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Topics - Kizzie

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The hardest part of CPTSD has been what I now know are emotional flashbacks (EFs).  Walker gives a good example from his own life of what these feel like:

I recall the first emotional flashback I was ever able to identify, although I did not identify it until about ten years after it occurred. At the time of the event I was living with my first serious partner. The honeymoon phase of our relationship came to a screeching halt when she unexpectedly started yelling at me for something I no longer recall....

What I do most vividly recall was how the yelling felt. It felt like a fierce hot wind. I felt like I was being blown away -- like my insides were being blown out, as a flame in a candle is blown out....I felt completely disoriented, unable to speak, respond or even think .....

Some years later, I came to understand the nature of this type of regression. I realized it was a flashback to the hundreds of times my mother, in full homicidal visage, blasted me with her rage into terror, shame, dissociation and helplessness
(pp. 3-4)

My EFs range from this stomach dropping, mind numbing variety through to really intense ones where it feels like I'm in a special effects movie and  everything is moving in slow motion, I hear and see like I'm in a tunnel or something, and things don't feel real or quite right. 

I am beginning to figure out when I'm having a milder version, what the triggers are, and more and more how to calm myself, but I'm still quite nervous about those moderate to big tsunami ones. I take heart from Walker's suggestion though that the more we practice managing them, the less intense and frequent they will be.

Therapy / Some Descriptions of Different Approaches
« on: August 30, 2014, 06:38:40 PM »
If you have an approach to add please let me know and I will add it here to the summary.

Relational Therapy

By facilitating a safe and positive relationship in the security of the therapeutic environment, the client is armed with a stronger sense of self and confidence. The primary goal of this technique is to empower the client with the skills necessary to recognize and create productive and healthy relationships. The therapist strives to address any and all past and present relationship traumas or impressions that have served to create discord in the present life circumstances of the client.

Cognitive Behavioural Therapy (CBT)

CBT is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events.  The benefit of this fact is that we can change the way we think to feel / act better even if the situation does not change. When people are in distress, their perspective is often inaccurate and their thoughts may be unrealistic. CBT helps people identify their distressing thoughts and evaluate how realistic the thoughts are. Then they learn to change their distorted thinking. When they think more realistically, they feel better. In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem-solving oriented. 

Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) is a cognitive-behavioural treatmentand is helpful for people who struggle with difficulties in managing their emotions. DBT normally involves a weekly individual therapy session and a weekly group therapy session that involves learning skills in managing attention (mindfulness skills), managing and coping with emotions (emotion regulation skills), dealing effectively with interpersonal relations, and tolerating emotional distress.

Eye Movement Desensitization and  Reprocessing (EMDR)

EMDR is an evidence-based psychotherapy for Posttraumatic Stress Disorder (PTSD). In addition, successful outcomes are well-documented in the literature for EMDR treatment of other psychiatric disorders, mental health problems, and somatic symptoms. The model on which EMDR is based, Adaptive Information Processing (AIP), posits that much of psychopathology is due to the maladaptive encoding of and/or incomplete processing of traumatic or disturbing adverse life experiences. This impairs the client’s ability to integrate these experiences in an adaptive manner. The eight-phase, three-pronged process of EMDR facilitates the resumption of normal information processing and integration. This treatment approach, which targets past experience, current triggers, and future potential challenges, results in the alleviation of presenting symptoms, a decrease or elimination of distress from the disturbing memory, improved view of the self, relief from bodily disturbance, and resolution of present and future anticipated triggers.

Note: Given that CPTSD differs from PTSD in that it involves repeated trauma and flashbacks which tend to be emotional rather than visual, EMDR must be tailored accordingly.  If you do plan to undertake EMDR, ensure that you ask the T if s/he has training in EMDR for CPTSD. See the post below for some links to information about CPTSD and EMDR. 

« on: August 30, 2014, 05:34:53 PM »
I found the Toolbox at our sister site Out of the FOG (OOTF) very useful so I'd thought it would be good to do the same here at OOTS.  I've added a couple to get us started and if you have anything you'd like to see added please post them here.   Note:  Any tools should be fairly short rather than a book or complete workbook - those should go in the "Resources" section. 

There are also summaries of some of the longer/more indepth threads kindly prepared by Cat so that newer members can locate information more quickly and easily.  Tks Cat for your efforts in this regard!   :hug:

If you would like to contribute a summary or tool, please feel free to do so!  If you have any questions please PM me.

