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What Is C-PTSD, and Do I Have It? Is It Me? [Episode 289]

What Is C-PTSD, and Do I Have It? Is It Me?

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“Do I have C-PTSD? Surely not—it’s not like I was a prisoner of war or something.” 

If you’re a victim of emotional abuse, you very well could have C-PTSD. In today’s episode, I want to introduce you to C-PTSD, how emotional and spiritual abuse can cause C-PTSD, what the symptoms are, and some practical ways that you can move forward and heal if you determine that you do have C-PTSD. I also want to debunk the theory that many emotional abusers have that their victims have Borderline Personality Disorder. Let’s dive in, shall we?

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NATALIE: Welcome to Episode 289 of the Flying Free Podcast. What happens when you get scared or badly hurt? Your heart rate increases, your breathing quickens, and you might break into a sweat or get goosebumps. Your body immediately prepares to get the heck out of dodge or kick some serious butt. Sometimes you shake from head to toe or your teeth chatter. You might cry or scream. Some people feel sick to their stomachs, mess their pants, or go into shock.

When we experience terror or pain, we may not even notice how our body is reacting in the moment. Afterward, when the threat has passed and our bodies are trying to calm down, we might realize what happened or how amped up we were. The fact that our brains and bodies work together in so many instantaneous ways to keep us safe when we’re in danger is amazing. It’s natural and expected. We depend on it for survival.

But can these normal, helpful reactions to traumatic events actually trip us up? What if our bodies start hitting the repeat button, telling us we’re not safe when nothing bad is still happening? What if all that terror, all those stress responses go into overdrive and rattle and echo around inside us without any sign of stopping?

Most of us have heard of post-traumatic stress disorder or PTSD. It can occur when a person experiences or witnesses a terrifying or traumatic event, such as a car accident, a murder, a sexual assault, domestic violence, a natural disaster like a fire, etc. There’s a broad range of symptoms that can vary over time and from person to person, but according to the Mayo Clinic, the major categories of PTSD symptoms are intrusive memories, avoidance — not wanting to talk about or visit the places where traumatic events happened — negative changes in thinking or mood and changes in physical and emotional reactions — everything from insomnia to overwhelming guilt.

We used to think of PTSD as something that only happened to soldiers who lived through the horrors of war. A Veteran who has flashbacks of a battle when he hears a backfiring car, for example. But PTSD affects people from every walk of life, in every culture, and at every age. What’s more, it doesn’t tell the full story of people who are experiencing repeated and prolonged trauma when their daily reality is often violent and unsafe.

How do we describe the effect of constant terror and stress and harm? Years and even decades of trauma instead of hours or days? The impact is real but complex. According to Wikipedia, complex post-traumatic stress disorder or C-PTSD is “thought to occur as a result of repetitive, prolonged trauma involving harm or abandonment by a caregiver or other interpersonal relationships with an uneven power dynamic. C-PTSD is associated with sexual, emotional, or physical abuse or neglect in childhood, intimate partner violence, victims of kidnapping and hostage situations, indentured servants, victims of slavery, sweatshop workers, prisoners of war, victims of bullying, concentration camp survivors, and defectors of cults or cult-like organizations.

Situations involving captivity or entrapment, such as a situation that lacks a viable escape route for the victim or the perception that there is no escape route, can lead to C-PTSD-like symptoms, which include prolonged feelings of terror, worthlessness, helplessness, and deformation of one’s identity and sense of self.”

So just as a single sexual assault can cause PTSD, so traumatic events that are ongoing, such as domestic violence and childhood abuse, can cause C-PTSD. One isn’t better or worse than the other. C-PTSD has a broader list of symptoms and encompasses more of a lived experience than a single event. Remember, the key difference is the repetitive, prolonged nature of the trauma and the lack of agency because of an uneven power dynamic or the inability to escape. Just because someone is not a prisoner of war doesn’t mean they can just up and walk out of an abusive relationship.

