What Puts The “Complex” in Complex Post Traumatic Stress Disorder (C-PTSD)?


Rather than try to explain this myself, i want to share this from the Out of the Fog website, which i think explains it well:

Although similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood and diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.

C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.

Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.

Similarly, a child who witnesses a friend’s death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics.


As a child, i was naive and full of dreams and passion. Unlike a lot of kids though, my fuel came from the negativity of the hostile world that i lived in. i didn’t have unconditional love. my world had domestic violence, school bullying and a constant barrage of confirmation that i was stupid and useless. In my constant “fight or flight” condition, something inside me continually chose “fight”, and became internalised as a big part of my “self and identity”

Because i never felt secure, i never trusted anyone. It might have been delusional, but it was real to me. i wasn’t conscious of it, and i didn’t understand that there were alternative ways to think. i turned hardship into arts and i wrote poetry, composed music and studied hard. A core energy pushed me forward and no-one ever seemed to care enough to ask me what i wanted to do, but if they had i would have said that i wanted to fight for people who suffer. i saw myself as the underdog who needed to fight for the life i wanted. life is hard, but i am not weak.


When traumatising events happen, because it’s a tremendous shock that is often beyond the emotional threshold that one can bare or process, the brain has a remarkable ability to shut down mentally in order to function normally. In the case of PTSD it can block traumatic memories, trying to keep them from being overwhelming.

That “shut down” can also mean turning off your normal interpretation of the world, by blocking emotions like sadness, grief or anger. These emotions are shut away from you.

The brain is trying to absorb the traumatic memory in a way that won’t damage you. Although you remember what happened, by shutting down the brain tries to reinterpret the experience as “fact” rather than “experience”. For example, i remember the sun went down yesterday, but i can’t remember the experience associated with that.

Our own survival instinct to shut down during trauma can be surprisingly effective, but although the brain kept a lot of things from your conscious, it doesn’t mean they weren’t experienced. Slowly, these memories start to emerge from behind the memory block, leaking back into the conscious. And it’s here that the trauma sets in, because you now need to process that piece of memory that wasn’t processed in the first place. And not only do you need to process it, but you need to process it out of context to the original trauma. You can find yourself standing in the aisle of a supermarket, sniffing baby powder and being bombarded by distressing thoughts and emotions.


For someone dealing with PTSD, when memories start flashing back there is a steady foundation to go back into. Although there has been a traumatic event, the sense of “self” is often strong and structured. Identity is relatively solid.

People with C-PTSD have often developed that sense of “self” through various small traumatising events, and eventually something triggers these accumulated events. So, that solid core “sense of self” is often not there to draw on. Identity is interwoven with the traumatising events, and the more you seek the stable part of yourself to keep a grip, the more you are going back into those small traumatising events.

While your memory is shut away, you can function normally in an auto-pilot condition. But when you start seeking your true-self you are also seeking the trauma of the past.

This is the analogy that i once used to describe what i felt.

Imagine a fish living in a lovely sea, and it’s thrown into the hot oil, and then thrown back to the sea. The fish was suffocating and traumatised from the hot oil, but a few second after the fish is thrown back to the sea it swims happily away. The next time the fish senses a rise of temperature, or the scent of oil, the fish stops swimming and suffers in the clear sea because the fish remembers that he was once dying in that hot oil tank. But as long as the fish processes the memory and comes out from the fear, the fish can swim away again. That’s kind of like PTSD.

Now, for C-PTSD, imagine the fish living in a muddy polluted oily tank since young. He learns how to breath slowly and how to cope with the critical conditions. He has never been to a clear sea, so he has no idea what it feels like. For him, a harsh and tough life is normal.

One day, the fish is thrown into the big clear lovely sea. Everyone expects the fish to live happily ever after, but the fish has spent its whole life inhaling and exhaling slowly to cope with the oily polluted environment it lived in. So it has no idea how to breath in the clear sea.

Hopefully the fish leans how to breathe in the clean water, but in the meanwhile the fish has an overwhelming urge to navigate back to harsh conditions of the oily tank, just to breath normally. And every time the fish senses oil or swims into a muddy environment its instincts cause it to start breathing slowly again, like it did in its early life.

It’s not a great analogy, but the fish story helped me to visualise my own journey.

We live in the world, so we all need to delve inside ourselves to make sense of things. What am i interested in? What do i want to study? Do i have the talent for that? Will people like me? Am i worthy? What will make me happy? There are a myriad of things we need to know about ourselves.

And i remember whenever i’d try to seek my “self” i’d feel negativity taking hold of my mind every time. i didn’t know how to live in a normal world, nor did i want to live in the past, and i was stuck in the middle of both while trauma flashed through my mind. Sometimes i’d just collapse on the floor and wait for it to stop.


Do you find yourself sorting through memories when you’re triggered by something? Is it hard to determine what is really the core you and what is something that has happened to you?


• Borderline Personality Disorder and Emotion Dysregulation – Complex PTSD, affect dysregulation, and borderline personality disorder
• Wikipedia – Complex Post-Traumatic Stress Disorder
• PsychCentral – Complex Post-Traumatic Stress Disorder
• Broken Toys – PTSD Strategies
• FetLife – PTSD – Survivors, Support and Coping
• FetLife – PTSD and Behaviour Modification

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