Therapy / CBT and Relational Therapy
« on: August 27, 2014, 10:47:35 PM »
So early this year I tanked.  I was drinking all day (never drank before mainly because my F was an alcoholic), depressed (that I was used to but this time it was bad) and having huge panic attacks (never had them that bad before). I had been quite independent, responsible and all of a sudden I couldn't get out of bed some days.  I had to reach out for help. 

Looking back I realize a part of me said "That's it, stop the facade and get well already!" My H was able to come home a month early (he was finishing up his last posting with the military on the other side of the country - a BIG reason I lost my bearings), I stopped drinking the day he arrived -- cold turkey (very bad idea - there is medical help to do it without risk of seizures and the like) and off we went to my GP. I told her all that was going on and what a humbling experience that was for someone who rarely asked for any help from anyone.

Long story short after a few false tries getting on the right medication I ended up on Celexa which has done wonders.  I spent two decades on Prozac and within a few weeks of starting this med I began to feel comfortable in my skin for the first time ever.  I'm not drinking (didn't really enjoy it - just wanted to be numb and blot out the fear), I don't have panic attacks any more, and I'm reaching out/opening up  as much as I can to others - on this forum and two others, in a support group for mood disorders and with an addictions counsellor.  I have Social Anxiety as a secondary disorder to CPTSD so this last bit is amazing.  I was very isolating and insular except with my H although I did not appear this way to most people.

An way, it all really helps and I wish I had reached out in earnest years ago.  Part of the problem was that I did not have names for any of what I was  experiencing and in fact struggled to believe that I had been abused because my parents were not physically or sexually abusive. And, I just plain did not want anyone to know what lay beneath the facade I had constructed to get by IRL.   

The one big piece that is still missing for me is dealing with my CPTSD both through therapy and by coming here.  I understand now that there is a lot of trauma I have not acknowledged and worked through, and that it fuels anxiety and depression left untreated. Walker's approach of working on both the cognitive or thinking aspects through Cognitive Behavioural Therapy, and the emotional or feeling aspects through Relational Therapy seem like the right path out of the storm for me.   

Web Sites, Support Groups & Organizations / Social Anxiety Support (SAS)
« on: August 26, 2014, 06:46:50 PM »
I developed Social Anxiety Disorder as a secondary disorder to CPTSD (which is common), and am a member of a great support group Social Anxiety Support -  Here's a description of SA and SAD from the site:

Social anxiety is a feeling of uneasiness, dread, or apprehension about social interaction and presentation. Frequently, the primary concern fueling social anxiety is a concern that one will be (or is being) judged negatively by other people, regardless of whether this is actually the case. The experience of occasional, mild social anxiety is quite common, as is the experience of anxiety in general. Social anxiety can range from a relatively benign, infrequent level of severity to being a major hindrance in everyday life.

Social Anxiety Disorder or Social Phobia are mental health diagnoses used to describe a level of social anxiety that is so distressing, excessive, and/or pervasive that it is significantly interfering with an individual's quality of life. The feared or avoided situations in Social Phobia can be very narrow and specific, or may extend to the majority of one's interactions with others.

General Discussion / So What is CPTSD?
« on: August 25, 2014, 11:17:34 PM »
By Dr. C. Courtois -

Complex traumatic events and experiences can be defined as stressors that are:

(1) repetitive, prolonged, or cumulative

(2 ) most often interpersonal, involving direct harm, exploitation, and maltreatment including neglect/abandonment/antipathy by primary caregivers or other ostensibly responsible adults, and

(3) often occur at developmentally vulnerable times in the victim's life, especially in early childhood or adolescence, but can also occur later in life and in conditions of vulnerability associated with disability/ disempowerment/dependency/age /infirmity, and so on.

Child abuse of all types (physical, sexual, emotional, and neglect) within the family is the most common form of chronic interpersonal victimization. Such abuse is often founded on problematic and insecure attachment relationships (between parent and child or others who have primary caretaking responsibilities). Parents and other caregivers who abuse exploit a child's physical and emotional immaturity and dependent status to meet their own needs or do so in response to their own inadequacies or distress, quite often their own history of unresolved trauma and/or loss.

Rather than creating conditions of protection and security within the relationship, abuse by primary attachment figures instead becomes the cause of great distress and creates conditions of gross insecurity and instability for the child including misgivings about the trustworthiness of others.... 