Domestic violence and childhood abuse are propped up by belief systems. Abusers believe they have a right to treat their victims like garbage; communities and societies and religions that endorse and perpetuate abuse; victims who are taught, sometimes from birth, that they have no right to demand better treatment, they deserve the abuse, what they’re experiencing is normal, they can’t survive without their abusers, and so on.

But those belief systems work in tandem with a physical reality. For example, children cannot survive without their parents. And a woman who loses job after job because of her partner’s unhinged behavior and the time she has to take off to recover from beatings is in a catch-22. Leave her marriage as a destitute woman unable to physically or financially care for herself, or stay and fall further apart with each passing day?

The issue isn’t even just what victims are suffering at the sometimes literal hands of their abusers. It’s all the ways their bodies are storing that trauma, all the ways their brains are surviving in constant fight, flight, freeze, or fawn mode.

For some, their bodies shake uncontrollably when they talk about their abusers. For one woman, whenever she sees a wooden spoon or brown leather belt, she feels like she’s going to puke, and she can’t focus for hours afterward. For one single mother, if she notices her children doing something dangerous, she feels paralyzed. She can’t move to help or even call out a warning.

PTSD feels like your body and mind have just been hijacked. Even if all you’ve known is abuse, even if you love your abuser, even if you justify the abuse or think you deserve it, your body will contradict you because it was made to keep you safe. It’s wise enough to know that you weren’t and aren’t safe, even if you were programmed to believe the opposite.

One woman in my support group, Flying Free, remembers feeling suicidal a month before her wedding to a covert malignant narcissist. There was nothing obviously bad happening. She was just counting down the days until she became a Mrs. on her honeymoon. She began having terrifying nightmares and insomnia, until years later, she finally understood that her body and brain were trying to warn her. They knew she wasn’t safe, even if she drove that unconscious knowledge away. It took her thirteen years to learn how to listen to her body and eventually leave.

For many sufferers, though, C-PTSD symptoms don’t start right away. They’re progressive, and the longer you suffer trauma, the more symptoms crop up, and the more often they wreak havoc on your day-to-day. Maybe ten years into your marriage is when you first notice the trembling in your jaw. You thought you were cold. It wasn’t until the following summer that you realized it was happening in 90-degree heat, and it starts whenever your husband gets a certain angry look on his face or begins to shake his leg when he’s sitting.

Maybe you taught yourself to be still and quiet when your emotional abuser would yell at you, but it’s as if your body listened too well. You regularly find yourself standing in your kitchen, hugging your arms around your chest, numbed out, ruminating over memory after painful memory trying to make sense of it all, but never arriving at any conclusions.

C-PTSD keeps us from living in the present by recycling our past trauma through our bodies and brains over and over because if our brains are stuck, our bodies are stuck, and many times, the trauma isn’t a car accident or a firefight during military service. It’s harm by people we love dearly in the form of emotional and spiritual abuse.

Emotional and spiritual abuse are not one-offs. They are belief systems, they are family of origin dynamics, they are religious dogma, all for the sake of preserving the status quo. And the only way to keep things the same is to control variables — to control people.

If you’re in a relationship or a community where people are actively working to control you, there are only so many ways to do so. Big surprise: They’re all based on lowering your own value of yourself, challenging your intuition, and elevating the value of what others say about you, increasing your responsibility, and reinforcing how to live life within their rules. In other words, emotional and spiritual abuse meet the qualifications that lead to C-PTSD.

1. An uneven power dynamic. This doesn’t have to be overt, like in the case of the president of a company and his or her underlings. It can be a priest to a parishioner, a husband to a wife, a mother to a child, a person of influence and status in the community and a “nobody,” for example.

Abusers feed you a warped view of reality over and over to brainwash you into believing whatever will keep you under their thumb. Your experience, your opinions, and your rights are irrelevant. If you don’t believe them, you know, even if they don’t say it, that there will be a price to pay, ranging from their disgust to damnation of your eternal soul.

2. Repetitive, prolonged trauma. Emotional and spiritual abuse happen within relationships and communities. Everything in your life is painted and affected by them. The pains, the betrayals, the snide remarks, the subtle meanness: All of it happens over and over, day in and day out. There is no end.

