One of the most frustrating things about complex post-traumatic stress disorder (cPTSD) is that it is wired into every neurological tributary in your body. In contrast, episodic trauma will affect parts of your brain that were involved in the episode and can cause PTSD because the memory of a traumatic event will conflate with the components of the event. Those components, then, can trigger that memory and make it feel as though it is happening in real-time again. For instance, let’s say you are driving in a bad, rainy downpour. You are tense because of the wind you are hearing, the lightning you are seeing, and the slippery road you feel under your wheels. Let say you make it home ok, though. It makes a good story at the water cooler the next day, but in a week you have forgotten about it. It was stressful, but not traumatic.
Let’s imagine the same scenario again, but this time, as you enter an intersection near your home, you are T-boned by a garbage truck. You are badly injured and go through months of therapy to repair your broken body. You finally heal enough to start living your life independently and feel confident enough to drive to the store on a sunny day. You head out to your car and realize that your partner forgot to get the garbage can out to the curb so you start to pull it down the driveway. As you get closer to the street, you hit a crack in the driveway that tips the can over and spills some of the contents out. Suddenly, the smell of the garbage and the mess on the driveway causes your heart to race, your temperature to rise and your leg and shoulder to hurt to the point you cannot lift the can back up. You feel your head start to throb and you have the sense that there is blood dripping from the side of your head. You start to shake and feel nauseous and want to run to the house and hide under the covers. You know that you are not in any danger in the reasoning part of your brain, but you simply cannot convince your nervous system that you are safe. It is remembering the traumatic event you had and does not recognize that it is not actually happening at the present time. The memory was triggered by the unique smell of rotting garbage, strewn out on the pavement and you cannot convince it otherwise. This is because the part of your nervous system that deals with emergencies has hijacked your body with the fight, flight, and freeze mechanism meant to manage life-ending threats (autonomic nervous system) more quickly than the reasoning part of the brain (pre-frontal cortex). There is no clock or sense of time in the autonomic nervous system, so it actually responds in the same way when it is triggered by an experience that makes it feel the same threat. It just takes over unless there is enough life experience for a person to stop the process quickly. The automatic response of the autonomic nervous system, when triggered, is what PTSD is about.
Complex PTSD is a little different. This is sometimes called childhood PTSD or developmental PTSD, but it can happen anytime there is a recurring threat to a person’s sense of safety over time. The threat doesn’t have to be life-threatening, but cPTSD usually develops because the threat feels overwhelming to the individual. An infant left to cry too often for too long, doesn’t know that their mother is in the next room, and will make sure that it gets the bottle eventually, can develop a sense that no one is there to help simply because they don’t know what they can’t know. Over time, a depressed mother or an overly distracted caregiver can contribute to a sense of life-threatening anxiety for the infant that develops over years into a fear of abandonment in adult relationships. Conversely, an adult can become aloof and cold, not believing in the value of human connection because their autonomic nervous system got set up in such a way as to feel triggered whenever anyone tries to get close to them. A child that grows up in a home where there might be a lot of stress or volatility in one parent may grow up to fear conflict because their nervous system tells them that bad things happen when there is a lot of commotion or strife in the home. As an adult, they may be afraid that their loving partner is about to strike them when they come home angry at a boss. An adult may tense up when they see their partner loosening a belt after dinner. Even if the adult knows in their pre-frontal cortex that their partner is not going to hit them, their autonomic nervous system may experience an automatic grimace at the memory of being beaten with the belt of an angry father. A person whose partner wants to spend a lot of time alone to think or who enjoys going out with friends might feel a deep sense of abandonment because of the experience of being raised by a withdrawn or depressed mother. Their autonomic nervous system doesn’t know the difference between the childhood experience when they were powerless to do anything with their fear and the current time when they could call a friend and connect to another person temporarily. This is complex PTSD. It is harder to deal with mostly because it develops system-wide through continual exposure over a time of development, such as childhood.