Rather than having a secure and relatively carefree childhood, abused children are worried and hypervigilant. The psychological energy that would normally go to learning and development instead goes to coping and survival.....

Child abuse, occurring in the context of essential relationships, involves significant betrayal of the responsibilities of those relationships ....

The seven categories of additional aftereffects [to PTSD] include the following:

1. Alterations in the regulation of affective impulses, including difficulty with modulation of anger and of tendencies towards self-destructivenesss. This category has come to include all methods used for emotional regulation and self-soothing, even those that are paradoxical such as addictions and self-harming behaviors;

2. Alterations in attention and consciousness leading to amnesias and dissociative episodes and depersonalization. This category includes emphasis on dissociative responses different than those found in the DSM criteria for PTSD. Its inclusion in the CPTSD conceptualization incorporates findings that dissociation tends to be related to prolonged and severe interpersonal abuse occurring during childhood and, secondarily, that children are more prone to dissociation than are adults;

3. Alterations in self perception, predominantly negative and involving a chronic sense of guilt and responsibility, and ongoing feelings of intense shame. Chronically abused individuals (especially children) incorporate abuse messages and posttraumatic responses into their developing sense of self and self-worth;

4. Alterations in perception of the perpetrator, including incorporation of his or her belief system. This criterion addresses the complex relational attachment systems that ensue following repetitive and premeditated abuse and lack of appropriate response at the hands of primary caretakers or others in positions of responsibility;

5. Alterations in relationship to others, such as not being able to trust the motives of others and not being able to feel intimate with them. Another "lesson of abuse" internalized by victim/ survivors is that other people are venal and self-serving, out to get what they can by whatever means including using/abusing others. Abuse survivors may be unaware that other people can be benign, caregiving, and not dangerous;

6. Somatization and/or medical problems. These somatic reactions and medical conditions may relate directly to the type of abuse suffered and any physical damage that was caused or they may be more diffuse. They have been found to involve all major body systems and to include many pain syndromes, medical illnesses and somatic conditions;

7. Alterations in systems of meaning. Chronically abused and traumatized individuals often feel hopeless about finding anyone to understand them or their suffering. They despair of being able to recover from their psychic anguish.

[Brackets mine]



A] Description from Out of the FOG- - This is easy to read and understand, and gives some insight as to why personality disordered behaviour can result in the development of CPTSD

B]  Pete Walker's Description of CPTSD - From the book "CPTSD: From Surviving to Thriving" (2013) 

"CPTSD is a more severe form of Post-traumatic stress disorder.  It is delineated from this better known trauma syndrome by five of its most common and troublesome features:"

Emotional flashbacks "...are sudden and often prolonged regressions to the overwhelming feelings states of being an abused/abandoned child" and involve "shame, alienation, rage, grief and depression."  These are unlike flashbacks experienced with PTSD in that EFs do not typically have a visual component. (p. 3)

Toxic shame - "can obliterate your self-esteem in the blink of an eye. In an emotional flashback you can regress instantly into feeling and thinking that you are as worthless and contemptible as your family perceived you .... toxic shame also inhibits us from seeking emotional comfort  and support.  In a reenactment of the childhood abandonment we are flashing back to, we often isolate ourselves and helplessly surrender to an overwhelming feeling of humiliation" (pp. 5-6)

Self-abandonment - "As the quest for perfectionism fails over and over, and as parental acceptance and nurturing remain elusive, imperfectionism becomes synonymous with shame and fear. Perceived imperfection triggers fear of abandonment, which triggers self-hate for imperfection which expands abandonment into self-abandonment" (p. 177).

Vicious inner critic - "The inner critic blames you incessantly for shortcomings that it imagines to be the cause of your parents' rejection. It is incapable of understanding that the real cause lies in your parents' shortcomings" (p. 168).   ".... most survivors spend tremendous amounts of time barely conscious of how incessantly self-critical they are" (p. 172).