3. No escape or what seems like no escape. There’s no end and what seems like no escape. Because of the first two aspects, escape either can’t be imagined or it’s impossible because of the lack of resources or because the consequences of leaving are so high.

This is a three-part stew of nastiness where one aspect constantly bleeds and feeds into the others, and it’s like an instruction manual for how to get C-PTSD. But many victims don’t recognize emotional or spiritual abuse to begin with, so figuring out that they’re experiencing C-PTSD is impossible. In fact, they’ve swallowed the bait of their abusers so fully that they often blame the symptoms of C-PTSD on their own weakness instead of the abuse that they’re suffering.

Let’s talk about emotional abuse for a minute. We all have bad days. We all act like buttholes sometimes. But acting like a jerky three-year-old on a random Tuesday is not the same as emotional abuse. Being impatient and fussing at your kids when you’re PMS-ing before you rein yourself in is not emotional abuse. Getting angry at someone when they mistreat you or your kids is not emotional abuse. Calling out someone when they lie or don’t follow through is not emotional abuse.

According to Psychology Today, “Emotional abuse is a pattern of behavior in which the perpetrator insults, humiliates, and generally instills fear in an individual in order to control them. The individual’s reality may become distorted as they internalize the abuse as their own failings.”

So there are three important aspects of emotional abuse. First of all, behavior patterns. If you experience normal human behavior, including isolated disagreements and frustrations in your relationships, you probably wouldn’t be listening to this podcast. The patterns, the never-ending merry-go-round, the consistency of an emotional abuser’s behavior — those are the problems. It’s a predictable cycle. You can count on them in the worst way. They keep making the same “mistakes.” No matter what they say about doing better or being sorry — if they even do say those things — they stay the exact same month after month, year after year. They may promise to change, but they never do.

Secondly, when it comes to emotional abuse, there is an intent to control through harm. Now, this is one of the hardest pills to swallow, maybe even more so than the fact that abusers rarely change because they don’t want to. It’s the evidence that they want to hurt you. They often actually enjoy hurting you. It’s not an accident. It’s not ignorance. It is calculated and intentional.

I know it’s hard to wrap our brains around that because that’s not something that we would do, but abusers do this all the time. You cannot project who you are as a person onto your abuser. And in the same way, your abuser will always try to project who he is onto you. He’s claiming that you’re the one that’s the problem. Abuse is nothing if not strategic. It’s a game to them and you are a pawn. Until you come to the radical acceptance of this reality, you will continue to be stuck in an emotional abuse cycle.

And the third important aspect of emotional abuse to consider is its impact on you. If you don’t remember feeling angry all the time, hating yourself often, struggling to remember what happened after disagreements, or being constantly confused about where you stand before your relationship started, then it’s pretty unlikely that you suddenly changed into a weak or terrible person. It’s more likely due to a combination of emotional or spiritual abuse and C-PTSD symptoms. Abuse is meant to destroy you systematically and progressively. So if you feel as if you’re falling apart, the question isn’t, “What’s wrong with me?” but “Why?”

Healthy relationships feed people. They help us flourish. Real love will expand your life. It will not diminish or squelch you. If a relationship is harming you, then the person or the people on the other side of that relationship are not safe. The sad thing is that even if you recognize that your relationship is unhealthy, even if you recognize emotional abuse and admit that it’s present in your marriage, for example, there’s often another obstacle to protecting yourself from further harm and C-PTSD symptoms, and it’s masked in the prettiest package you have ever seen. Do you know what it is? Spiritual abuse.

Spiritual abuse is also based on the aim of controlling another person or people but through a specific means: religion. This includes but isn’t limited to using the Bible or another religious text to make people believe and do what they want you to do. It’s endorsing their opinions with God or God’s word. Spiritual abuse also includes using religious authority to control another person. It can span every facet of life: sexuality and procreation, food and drink, physical fitness, marital status and divorce, gender roles, personal boundaries, parenting, music, hobbies, clothing, hair, and makeup styles, Bible translations, all the way down to the specific words you use for prayers, the number of times you pray each day, and the names you use for God.

