Injured, Not Broken: Why It’s So Hard to Know You Have CPTSD


From Brickel & Associates, LLC: “When a child experiences neglect, anxiety, or danger repeatedly in a close relationship, that child often grows up with a sense that they are not okay. Psychology has a name for the longterm, consistent type of trauma that leaves a person feeling insecure, overwhelmed, and unsafe in the world: complex post-traumatic stress disorder, or CPTSD.

In our practice as trauma-informed therapists, we recognize that many of those seeking our care have a history of trauma throughout their childhood. It is likely they have complex trauma that has resulted in CPTSD. It’s hard for trauma survivors themselves to recognize this.

Because living in a triggered state of alarm is so familiar, many don’t realize trauma is the source of their feeling ‘not okay.’ That’s why I want to address CPTSD here and to encourage those who feel overwhelmed or hopeless to realize they are not broken. They are injured, and these injuries are treatable . . .

What makes CPTSD so hard to recognize?

Because it happens in the formative years, complex trauma impacts your ability to understand and maintain emotional stability. You may struggle to find a sense of safety and trust throughout your life, and therefore, it is difficult to regulate emotions in relationships.

Complex trauma may lead to a disorganized attachment style, where you struggle to know whether what you think and feel is right or wrong. Standing up for yourself and setting boundaries may feel completely unfamiliar.

It’s often hard to figure out who to trust — if anyone, especially in relationships. In the struggle to make sense of why life feels so bad, those with CPTSD often fault themselves. Many feel intense shame and self-hatred, because they can’t seem to manage emotions ‘like everybody else.’ It’s hard to untangle one’s trauma from one’s identity. That’s the complex piece.

What causes CPTSD?

Complex trauma comes from a history of living with abuse or neglect from those who were supposed to protect and maintain your safety. It changes the way you view life. It can leave an imprint on your nervous system (which is why a bottom-up approach to therapy is so important).

With complex trauma, you were not taken care of appropriately as a child, and that affects you as an adult.

The adverse childhood experiences that can result in CPTSD can be:

  • Physical
  • Sexual
  • Emotional
  • Attachment trauma
  • Profound neglect
  • Or all of the above!

Here are 12 things to know about CPTSD — and how you may recognize it in yourself:

  1. People with CPTSD may struggle with emotional flashbacks . . .
  2. CPTSD can cause fragmentation, dissociation, and other needed methods of coping . . .
  3. CPTSD causes lack of trust, shame, and voicelessness . . .
  4. CPTSD survivors may be diagnosed with Borderline Personality Disorder . . .
  5. Complex trauma survivors long to be loved . . .
  6. CPTSD is so deeply ingrained in the nervous system and self-view, it’s hard to see . . .
  7. In those with CPTSD, the nervous system remains prepared for danger always . . .
  8. So many complex trauma survivors like to believe ‘it wasn’t that bad’ . . .
  9. CPTSD survivors have no point of reference for what life could look like . . .
  10. Complex trauma survivors think they’re broken . . .
  11. Attachment trauma is complex trauma . . .
  12. Complex trauma survivors are STRONG.”

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  1. I would not call a broken arm a post-traumatic arm syndrome.

    The books that cover fractures have somewhere the word “TRAUMA” in them, not POST-TRAUMA.

    See, what kind of linguistic appreciation and the subsequent respect can be granted to a profession, even a series of them, when they can’t use words that actually mean what they are supposed to mean?.

    Post-gravity syndrome?. Post-quantum depression?. Alternate biology?.

    And yeah, post-partum depression refers to depression after birth in the mother, but post-traumatic stress disorder is a correlation devoid of causality. How is it that the disorder emerges years after is tried to be explained or justified with hoockipookie devoid of causality: more correlations and “constructs” will be used, etc.

    Spaguetti explanations for PTSD, let alone cPTSD.

    As is the diagnosis of depression, 30 to 70% of a given sample of the population can’t be depressed as in ill, they had to be so “dysfunctional”, according to the principles that MI is severe enough to be diagnosed, that the economy would collapse…

    And if its mild enough, how is that a disease/disorder?. I can complain about a lot of things, and that does not make me or anyone else disorered just for complaining. The courts would be filled with sick/disordered people.

    And I am not mixing apples and oranges, I am arguing from common sense, logical and principles of what disease/disorder means, or is supposed to mean in practice.

    I think everyone writing about mental issues, me included, should really make a heavy use of linguistic atunement before writing more non-sense…

    And in case I didn’t make my point more clearly: the broken arm was injured by trauma BEFORE being diagnosed, but that does not make the disease nor the diagnosis post traumatic. It was, and still is traumatic, not post-traumatic.

    Saying post-concussive syndrome is equally misleading, I think more accurately concussive-syndrome, which in medical parlance is just called concussion.

