In a world where no one should bear the weight of trauma, it's disheartening to discover that 50 to 70% of us may find ourselves grappling with at least one haunting experience in our lives.
And while traumatic events can cause periods of distress that gradually wear off, the effects can also linger and accompany us throughout our lives, paving the way for conditions like PTSD (Post-Traumatic Stress Disorder) and CPTSD (Complex Post-Traumatic Stress Disorder).
What Is Complex PTSD?
Complex Post-Traumatic Stress Disorder is a mental health condition that can occur if you’re exposed to chronic trauma.
As its name suggests, CPTSD is a more complex form of PTSD. While both are related to the experience of trauma, complex PTSD is associated with prolonged, repeated trauma, whereas PTSD can occur from a single traumatic incident.
In order to make you more familiar with the condition and ways to cope with the symptoms, in this article, we’ll break down:
What Are the Main Symptoms of Complex PTSD?
When it comes to dealing with trauma, there's no universal way to respond. The nature of your experiences and the duration or frequency with which you undergo them can influence how trauma symptoms manifest later in your life.
That being said, there are a set of symptoms that are commonly associated with CPTSD and some of these overlap with the signs of PTSD. These include:
Flashbacks of a traumatic event: Flashbacks are mental images reliving certain aspects of a trauma. These may be triggered by things that remind you of the trauma, such as a sound, smell, or even a place.
Hypervigilance of your surroundings: Hypervigilance involves constantly being aware of potential dangers. When you experience hypervigilance, you may feel like there are hidden threats all around.
Pervasive negative emotions and thoughts: You may experience frequent negative thoughts like “It’s all my fault,” or “I can’t trust anyone.” These thoughts may be associated with your past traumas.
In addition to this, if you have complex PTSD, you may also experience feelings of guilt, problems managing and controlling your emotions, feeling disconnected from others, and trouble making and maintaining relationships.
Apart from the emotional and psychological symptoms, it’s also important to recognize the physical CPTSD symptoms, as these can also have a significant impact on your life. Some of these symptoms may include sleep difficulties, ringing ears, digestion problems, and aggravated (or new) allergies.
What Causes CPTSD?
CPTSD is a complex and multifaceted condition, so finding a cause is not always straightforward. While complex PTSD arises from exposure to chronic trauma, the items outlined below are risk factors, not conclusive causes of CPTSD:
Recurrent and Prolonged Trauma: Unlike a single traumatic incident, recurrent and prolonged trauma involves a series of traumatic events or an ongoing situation that continues to exert a negative impact on your wellbeing. Some examples include domestic abuse or violence or witnessing violence or abuse repeatedly.
Adverse Childhood Experiences (ACEs): ACEs are traumatic events that happen to someone during childhood, from 0 to 17 years old. They often include emotional, physical, or sexual abuse, neglect, or household challenges, such as growing up with caregivers who have mental health problems, substance abuse issues, or being in an unstable home environment due to parental separation or a family member being incarcerated.
Low Socioeconomic Status: A study looking into the link between PTSD and poverty found that one-third of women living in poverty screened positive for PTSD, with 43% screening positive at least once during a 12-month period. This finding may indicate that people from low socioeconomic backgrounds are more likely to experience complex PTSD. However, more research is needed to fully understand this relationship.
Age & Gender: Those who experience a prolonged traumatic event in childhood or adolescence are more likely to develop CPTSD because they are at a developmentally vulnerable age. Furthermore, complex PTSD is more common in females than males, with around 2.3% of males experiencing CPTSD compared to 4.6% in females.
Genetic Predisposition: It is possible that your genetics can predispose you to complex PTSD. So far, the research has only looked into heritability in PTSD and has found a heritability of 30 - 40%. Again, more research is needed to identify whether there is a similar pattern between CPTSD and genetics.
How Can I Cope With Complex PTSD Symptoms?
The complex interplay of CPTSD symptoms can leave you feeling exhausted and make it difficult to maintain relationships. However, there are certain strategies that may help you cope:
1. Therapy for CPTSD
Research indicates that trauma-focused therapy is highly effective at helping those with complex PTSD manage and overcome their symptoms. That’s why psychotherapy - but more specifically, trauma-focused cognitive behavioral therapy (CBT) - is often recommended for people with complex PTSD.
In CBT, you work with a trained mental health professional, such as a psychiatrist, psychotherapist, or psychologist. Some of the areas you may focus on during therapy include:
Understanding your past traumatic experiences and how your body has reacted to these.
Reframing negative thought patterns.
Exposure therapy, which involves gradual exposure to your fear in order to learn to manage it.
2. Neurofeedback for Complex PTSD Symptoms
Trauma can have a profound effect on your brain biology, causing your mind to enter a state of hypervigilance where you constantly look for threats around you.
To be able to stay alert like this at all times, your brain has to suppress other processes, such as memory and impulse control. It’s this chronic suppression that can take its toll on the way your brain functions.
Brainwaves are patterns of electrical activity occurring in the brain. There are five of them (delta, theta, alpha, beta, and gamma), they are associated with different states of consciousness, including alertness, relaxation, as well as sleep, and they can provide insights about your current mental state.
So, for instance, alpha brainwaves are associated with a state of calmness and relaxed alertness. Therefore, the suspected dysfunction in alpha brainwaves for those with CPTSD may lead to difficulty paying attention to the present, absentmindedness, and confusion.
Luckily, these changes aren’t permanent - your brain is constantly adapting and learning in a process called neuroplasticity. Neuroplasticity allows neurons (nerve cells in the brain) and the connections they form with each other to adjust their activities in response to learnings or changes in the environment and compensate for injury.