The fight, flight, freeze system that is meant to help us address imminent danger and provide us with the ability to act quickly to avert disaster, can get stuck in a threat response gear. This can cause us to see even completely benign events or very safe people as threatening. Our nervous system cannot tell the difference without our head intervening. We feel threatened because we feel threatened, not because there is a real threat. This often causes us to react as though we are in danger when we encounter someone who does something that triggers that system into action. If we respond with a fight mechanism, we will likely trigger that other person’s sense of danger and they will respond as though they are being threatened as well. Escalation is the obvious result, often ending in the relationship being injured if not the people involved.
There are times of real threat, but far more often, this is just a perception based on a triggered, preprogrammed autonomic nervous system response. One example of this happened with one of my granddaughters when she was about six months old. I had not had much time with her at that point in her life so she was not at all used to me. We happened to be in a room in a restaurant that had a door trigger set up to cause loud party sounds and strobe lights to be activated when it was opened. Unfortunately, at the very moment my daughter-in-law handed my granddaughter to me, someone opened that door. The sounds and lights startled both of us and she started to scream. An event that could have been an opportunity to bond with a loving and willing grandmother, turned into a terrifying event for my granddaughter. Thereafter, that trauma was wired into her nervous system and she did not willingly come to me for at least a couple of years. The strobe lights, bells and whistles, and grandma’s face all got coupled together as a frightening experience and my presence then was a trigger for the fear response she had at six months of age. She really didn’t feel comfortable around me until I started to care for her once a week for a short time when she was around 2–1/2.
When she was about 4-years-old, we went on a special outing with the whole family. We had done several similar outings that she had always enjoyed but this particular place had a room that had strobe lights and loud music. As we approached the entrance, my grandaughter showed a lot of anxiety and as soon as we entered it, she wanted out even though it was meant for children. While I cannot prove it, of course, I believe her nervous system remembered that earlier terrifying event and gave her the same internal sense of danger, even though there was no active threat happening at the time. Remember, the autonomic nervous system has no internal clock. Whatever is happening at the moment is the reality that it works with.
My granddaughter’s experience was not pervasive over time so it will not likely cause her stress in adulthood, but she may continue to dislike loud noises and strobe lights for the rest of her life unless she has enough positive experiences to off-set what happened to her at six months.
The point is that sometimes our nervous system tells us that we are in danger when it is really just “remembering” a past event that it has not yet had explained or off-set enough with positive experiences for the impulse to change. If my granddaughter and I had been able to continue to interact in non-threatening scenarios, that impulse could have been de-coupled and we could have had a happier connection between us.
I started to understand the power of this knowledge a few years ago when I thought about it in the context of a near-drowning experience I had as a 7-year-old. It was springtime and I was playing in a river that I had played in the previous fall. In the fall, the water was low and there were plenty of rocks to jump on, but this was after the spring thaw and the water was moving fast. I didn’t recognize the danger because my nervous system had not alarmed me to it. There was seemingly no need because my previous experience had been safe and fun. In the spring, however, I slipped off of one rock and got caught underwater on another one. Fortunately, an adult on shore was alerted and he jumped into action and saved me.
For the next 50 years, whenever I was around rushing water, my pulse would rise and I would feel my throat tighten. At times I could sense my body going stiff and unresponsive. The sight and sound of rushing water was a trigger and it did not matter if I was a safe distance away, my nervous system could not be convinced. This was especially intense for me whenever I had my children around and at times would keep me from enjoying safe experiences with them even if my husband was right there helping.
It wasn’t until I went back to that original river and saw the rock I had been stuck on, talked my way through the experience, and convinced myself that there was no ongoing threat that I was able to decouple that nervous system response from any current experience that could be triggering. My pre-frontal cortex rewrote the story around that threat and my nervous system let go of its automatic response.
This process is what we need to learn how to do in the relationships we find contentious. Often we are responding to a narrative or a story that our nervous system wants us to believe is threatening that really isn’t which can escalate the other person’s sense of fear and danger. Forcibly bringing our pre-frontal cortex to the encounter to inform ourselves that we are in a new experience, not still in the one that created the crisis in the first place, can help us to reset relationships to a less contentious place and may save us from discarding people that we might actually want in our lives.