It sounds funny to non-religious people who would simply brush off some of the rules and advice and judgment I’m describing. But if you’re taught a certain way of thinking, a complete worldview and framework for reality from the time you’re young by the very people you’re meant to trust the most, it’s pretty difficult to discount, deny, or distance yourself from that truth.

I talk about this and illustrate it in my book, All the Scary Little Gods, which you can get on Amazon. It’s almost unimaginable that the God who is supposed to love you is actually a God of abuse. That the people who were supposed to have your best interests at heart actually just used you like a Lego character. That all the most important things you were taught are really warped and destructive, not beautiful and helpful and holy.

This probably sounds extremely cynical and maybe even anti-religious. It might even sound overdramatic or like an exaggeration, but what I’m describing is the opposite of love. It is the antithesis of a good God. And sadly, it’s the rule instead of the exception.

In many Christian families, churches, and denominations, emotional and spiritual abuse is an epidemic in conservative Christian circles, as well as religions like Islam and Judaism because of their misogynistic beliefs about women.

So let’s talk about patriarchal, or complementarian, marriage. According to Wikipedia, “Complementarians assign primary headship roles to men and support roles to women based on their interpretation of certain biblical passages. One of the precepts of complementarianism is that while women may assist in the decision-making process, the ultimate authority for the decision is the purview of the male in marriage, courtship, and in the polity of churches subscribing to this view.”

By its definition, there is an uneven power dynamic in a complementarian marriage that is truly functioning according to complementarian rules and not egalitarian ideals. That’s a school of thought that promotes equality for all, regardless of gender.

Now, please note, there are some who claim to be complementarian in their beliefs, and yet their marriages are functioning practically as egalitarian marriages. It’s important to maintain consistency with reality, not just verbal head nods in one direction or another. And I wrote about this in an article on my website, flyingfreenow.com, that explains complementarianism versus egalitarianism.

So when you have an uneven power dynamic in a marriage, plus emotional abuse and spiritual abuse if the husband or the church are telling the woman that she is at fault for pointing out the abuse, plus you have the teaching that divorce is wrong and that no matter what the authority or the husband does to her, she is stuck in the marriage until she dies, well, guess what? You’ve got all three ingredients for an emotionally and physically crippling case of C-PTSD.

How is this scenario any different from a prisoner of war?  Women are being brainwashed with controlling propaganda, held against their will and told it’s good for them, put in a place of subservience with all their actions controlled by others, told that their opinions are meaningless and their experiences are rubbish, and they are dehumanized with no way out.

So the woman of faith in an emotionally abusive marriage has her freedom of thought, action, opinion, and choice stripped away. She is disrespected as a human being, viewed as less than by virtue of her lack of a particular body part. There’s even an us versus them mentality, with dire warnings over the terrible consequences of not following the religious rules.

This is psychological abuse in a distilled form. What is more terrifying, for example, than eternal consequences? What is more corrupt than a comprehensive theology that imprisons every aspect of your life and your identity? Your life becomes one long traumatic event, and any sign of poor mental health because of this coercive control is an indication that you are in rebellion, not that you’re being mistreated and abused. After all, mental illness is just a lack of faith in God, right? No, no, and no.

For women who have been so effectively brainwashed, they distrust their gut or intuition, their bodies, and their minds, which also means they’re often suffering in silence and likely hating themselves for their perceived weaknesses. So the cycle continues, and our bodies and mind bear the evidence.

I’m going to tell you nineteen effects now of complex post-traumatic stress disorder because our bodies can only carry so much stress before it spills over. Most of the abuse victims I work with have full-blown cases of C-PTSD and they are largely unaware of it. Many of you listening to this podcast have debilitating symptoms of C-PTSD every day of your lives. And you know what? It’s a killer. This is why I say emotional and spiritual abuse, they are physical abuse. They don’t leave bruises on the outside of your body. They destroy your body physically from the inside out.