Brain training technologies such as neurofeedback can promote neuroplasticity and train your brain to regulate your brainwaves to achieve the desired brainwave state so that it can be easier for you to stay calm in stressful situations, like when you're struggling with difficult emotions and traumatic memories.
3. Releasing Trauma From the Body
Trauma might store itself in your body, causing a range of physical, psychological, and emotional symptoms.
In The Body Keeps the Score, Dr. Bessel Van der Kolk suggests that part of coping with CPTSD symptoms is learning how to release past traumas from the body through activities such as:
Yoga: According to The Body Keeps the Score, yoga can help develop a healthier relationship between your body and mind, as it encourages you to become more aware of your body sensations, helping you tap into the physiological effects of trauma.
Theater: Participating in a theater group can help you regain control of your body after chronic trauma by challenging your often-automatic desire to be invisible. Instead, you have to stand in front of a crowd and make yourself seen and heard. As a result, you can potentially regain the feeling of control within your body.
Theater can also help you build self-esteem, making you feel more capable. By being part of a community, you can learn that you are valuable to others, and this can increase feelings of connection and hope.
Trauma can be a heavy weight to carry, influencing your everyday emotions, how you see yourself, and how you relate to others.
The intricate nature of CPTSD, stemming from prolonged trauma, means that the journey to healing can be a challenging one. Nevertheless, it’s important to remind yourself that it is possible to learn to manage and overcome the symptoms.
With a trained mental health professional by your side, and armed with strategies to help you release trauma from your body, you can start your journey to recovery. Take that first step toward healing by reaching out for support today!
Myndlift provides a personalized expert-guided brain training program that can help you elevate your wellbeing by improving your sleep quality, focus, calm, and self-control over mood. Take this 10-second quiz to check if you’re eligible to kick-start your journey for better brain health.
About the author:
Emma is a practicing trainee Child and Adolescent Psychotherapist studying at the University of Cambridge and a psychology writer with years of experience. She achieved a 1st Class Honors Degree in Psychology from Aston University in Birmingham.
About the reviewer:
Kaija Sander is a cognitive neuroscientist and scientific consultant for Myndlift. She holds a BSc in Biomedical Science with a specialization in Neuroscience and Mental Health from Imperial College London and a PhD in Neuroscience from McGill University. Her doctoral research focused on brain connectivity relating to second language learning success. She is passionate about the broader applications of science to have a positive impact on people’s lives.
Bunting, L., McCartan, C., Davidson, G., Grant, A., McBride, O., Mulholland, C., Murphy, J., Scjubotz, D., Cameron, J., & Shevlin, M. (2020). The Mental Health of Children & Parents in Northern Ireland. Ulster University. https://www.ulster.ac.uk/__data/assets/pdf_file/0004/683977/Youth_Wellbeing_Executive_Summary_FINAL.pdf
Davis, S. (2018, November 15). Complex Post-Traumatic Stress Disorder (CPTSD) and Adverse Childhood Experiences. CPTSD Foundation. https://cptsdfoundation.org/2018/11/15/complex-post-traumatic-stress-disorder-cptsd-and-adverse-childhood-experiences/
Golin, C. E., Haley, D. F., Wang, J., Hughes, J. P., Kuo, I., Justman, J., Adimora, A. A., Soto-Torres, L., O'Leary, A., & Hodder, S. (2016). Post-traumatic Stress Disorder Symptoms and Mental Health over Time among Low-Income Women at Increased Risk of HIV in the U.S. Journal of health care for the poor and underserved, 27(2), 891–910. https://doi.org/10.1353/hpu.2016.0093
Korn, D. L., & Leeds, A. M. (2002). Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex posttraumatic stress disorder. Journal of Clinical Psychology, 58(12), 1465–1487. https://doi.org/10.1002/jclp.10099
McGinty, G., Fox, R., Ben-Ezra, M., Cloitre, M., Karatzias, T., Shevlin, M., & Hyland, P. (2021). Sex and age differences in ICD-11 PTSD and complex PTSD: An analysis of four general population samples. European psychiatry: the journal of the Association of European Psychiatrists, 64(1), e66. https://doi.org/10.1192/j.eurpsy.2021.2239
Melegkovits, E., Blumberg, J., Dixon, E., Ehntholt, K., Gillard, J., Kayal, H., Kember, T., Ottisova, L., Walsh, E., Wood, M., Gafoor, R., Brewin, C. R., Billings, J., Robertson, M. C., & Bloomfield, M. (2022). The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study. European Psychiatry, 66(1). https://doi.org/10.1192/j.eurpsy.2022.2346
Peniston, E. G., & Kulkosky, P. K. (1991). Alpha-Theta Brainwave Neuro-Feedback for Vietnam Veterans with Combat Related Post-Traumatic Stress Disorder. Medical Psychotherapy, 4, 47-60. 10.1021/ma0483701
PTSD UK. (n.d.). EMDR for Complex PTSD. https://www.ptsduk.org/emdr-for-complex-ptsd/
PTSD UK. (n.d.). Post Traumatic Stress Disorder stats and figures. https://www.ptsduk.org/ptsd-stats/#:~:text=It%27s%20estimated%20that%2050%2D70,%E2%80%93%20painful%2C%20but%20not%20destructive.
PTSD UK. (n.d.). Unexpected physical symptoms of PTSD. https://www.ptsduk.org/10-unexpected-physical-symptoms-of-ptsd/