The Difficult Road to Intimacy: Living with Complex Post-Traumatic Stress Disorder

***Trigger Warning ***

The following material has been reported to be highly triggering to some.

Living with complex post-traumatic stress disorder (CPTSD) is very challenging. It affects every aspect of the lives of those who suffer under its symptoms. In this article, we are going to examine together with a brief synopsis of CPTSD and how this disorder creates difficulty in forming and maintaining intimate relationships.

An Overview of Complex Post-Traumatic Stress Disorder

CPTSD isn’t yet in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the Bible used by psychiatrists and psychologists to diagnose mental health issues. Instead, it is part of a category called Trauma and Stress-Related Disorders under post-traumatic stress disorder (PTSD).

The problem is that while PTSD generally involves a single traumatic event, complex post-traumatic stress disorder involves exposure to repeated traumatic events. One argument is the reason for the exclusion of CPTSD from the DSM-5 is that while PTSD affects 7-8% of adults, CPTSD occurs in .05% of adults.

The symptoms of complex post-traumatic stress disorder are broader than those of PTSD. In the following sections, we’ll examine these deeper problems and how they affect a survivor’s ability to form and maintain healthy intimate relationships.

Trust Issues

One of the most profound and perhaps the root of all the other issues, that will be mention below, involves problems trusting others.

Since many who live with complex traumatic-stress disorder in their lives formed the condition as the result of enduring ongoing trauma while young, it isn’t hard to see why trust issues are a problem.

The trauma normally involves some type of abuse and betrayal by the very people who were supposed to care for and nurture survivors, when they were children. This repeated behavior by caregivers trains the child’s brain to cope with the inevitability of more trauma. Furthermore, when these children become adults, their brains are already hardwired to be fearful of intimacy and cautious of trust.

Flashbacks

Flashbacks are not simply remembering a traumatic event. Flashbacks thrust survivor back in time and relive the events as though they are occurring today.

There are three types of flashbacks, visual, somatic, and emotional. Although all three are harmful to the formation of relationships, emotional flashbacks are more so than the other two.

When survivors experience emotional flashbacks, they are irrational, and will often lash out at innocent people in their current lives. Normally, people who have these flashbacks do not understand where the emotional outburst comes from, and it takes a long time to make amends to those they harm.

Painful Loneliness

Survivors who live with CPTSD feel disconnected from humanity and themselves. In fact, survivors often describe how they feel as though they are here on earth by mistake and do not belong anywhere. Survivors often remain in an intense state of loneliness even when standing in a crowded room, because of the disconnection and lack of trust they feel toward and from other people.

The lack of trust survivors experience causes them to either consciously or subconsciously push anyone who wants to get close away and is compounded by internal beliefs that they are damaged goods, broken, and unlovable.

Hypervigilance

Survivors of complex trauma have a deep subconscious need to watch for any indication that someone is going to harm them. This results in survivors constantly scanning their environment for signs and sounds that tell their brains to prepare to fight, flee, or even freeze.

The signs might include non-verbal movements, body language, and tone of voice of another person, as well as sounds in the room or outside, that remind them of a previous traumatic event.

Hypervigilance is exhausting and makes a survivor choose to be alone rather than to be in a group where they can socialize and form relationships.

Body Image Difficulties

Due to the trauma perpetrated by caregivers in childhood, many people living with complex traumatic-stress disorder have deep-seated body image problems.

Too often, people who have CPTSD see their bodies as ugly, fat, and undesirable. These difficulties with self-image can lead to not only the formation of eating disorders, but also making the survivor fearful of allowing others to see them unclothed.

It is easy to see how this internal terror can lead to the survivor choosing not to get involved in an intimate partner relationship.

Searching for a Rescuer

Survivors often have one of two different reactions when it comes to relationships. They will either search incessantly for someone to rescue them, or they will avoid relationships altogether.

Those who search for someone to rescue them feel helpless and believe they need someone to save them from the pain of their past. They believe if they get involved with the right person they can feel complete again, and rely on them for comfort and support.

Sadly, this thought process often leads to survivors choosing the wrong partner, due to human tendencies to find romantic relationships that mimic our childhoods. These unfortunate people ignore behaviors that others would see as clear warning signs. Instead, out of deep desperation, they look past any flaws, in order to experience love and validation.

This lack of discernment of others can lead to the perpetuation of exploitation and intimate violence.

Choosing Not to Form Any Intimate Relationships

Survivors living with complex post-traumatic stress disorder have the same desires and needs for intimacy, sex, and attachment as anyone else. The difference is that they may choose to avoid forming intimate partner relationships.

It is vital to understand that in childhood these adults experienced a betrayal of trust, and often the sexual violation of their bodies.

Due to the betrayal of their trust in childhood, when these survivors do find themselves in a romantic relationship they often confound their partners by allowing them to draw close, but then quickly withdrawing.

Then, due to the sexual violation in childhood, sex is a huge issue for some. Forcing survivors to act like they are enjoying sex with their partner. When in fact, they are not. This pretense can result in them feeling dirty, used, and full of revulsion.

It is easy to see that in either scenario there will be big problems with anyone who attempts to form a loving and long-term relationship with survivors, leading to broken hearts and break-ups.

Because of the pain survivors inflict on others and themselves, many choose to live in terror of forming intimate relationships and avoid them totally.

The Problem of Shame in the Forming of Intimate Relationships

Shame is a fundamental emotion that shapes our lives from the time we are born until our death. When used in a positive manner, shame can help children learn to control their emotions and treat others with respect and dignity.

However, when shame is used as a weapon to control and harm children, the effects are lifelong and cause great difficulties later in life in the formation of healthy intimate relationships.

A paper published in 2010 in the Journal of Traumatic Stress1 titled The Impact of Dissociation, Shame, and Guilt on Interpersonal Relationships in Chronically Traumatized Individuals: A Pilot Study offers some insights into how shame shapes our relationship formation later in life.

The researchers found that the accumulation of shame throughout a person’s lifetime is a predictor of intimate relationship difficulties. Not only this but when coupled with severe dissociative symptoms, survivors can feel an intense sense of disconnectedness to other people.

With such internal conflicts happening inside the minds of survivors of complex trauma, it is almost impossible to form and maintain intimate relationships.

Do Not Lose Hope

Reading this article might have caused some readers to feel there is no hope of them forming lasting, loving, and fulfilling relationships due to having lived through complex trauma.

That is not the purpose of this piece. The purpose of this article is to help survivors be less of an enigma to themselves, by explaining some of the most troubling problems with complex trauma and relationships.

In the articles that follow, we will examine together the effects complex trauma has on the brains of survivors and ways to help yourself conquer your symptoms.

Whatever you do, do not lose hope.

References

1. Dorahy, M. J. (2010). The impact of dissociation, shame, and guilt on interpersonal relationships in chronically traumatized individuals: A pilot study. Journal of Traumatic Stress, 23(5), 653-656.