The purpose of language is to help us to get a better grip on reality; the more words there are in our vocabulary, the higher the chance we have of being able to describe what we want, what ails us, what is driving us mad – and then in turn, to summon the help we may badly need. Published in The School of Life

The purpose of language is to help us to get a better grip on reality; the more words there are in our vocabulary, the higher the chance we have of being able to describe what we want, what ails us, what is driving us mad – and then in turn, to summon the help we may badly need.

It can help if the words we have to hand are pretty (and even have a long and distinguished history), but at heart, all we really require is that they should help us. Such is the case with one of the most useful terms in modern psychology: Complex PTSD.

PTSD stands for Post Traumatic Stress Disorder, a condition officially recognised in 1980 to describe exposure to a relatively brief but devastating event: typically, a war, a rape, an accident or terrorist incident. Complex PTSD, recognised in 1994, describes exposure to something equally devastating but over a very long time, normally the first 15 years of life: emotional neglect, humiliation, bullying, disrupted attachment, violence and anger.

A lot of us, as many as twenty percent, are wandering the world as undiagnosed sufferers of ‘Complex PTSD’. We know that all isn’t well, but we don’t have a term to capture the problem, don’t connect up our ailments – and have no clue who to seek out or what treatment might help.

Here are twelve leading symptoms of Complex PTSD. We might think about which ones, if any, apply to us (more than 7 might be a warning sign worth listening to):

1. A feeling that nothing is safe: wherever we are, we have an apprehension that something awful is about to happen. We are in a state of hypervigilance. The catastrophe we expect often involves a sudden fall from grace. We will be hauled away from current circumstances and humiliated, perhaps put in prison and denied all access to anything kind or positive. We won’t necessarily be killed, but to all intents, our life will be over. People may try to reassure us through logic that reality won’t ever be that bad; but logic doesn’t help. We’re in the grip of an illness, we aren’t just a bit confused.

2. We can never relax; this shows up in our body. We are permanently tense or rigid. We have trouble with being touched, perhaps in particular areas of the body. The idea of doing yoga or meditation isn’t just not appealing, it may be positively revolting (we may call it ‘hippie’ with a sneer) and – deeper down – terrifying. Probably are bowels are troubled too; our anxiety has a direct link to our digestive system.

3. We can’t really ever sleep and wake up very early – generally in a state of high alarm, as though, during rest, we have let down our guard and are now in even greater danger than usual.

4. We have, deep in ourselves, an appalling self-image. We hate who we are. We think we’re ugly, monstrous, repulsive. We think we’re awful, possibly the most awful person in the world. Our sexuality is especially perturbed: we feel predatory, sickening, shameful.

5. We’re often drawn to highly unavailable people. We tell ourselves we hate ‘needy’ people. What we really hate are people who might be too present for us. We make a beeline for people who are disengaged, won’t want warmth from us and who are struggling with their own undiagnosed issues around avoidance.

6. We are sickened by people who want to be cosy with us: we call these people ‘puppyish’ ‘revolting’ or ‘desperate’.

7. We are prone to losing our temper very badly; sometimes with other people, more often just with ourselves. We aren’t so much ‘angry’ as very very worried: worried that everything is about to become very awful again. We are shouting because we’re terrified. We look mean, we’re in fact defenceless.

8. We are highly paranoid. It’s not that we expect other people will poison us or follow us down the street. We suspect that other people will be hostile to us, and will be looking out for opportunities to crush and humiliate us (we can be mesmerically drawn to examples of this happening on social media, the unkindest and most arbitrary environment, which anyone with C-PTSD easily confuses with the whole world, chiefly because it operates like their world: randomly and very meanly).

9. We find other people so dangerous and worrying that being alone has huge attractions. We might like to go and live under a rock forever. In some moods, we associate bliss with not to having to see anyone again, ever.

10. We don’t register to ourselves as suicidal but the truth is that we find living so exhausting and often so unpleasant, we do sometimes long not to have to exist any more.

11. We can’t afford to show much spontaneity. We’re rigid about routines. Everything may need to be exactly so, as an attempt to ward off looming chaos. We may clean a lot. Sudden changes of plans can feel indistinguishable from the ultimate downfall we dread.

12. In a bid to try to find safety, we may throw ourselves into work: amassing money, fame, honour, prestige. But of course, this never works. The sense of danger and self-disgust is coming from so deep within, we can never reach a sense of safety externally: a million people can be cheering, but one jeer will be enough once again to evoke the self-disgust we have left unaddressed inside. Breaks from work can feel especially worrying: retirement and holidays create unique difficulties.

What is the cure for the arduous symptoms of Complex PTSD? Partly we need to courageously realise that we have come through something terrible that we haven’t until now properly digested – because we haven’t had a kind, stable environment in which to do so (it’s always hard to get one but we’ve also been assiduous in avoiding doing so). We are a little wonky because, long ago, the situation was genuinely awful: when we were small, someone made us feel extremely unsafe even though they might have been our parent; we were made to think that nothing about who we were was acceptable; in the name of being ‘brave’, we had to endure very difficult separations, perhaps repeated over years; no one reassured us of our worth. We were judged with intolerable harshness. The damage may have been very obvious, but – more typically – it might have unfolded in objectively innocent circumstances. A casual visitor might never have noticed. There might have been a narrative, which lingers still, that we were part of a happy family. One of the great discoveries of researchers in Complex PTSD is that emotional neglect within outwardly high achieving families can be as damaging as active violence in obviously deprived ones.

If any of this rings bells, we should stop being brave. We should allow ourselves to feel compassion for who we were; that might not be easy, given how hard we tend to be with ourselves. The next step is to try to identify a therapist or counsellor trained in how to handle Complex PTSD (this may well be someone trained in trauma informed work, which emphasises directing enormous amounts of compassion towards one’s younger self) – in order to have the courage to face trauma and recognise its impact on one’s life.

Rather touchingly, and simply, the root cause of Complex PTSD is an absence of love – and the cure for it follows the same path: we need to relearn to love someone we very unfairly hate beyond measure: ourselves.

By The School of Life
Published in The School of Life
17 July 2020