusing 

• Inconsistent employment 

• Deep loneliness

• Panic attacks

• flashbacks

• Depression 

• Relationship difficulties

• Overly critical of self

• Withdrawal 

• sleep disturbance

• digestive problems

• health issues

Some of these mind and body experiences may look like:

• False beliefs about self

• Constantly feeling overwhelmed and helpless

• Troublesome somatic sensations

• Not being able to distinguish past and present

• Hypervigilance of internal rhythms and other people

• Shutting down in response to painful emotions, memories, and sensations

• Addiction

• Denial

• Toxic relationships 

• Physical health problems as one comes into adulthood 

At the core of mental and emotional symptoms in CPTS(D) are always a blend of avoidance, intrusive, and depressive expressions. 

Emotions are a combination of cognition, environment, and awareness to felt sensations. If we cannot be in relationship to emotions it disrupts every aspect of our lives. Emotions give purpose and meaning to life.

avoidance

In an effort to move away from a painful childhood, avoidance strategies are developed. These look like denial, repression, idealizing (especially parents), minimizing pain, and dissociating. External methods of avoidance may look like drug and alcohol abuse, disordered eating, over exercise, all in an attempt to avoid pain. 

intrusive

Intrusive symptoms involve panic attacks, hypervigilance, flashbacks, nightmares. It is a re-experience of painful childhood memories, from a time before you had language to communicate, so now they show up as sensations. A vague feeling that something is wrong and often physical pain. There is a feeling a being hijacked from yourself and your life. This is the high-arousal side of the picture.

Depressive

The low arousal side is the arena for hopelessness, despair, depression. These experiences are often a result from living in an environment that was threatening and offered no escape. As a young child, without the opportunity to change your environment, you feel helpless and powerless. Shame and unworthiness fall into this category as well. 

shame

This is a distorted sense of self as all bad. When caretakers are abusive, unavailable, and scary, the child is left with confusion and often interprets the situation as their fault. 

Physical symptoms

Unresolved trauma takes a toll on your health. It is insidious, silent, and can be gradual or cumulative. Below any trauma is underlying stress. 

Healing CPTS(D) is recreating a balance of cognition and emotion so that we can connect with others and feel safe in our environments and decisions.