Here are some effects: Persistent anxiety and unrest, and when you have that kind of anxiety constantly, your body is releasing cortisol and other hormones that in normal amounts are fine and good. But in large doses on a daily basis, that begins to wear your body down.

Difficulty regulating your emotions. Difficulty remembering the events surrounding any abusive incidents. Reliving experiences. I call it looping — some people might call it ruminating — over and over and over in an effort to solve the problem. Feeling helpless. Paralysis of initiative. Shame. Guilt. Self-blame.

A sense of being different from the rest of the human race. Attributing total power to the perpetrator — they seem more powerful than they really are. Becoming preoccupied with the relationship to the perpetrator. A desire for revenge alternating with feelings of gratitude toward the perpetrator. A sense of alliance with the perpetrator and relief when buying into the perpetrator’s belief system.

Rationalizing the abuse. Repeated and desperate search for a rescuer — someone who will listen and validate their experiences. The feeling that unless someone else believes them, it can’t be true. Repeated failure to protect themselves. A loss of sustaining faith that borders on despair. A disconnection that alternates with feelings of terror and confusion.

This list was also found on Wikipedia. Here are some physical symptoms of complex post-traumatic stress disorder. Anxiety, depression, chronic fatigue syndrome, back and neck problems, chronic headaches, vision problems, nerve twitches, insomnia, gastrointestinal issues, heart palpitations, panic attacks, asthma, stress, immune system breakdown, endocrine system breakdown, unbalanced hormones, and brain fog.

And it’s not limited to this list. These are just some of the most common. There are also long-term effects of C-PTSD. And over the long haul, your health can break down permanently. And this is why I continue to insist that emotional abuse is a covert kind of physical abuse rendered all the worse for the fact that it cannot be proven by the victim. The victim can’t go to the church and go, “I’m being abused,” when she has no visual evidence of what’s going on.

Have you ever heard the saying that stress is a silent killer? Well, this is especially true of chronic stress. So let’s continue the cooking analogy. Take everything I’ve already listed and put it in a bucket. Mash it around a bit. Now, let’s put it on a slow cooker on low heat and just let it simmer over a long period of time. What do you think is going to happen?

Fibromyalgia, irritable bowel syndrome, hypertension, obesity, coronary heart disease, psychosomatic syndromes — these are physical ailments without a clear medical explanation. 41 autoimmune diseases, vulnerability to serious illness, getting sick more often — a broken immune system can’t put up much of a fight. Brain damage, cancer, and early death.

This raises a question. Are we facing a mental and physical health crisis or the fallout of an emotional and spiritual abuse epidemic? In addition to the difficulty in diagnosing C-PTSD and the confusion over what constitutes abuse, many victims wonder if they themselves are the problem. I’ve found this to be especially true when it comes to the question of personality disorders, specifically Borderline Personality Disorder.

This disorder or BPD is a mental health condition characterized by the intense fears of abandonment and a lack of emotional stability. The most common symptoms include unstable relationships, impulsive, self-destructive behaviors, feeling suspicious or out of touch with reality, explosive anger, and self-harm. These symptoms are long-standing and usually start in childhood or adolescence. Diagnosis is based on a minimum number of symptoms and the level of impact they have on a person’s daily life.

So let’s talk about the differences and similarities between C-PTSD and Borderline Personality Disorder.  Complex PTSD is not a personality disorder, but it occurs as a result of living with a personality-disordered individual, for example, for a length of time. It can happen to anyone put in those circumstances regardless of their original personality, their strength, their intelligence, their skillset, their will to survive or problem solve, and so forth.

What often confuses people is that symptoms of C-PTSD and BPD can overlap. Take dissociation, for example. That can occur in both of those situations. C-PTSD sufferers may appear out of control because of trauma triggers.

This isn’t to say that a person diagnosed with Borderline Personality Disorder cannot also be suffering from PTSD or C-PTSD. It’s just that they’re not identical and they’re not necessarily related. Of the key differences, according to biomedcentral.com, “BPD involves a generalized under-regulation of intense distress related to real or perceived abandonment or rejection, whereas emotional dysregulation in PTSD is characterized by attempts to over-regulate (e.g., emotional numbing, avoidance, dissociation) distress related to reminders of traumatic experiences.”