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      • “the trauma is the cause of the psychosis” that sounds a traumatic psychosis, not a post-traumatic psychosis to me.

        Post-mercury encephalopathy?. That could be more aptly mercury brain toxicity, it could take years to be evident.

        Some inside the head hematomas could give symptoms and be diagnosed months after a head trauma. And I have trouble saying it’s post-traumatic, as opposed to traumatic.

        Some are diagnosed after decades, and still…

        Like in post diabetic nephropathy?.

        Maybe delayed traumatic psychosis would be more apt?.

        And even if conditioned, the conditioning happened after the trauma or during it, or neither?. And the psychosis after the conditioning, during it or when?.

        Might sound punctilious, but what if, assuming, the conditioning happens only when not traumatized?.

        What if the trauma deconditions and it cycles up and down: trauma-conditiong-trauma, etc., close to zero in the long run until I miss the final trauma that was to decontition me one last time, and that lead to my now, decades later, psychosis?.

        Like in the old movies: one hit to the head gives me amnesia, another takes it away and I have my memory back. And I missed the last and now I have amnesia?.

        Seen like that, as mere words without actual evidence of causality seems like impossible to rule out: unfalsifiable…

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  2. Mad in America, please don’t repost articles like this.

    It is in essence a promotional article for private therapy. Sure, there are some accurate descriptions of cptsd and attachment trauma, but like all promotional articles it essentially leaves the reader with “seek therapy”, whereas from reading the science news of Mad in America, we know that therapy doesn’t have much efficacy. In fact the attachment exist Dan Brown noted that traditional trauma therapy actually makes things *worse* for those with disorganized attachment. I myself have been in that boat.

    Psychiatry and psychology continually does a bait and switch by having good recognition of describing conditions and what caused them, then suggesting the answer is simple and easy – often blaming the victim further for being “resistant” to unhelpful treatment.

    Please don’t republish articles that are really meant to build business without checking first it will do no harm.

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  3. Doesn’t have to be from childhood. I had an uneventful childhood and then made the mistake of marrying a covert narcissist. I recognized that I was experiencing symptoms consistent with CPTSD about 10 years in, but it took me another 10 years to realize her behavior and treatment of me was the cause; by that time I was literally begging her to stop her patterns of abusive behavior. Therapy wouldn’t have helped me or her. Awareness of these abusive personality types, and perhaps forces hospitalization and/or incarceration is the answer.

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  4. “Complex trauma comes from a history of living with abuse or neglect from those who were supposed to protect and maintain your safety.”

    Wouldn’t that definition also describe the forced “treatment” betrayal and “torture,” against most psych survivors?

    “With complex trauma, you were not taken care of appropriately as a child, and that affects you as an adult.” Oh, so it only applies to child abuse survivors.

    So the cause / etiology of “complex trauma” is “child abuse or neglect” – not any sort of “life long, incurable, genetic mental illness.” Yet to this day, NO “mental health professional” may EVER bill ANY insurance company, for EVER helping ANY child abuse survivor, honestly.

    Do you see the problem, unfortunately systemic child abuse covering up, psychologists and psychiatrists?

    The proper way to help a child abuse survivor is NOT to misdiagnose child abuse as CPTSD, nor any of the other scientifically “invalid” DSM disorders, for profit.

    It is to get the child away from the abusers, and to give the child lots of freely given love, support, and honesty … when the child is mature enough to handle the truth.

    At least that’s the opinion of the mother of a child abuse survivor, who was able to close down a school that had a pedophile on their school board; a mother whose child has seemingly healed, hopefully, and thankfully.

    My son went from remedial reading in first grade, after the child abuse, to graduating university Phi Beta Kappa, not to mention winning a psychology award.

    And my beloved son is now a productive member of society and a community activist, doing lots of good works for his neighborhood. And getting us both into his local newspapers, with an insanely complex gingerbread house replica of his local library, and other creative community improvement projects.

    As an artist, former kitchen / bath designer, who also has a business degree, and is also a psychopharmacological researcher, et al.

    I’m quite certain teaching everyone to develop both the left and right sides of their brain, is infinitely more important than the “powers that shouldn’t be” – including those in charge of the education system of the psychiatrists and psychologists today – would like people to believe.

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  5. There is also the issue of the positive predictive value of child abuse:

    Most persons enduring abuse in childhood probably don’t have anything specific.

    Take schizophrenia, they say child abuse increases the chances of “having” it, but most persons suffering child abuse don’t develop it.

    Using it to put solidity to a given diagnosis in a given person is flawed, it’s bad practice.

    Seen like that, even if it increases the chances 20 fold, it lacks explanatory power as research hypothesis generator: no actual theory has been proposed to connect abuse with hallucinations and delusions even if they correlate.

    Or am I wrong?.

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