Social anxiety - "Many therapists see CPTSD as an attachment disorder. This means that as a child the survivor grew up without a safe adult to healthily bond with.....  When the developmental need to practice healthy relating with a caretaker is unmet, survivors typically struggle to find and maintain healthy relationships.  ........childhood abuse installs a powerful people-are-dangerous program (pp. 50-51)

See various CPTSD related articles by Walker here -

C]  Clinical Description

CPTSD was first proposed as a diagnosis by Judith Herman is her 1992 book “Trauma and Recovery” to describe a cluster of symptoms which results from ongoing or repeated trauma over which the victim has little or no control, and from which there is no real or perceived hope of escape (e.g., children who are subjected to abuse and/or neglect by their parents). It is in this respect that CPTSD differs from the more well-known diagnosis Post Traumatic Stress Disorder (PTSD) which typically involves a single instance of acute trauma such as witnessing a tragedy or being the victim of an act of violence.  That is, CPTSD is a layering of repeated trauma which results in additional symptoms to those of PTSD. In addition to the recurring flashbacks, avoidance or numbing of memories of the traumatic event, and hypervigilance experienced in PTSD, CPTSD involves five additional symptoms which include alterations in:

•   regulation of emotions (e.g., anger, hair trigger flight/flight responses, suicide ideation);
•   consciousness (e.g., dissociation);
•   self-perception (e.g., fragile sense of self; pervasive sense of shame, guilt, self-blame, of being completely different from other human beings)
•   perception of the perpetrator(s) (e.g., preoccupation with relationship with perpetrator);
•   relations with others (e.g., isolation and withdrawal, distrust of others, relationship difficulties, loneliness and feelings of abandonment/rejection);
•   systems of meaning (e.g., sense of hopelessness and despair, depression). 

For further information see "Judith Herman and the Formulation of C-PTSD" at  (Includes a video of an interview with Judith Herman)

It should be noted that the term CPTSD has yet to be recognized as an official diagnosis, but has been and continues to be used extensively by both professionals (i.e., traumatologists, researchers, therapists) and the public.  The disorder is also known as Complex Trauma, Developmental Trauma Disorder (when the sufferer is a child), and a Disorder of Extreme Stress Not Otherwise Specified (DESNOS). However, given that CPTSD is widely used, it has been adopted so that those of us who are dealing with it -- by whatever name -- can begin our journey out of the storm that is CPTSD, to share our knowledge of and experiences, and to support and encourage one another on our journey.

Note: For a discussion of the various terms/diagnoses used for CPTSD see
Developmental trauma, complex PTSD, and the current proposal of DSM-5 by Vedat Sar Mar 2011 at

Introductory Post / My Family's Legacy
« on: August 25, 2014, 10:08:34 PM »
I grew up in a home that outwardly appeared fairly normal, but behind closed doors was rife with crazy making behaviour on the part of my parents and brother.  My F was an alcoholic and up until I turned 50 I thought it was ground zero for my family's and my problems.  I went to an Adult Children of Alcoholics group when I was in my late 20’s and read everything I could get my hands on, and while reading and attending the ACoA group helped, it still felt like there were pieces missing, big pieces.  I knew a lot about what addiction does to a family, and that in mine I was the Scapegoat and Lost Child, my brother the Golden Child, and my mother the Enabler.  So why was I still struggling?  I was diagnosed back then with chronic depression and prescribed an antidepressant, and there things sat for a decade or two. 

Long story short, a number of things happened in my 50’s that led me to look for those missing pieces in earnest. I found my way to Out of the Fog where I learned that my M and B suffer from Narcissistic Personality Disorder.  I finally understood just how crazy and soul crushing life had been in childhood and that I carried that with me into adulthood, my family’s lasting legacy. I had been emotionally abused and neglected as a child and developed CPTSD as a result.

I finally feel like I have all the pieces.

I started this site with the blessing of the kind folks at Out of the Fog (and bless their hearts space on their server), as a safe place where those of us who suffer from CPTSD can share information and encourage and support one another on our journey out of the storm that is CPTSD.


Books & Articles / Books
« on: August 23, 2014, 06:18:22 PM »
Be sure and check out our "Books" section here.

Also, if you have a good book or article you've read that relates to CPTSD in one way or another, please feel free to share it here.   :yes:

Books & Articles / Popular Articles
« on: August 23, 2014, 06:16:01 PM »
This thread is for online articles that are written for the public (versus clinical or academic articles)

- Article about CPTSD from Good Therapy web site -

- About CPTSD from the US Dept of Veterans Affairs -

Books & Articles / Academic Articles
« on: August 23, 2014, 06:01:09 PM »
This thread is for articles which are clinical or academic in nature (not written for the public per se) 

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