So why is the difference so important? Because so many abuse victims and survivors are told that they are personality disordered or unstable or crazy. And by the way, being diagnosed with BPD doesn’t mean that you’re crazy, all right? They’re diagnosed by their abusers that way. Abuse victims feel unhinged, so they often believe the lie that the issue lies with them, that there is something wrong with them. Which again, raises the issue of mental health condition stigmas.

Borderline Personality Disorder is a common pick for emotional abusers who want to gaslight their victims, but their assumptions should never be taken seriously without the diagnosis of a trauma-informed, personality-disordered savvy therapist. So let’s make the distinction between BPD and C-PTSD clear while also drawing a line in the sand.

Being abused makes you feel crazy. It brings up a lot of strong emotions. It can cause you to feel unstable, depressed, and even suicidal. But you’re not misinterpreting reality or being mistreated because you’re off your rocker. You’re just a good person in a terrible situation.

How do we prevent emotional and spiritual abuse that causes complex PTSD? First of all, we educate ourselves. We read and learn all we can about it. We listen to survivors. We listen to podcasts like this one. We examine our own beliefs about women and how they line up with how Christ viewed women. We figure out why it is that we think a body part makes some people authority figures over others. We figure out where our faith traditions strayed from what the Bible teaches about humanity, both men and women.

Number two, we speak the truth out loud even though it makes people angry. We learn to tolerate the disapproval of men in order to gain the approval of our heavenly Father. We see people as small and we see God as big. And I talk about this in my book, All the Scary Little Gods: to see God in a completely different light is to change the entire course of your life.

Number three, if we are a survivor, we get help for ourselves. We don’t wait for a rescuer. We grab hold of Jesus Christ and we learn and grow strong — strong enough to break free. We get therapy, not from a biblical counselor who knows nothing about emotional abuse, but from a trained, trauma-informed therapist who can diagnose C-PTSD. EMDR therapy is a proven therapy for sufferers of C-PTSD. IFS therapy is another excellent therapy.

We find a community of women that know the unique dynamic of abuse, especially in the context of faith, such as the Flying Free Sisterhood program. And you can learn more about that by going to joinflyingfree.com.

And number four, we tell our stories. We empathize with abuse targets, we call a spade a spade, we get out of our legalistic prisons, and we find hope and freedom through Christ.

Now, if you think you may have C-PTSD, then again, like I mentioned earlier, you may benefit from our private Flying Free Sisterhood program. I actually have a course within this program called “Healing from C-PTSD,” where we do a deep dive into this subject. We would love to have you join us in learning the skills you need to become spiritually and emotionally and physically strong and healthy again. You can heal from complex PTSD.

If you would like to do this work with me and other amazing coaches and Christian women in the Flying Free Sisterhood program, head over to joinflyingfree.com. You can read all the details over there and complete an application to join us. It is very cost effective. It’s only $29 a month or $290 for an entire year of so many live supports every month, weekly coaching, all the education that you need, and a private forum where you can get your questions answered every single day that you are a member.

And that is $290. That is the cost of maybe two therapy sessions. Go get therapy too for sure, but join the Flying Free Sisterhood to augment and just fast-track your progress and your healing. Joinflyingfree.com.

"I am so thankful that I found this podcast. Hearing these stories and knowing I'm not alone is so encouraging. I now know there is a vibrant community of other women who really understand. Feeling seen and understood for the first time in two decades is healing to my soul."
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The Comments

  • Avatar
    Annabelle
    August 21, 2024

    Thank you for this very helpful podcast, Natalie. My previous licensed professional counselor diagnosed me with PTSD, but it is because C-PTSD is not officially recognized yet, so professional counselors do not have the option to choose “C-PTSD” as the diagnosis and they put “PTSD” instead on the official form. C-PTSD is real, super common in cases of emotional abuse, and its effects are absolutely awful and long lasting. I’m still living with them on a daily basis. Thankful for your work bringing clarity to more people.