September is C-PTSD (Complex Post Traumatic Stress Disorder) Awareness Month. Like most people, you’ve probably heard of Post Traumatic Stress Disorder (PTSD). You may even know someone living with it. When we think of trauma, we often think of car accidents, single incidents (such as being the victim of a crime), or being in combat. Many of us are familiar with some of the symptoms. Debilitating flashbacks, horrible nightmares, severe anxiety, and avoidance of people and places that remind the person of the traumatic event. PTSD has been acknowledged as a disorder in the US since 1980, when it was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is used across the US by mental health providers. Adding a diagnosis to the manual gives clients access to treatment, as providers can identify the disorder and design effective interventions. Learning about PTSD is a standard part of training for therapists, social workers, and psychiatrists.
In contrast, C-PTSD was first conceptualized in 1992 by Psychologist Judith Herman in her book Trauma and Recovery. Although CPTSD was added to the World Health Organization’s International Classification of Diseases in 2019, it is not in the DSM, which creates a barrier to treatment for clients and potentially dangerous gaps in knowledge for providers. Since C-PTSD is not an “official” diagnosis in the US, training programs for providers are designed without its inclusion. Furthermore, lack of official status decreases public awareness, causing clients to suffer in silence or access inappropriate or unhelpful treatments. There is also a lack of research on how to support clients with C-PTSD. Despite this, estimates of how many individuals suffer from C-PTSD range from 1-8% of the global population.
The eleventh revision of the World Health Organization’s International Classification of Diseases (ICD-11) defines C-PTSD as a “mental health condition that develops after experiencing chronic trauma.” In contrast to PTSD, C-PTSD develops through prolonged exposure to trauma from which the person cannot escape. Often, the traumatic events begin in childhood, when we are most vulnerable and unable to escape our environment. C-PTSD symptoms can develop from any type of chronic trauma, including emotional abuse and neglect, failure to provide protection and nurturance, and verbal abuse. Symptoms include anxiety, emotional flashbacks, avoidance of people and places that may trigger symptoms, heightened emotional responses, difficulty with interpersonal relationships, feelings of shame and being different or damaged, and social withdrawal.
Why should mothers be aware of this diagnosis? Motherhood has a unique way of revealing things to us—things about ourselves, our lives, and our pasts that we previously were out of touch with. As young children, we do not question our environment or our caregivers. Our home and caregivers are all we know, and we depend on them for survival. Therefore, we internalize those spaces and people within them as the standard for a healthy, loving, safe environment. We see our homes and caregivers as positive, no matter the mental gymnastics we perform to get there because our survival depends on it. We have nowhere else to go, and the awareness that our home or caregivers are unstable or unsafe is too terrifying for a child to bear.
We naturally carry these stories and illusions of safety into adulthood. We do not realize that our patterns of thinking, feeling, and behaving are survival strategies we developed when we were young. The resilience that saved us as children comes at a cost in adulthood. Becoming parents is sometimes the catalyst for seeing the truth of the past. The instincts we feel to love, nurture, and parent our children differently shed some light on our own lives—the ways we were treated as children suddenly don’t seem right. If we follow the thread from our adult troubles, it often brings us to the past. We do not recognize the trauma from our earlier years until faced with the task of providing love, nurturance, and protection to our child, the very things we may have been denied.
If this resonates with you, you may wonder how you can be a good mother to your own children. How do you show love when it was not shown to you? How do you provide nurturance without a model? How will you know when to protect them and when to push them to be independent? You may have also undergone therapies or taken medications for disorders like major depression, various anxiety disorders, personality disorders, or even severe mood disorders. Misdiagnosis is another reality for those with C-PTSD. Lack of awareness causes mothers to muscle through life, living with a disorder many do not know exists.
Although C-PTSD is still not given the recognition it needs and deserves, more and more providers are educating themselves and seeking out training to provide accurate diagnoses and effective interventions. Books, podcasts, online communities, and providers are available with education, support, and tools to help you navigate the challenging but worthwhile journey of trauma healing. At Mom Over Matter LLC, we view helping mothers heal from trauma as one of our highest callings. The ripple effects of healing spread to children, families, communities, and society. Whether you want to take a deep dive into processing through therapy or want to work on concrete skills and tools, our therapy and coaching services can provide needed support. You are not alone.
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