September is CPTSD Awareness Month, an opportunity to increase understanding of a condition that can be surprisingly difficult to recognize – even for people who live with its effects. Though the phrase “post-traumatic stress” may make you envision symptoms such as vivid flashbacks or avoidance, the effects of complex trauma can manifest in surprising ways, including perfectionism, people-pleasing, and trust issues.
You may have spent years assuming these were facets of your personality instead of recognizing them for what they are – adaptations to prolonged, repeated trauma.
Complex Trauma Often Develops Gradually
Post-traumatic stress disorder can develop after experiences such as an assault, serious accident, natural disaster, or other shocking or frightening event.
Complex PTSD, or CPTSD, often results from repeated or prolonged experiences in which you felt threatened, trapped, or unable to escape, such as childhood abuse or neglect, domestic violence, prolonged bullying, or repeated exposure to frightening circumstances. You’ll eventually learn adaptive responses to protect yourself when these experiences persist for months or years.
For example, children growing up with emotionally unstable or unpredictable parents often become incredibly intuitive and skilled at interpreting subtle changes in other people’s mood, tone of voice and facial expressions. Years later, as an adult, you may instinctively take a room’s “temperature” moments after walking through the door. While you might chalk this ability up to empathy or sensitivity, it’s more likely that your nervous system is always on high alert, scanning for various threats.
Survival Strategies vs. Personality Traits
With complex trauma, it can be hard to distinguish the coping mechanisms you developed years ago from facets of your personality. For example, many people with CTPSD are exceptionally agreeable and easygoing because they’ve learned that arguments lead to anger, rejection, or punishment. On the flip side of that, they struggle to set boundaries, find it hard to express their feelings, and become anxious whenever someone seems disappointed in them.
Hyperindependence, perfectionism, and a rigid preference for control are other, lesser-known characteristics of complex trauma. When these characteristics are distressing or interfere with your relationships, it can be worth exploring where they came from.
Hypervigilance Doesn’t Always Look Like Fear
Being constantly alert for danger is a common trauma response, but hypervigilance isn’t always obvious. You may notice that you:
- Automatically gauge other people’s facial expressions and tone of voice
- Have difficulty relaxing when everything is going well
- Assume a minor disagreement means a relationship is in danger
- Startle easily
- Constantly envision the worst-case scenario
- Feel responsible for managing other people’s emotions
You might not consciously feel nervous, tense, or afraid. Maybe you’re even the person everyone looks to during stressful situations because you are typically so capable. The struggle is that even when there’s no emergency, your body remains prepared for one anyway.
Shame Can Hide the Original Problem
Complex trauma can also change your self-image. When frightening or harmful experiences repeatedly occur, especially during childhood, the path of least resistance is to conclude that you must be profoundly flawed or unlovable. That harmful belief can persist long after your environment or circumstances change.
You may have an extremely harsh inner critic, feel ashamed when you make minor mistakes, or believe you must “earn” acceptance through constant overachievement. Criticism may feel disproportionately painful because it activates much older, deep-seated beliefs about your worth or safety.
Complex Trauma Can Affect Relationships
Relationships frequently bring trauma adaptations to the surface. Someone with complex trauma may desperately want closeness while also struggling to trust people. You might fear abandonment, avoid conflict, withdraw when emotions become intense, or continually look for tiny signs that others are upset with you.
Feeling unsafe around people who say they love you can be confusing. Intellectually, you may know they won’t abandon, humiliate, or hurt you, but your nervous system still defaults to lessons it learned years ago.
Emotional Numbness Can Be a Trauma Response, Too
Intense emotions are not always a hallmark of trauma. Sometimes, people respond by becoming detached or numb. At this point, positive experiences may not feel as enjoyable as they should. You may have difficulty describing your feelings or explaining why something has upset you.
For some people, alcohol or drugs become another way to dial down the intensity of overwhelming emotions, intrusive thoughts, or chronic tension. When trauma and substance use occur together in a dual diagnosis, a treatment plan designed to address both issues simultaneously is essential for lasting recovery.
Many CPTSD Symptoms Overlap With Other Conditions
If you’ve recognized yourself in any of the patterns typically associated with trauma, that does not necessarily mean you have CPTSD. Anxiety, depression, ADHD, autism, personality disorders, chronic stress, and other conditions can share symptoms with complex trauma, and many of these concerns overlap.
That’s one reason this blog and other mental health content you find online should be a starting point to spark your curiosity, not a substitute for professional assessment.
Our clinicians can look beyond individual symptoms, considering your history, relationships, coping patterns, daily functioning, and other factors that have affected you throughout the years.
Understanding the Pattern Creates Opportunities for Change
The goal of seeking therapy for complex trauma isn’t to blame every present-day problem on the past. It’s to learn why you developed specific behavioral patterns and determine whether they still serve you.
Insight Into Action Therapy’s clinicians take an integrative, collaborative approach, helping our clients explore their trauma alongside concerns such as anxiety, depression, relationship difficulties, emotional dysregulation, and substance use. Treatment can help you identify triggers, regulate difficult emotions, challenge deeply rooted beliefs, strengthen relationships, and develop coping strategies that fit your life today. Reach out to us to book your appointment.
