Most people coming out of a relationship where there is narcissistic abuse suffer from CPTSD or Complex Post Traumatic Stress Disorder.  You might wonder what is the difference between CPTSD and PTSD?

PTSD is the most commonly used term to describe a set of symptoms one might have after a single traumatic event where they have experienced severe trauma.  This is typical coming out of the atrocities of war, being a victim of a violent crime, experiencing a sudden death of a loved one, a natural disaster, being involved in or witnessing a traumatic accident.

PTSD symptoms can manifest in four main categories:

1. Intrusive Memories: Individuals with PTSD often experience recurrent, distressing memories of the traumatic event. These memories can be intrusive and feel as if the event is happening again (flashbacks). They may also have nightmares related to the event.
2. Avoidance: People with PTSD may try to avoid situations, places, or people that remind them of the traumatic event. They may also avoid talking about the event altogether and may withdraw from friends, family, and activities they once enjoyed.
3. Negative Changes in Thinking and Mood: PTSD can lead to negative changes in thoughts and feelings. This may include persistent negative beliefs about oneself or the world, distorted thoughts about the cause or consequences of the event, feelings of detachment or estrangement from others, and a reduced interest in activities once enjoyed. Individuals may also experience persistent negative emotions such as fear, anger, guilt, or shame.
4. Changes in Reactivity and Arousal: People with PTSD often experience heightened arousal and reactivity. This can manifest as irritability, anger outbursts, reckless or self-destructive behavior, hypervigilance (feeling constantly on guard), difficulty concentrating, and exaggerated startle response. Feeling a great deal of anxiety is also common with PTSD.

CPTSD results from prolonged, repetitive trauma, often occurring in childhood or situations where escape is difficult or impossible. Common scenarios include:

• Long-term abuse (physical, emotional, psychological or sexual)
• Chronic neglect or abandonment
• Domestic violence
• Captivity situations (e.g., prisoners of war, human trafficking victims)
• Living in a war zone for an extended period

CPTSD can also result from childhood trauma which may result in choosing friendships and relationships where the original trauma is repeated or activated in some way.  One can find themselves repeating patterns of abuse and neglect in the majority of their relationships causing them to become very mistrustful, hyper-vigilant and avoidant of forming close connections.

The symptoms of CPTSD include all the symptoms of PTSD but may also include:

• Affective Dysregulation: Difficulty managing emotions, experiencing extreme emotional responses, or feeling numb.
• Negative Self-Concept: Persistent feelings of worthlessness, shame, or guilt; a pervasive sense of being damaged or different from others.
• Disturbances in Relationships: Problems with relationships, including difficulty trusting others, feeling disconnected from others, or being overly involved in abusive relationships.

In my experience working with people who have CPTSD after narcissistic abuse, the typical symptoms I notice are

• High levels of anxiety
• Obsession about the narcissist and his/her new partner
• Rumination (inability to stop thinking about it,)
• Avoidant behaviors (avoiding people and places where one might see or be reminded of their abuser.
• Agoraphobia, (fear of leaving the house)
• Suicidal Ideation (thoughts about ending their life)
• Lack of interest in anything
• Depletion of vital lifeforce energy
• Revenge Fantasies
• Loneliness and Isolation

Symptoms of PTSD can go on for months and even years after the original trauma or after breaking free from a traumatic situation.  In some cases, the effects of PTSD can continue indefinitely.

There is effective treatment to come to terms with the trauma and learn to manage the symptoms.  For sufferers of CPTSD, the typical symptoms such as anxiety, obsession, rumination, and avoidance behaviors can diminish with time and effective treatment.  However, I like to compare CPTSD to having had heat stroke.  You can feel normal again until you spend too much time in the sun or it gets too hot.  If you find yourself in another situation where the familiar abusive patterns erupt, you will find the symptoms of CPTSD returning.

People with PTSD need to practice extreme self-care.  They will need to learn to recognize when they are feeling tired, stressed, agitated, angry, or anxious and get to safety and take care of themselves.  They will need to learn how to self-regulate and calm their nervous system.

PTSD and CPTSD are both painful and difficult disorders and require patience and good treatment to feel like you can live a normal life again.