Help on how to recover from CPTSD

August 7, 2022 4:34 PM

After years of trying to figure why I would at times have such a hard time functioning, my therapist has diagnosed me with CPTSD. I'm glad to have a diagnosis but I'm not sure where to start on my healing journey.

The symptoms for CPTSD fits me to a tee and I'm relieved that I found some sort of answer to all the strange symptoms that I've been having. Although I have frequent bouts of depression, I did not meet all of the diagnostic criterion for major depressive disorder such as being depressed for more than two weeks. Usually I would have suffer through two or three days of intense depressive moods, and then feel better. I figured out that it was because I was constantly being triggered and I subconsciously began to isolate myself to curtail some of these depressive episodes.
Growing up was very difficult, being the daughter of working class immigrants. I'm convinced that my parents definitely had some of their own trauma that they passed on to my sibling and I. I had very little emotional support from anyone and remember dealing with my own issues by myself.
The symptoms I am currently struggling with the most include: emotional flashbacks, constant isolation, anger and trust issues. I want to know how others have healed and which treatments have been the most successful. Currently I am in therapy but my therapist does not specialize in trauma informed therapy so I'm not sure if it's helping. I want to feel better. I'm sick of the triggers and the constant emotional rollercoaster and I just want OFF.

posted by sheepishchiffon to Human Relations (14 answers total)

I think my PTSD shows up in a more body-based way than yours does (based on your description, at least) but I've had a lot of progress with somatic therapy. I spun my wheels in regular talk therapy for years, and things only got better for me when I started seeing a trauma specialist. I've been seeing a sensorimotor therapist for a bit now, and we've recently started doing memory processing work. It's intense, but one of the unexpected benefits has been — after 30 years of nighttime being my worst time, and highly disordered sleep due to anxiety and panic — that I sleep like a "normal" person now. It was like a switch flipped after we finished our work with the first memory. I'm still kind of floored by it — I honestly thought I was going to have to live with that dysfunction for the rest of my life. I'm hoping that as I continue to do it, the other parts of my nervous system that have been dysregulated for so long will gradually come back into harmony.

Something I've been noticing as the dissociation breaks is that a lot of feelings are coming up to the surface, often in a way that feels random and overwhelming. There was one day where I threw up out of nowhere, and several days where I've come close. The work is really hard, but it's rewarding, too, and it's the only thing I've found that has ever seemed like it's working (in contrast with certain practices that are helpful, like meditation, yoga, weight training, running... but haven't resolved the problem at the root, at least for me.)
posted by Kosh at 4:57 PM on August 7, 2022 [6 favorites]

First, it does get better then it feels right now. If you like your therapist and have a trusting relationship with them, I would continue with this therapist for now. You can also inform them that you want them to tell you if/when they feel you would benefit more from someone focused on trauma informed therapy and they may even be able to recommend a good fit.

It can take a long time to feel like you’re making progress with cptsd and some things will never entirely go away. Flashbacks should start to happen less over time in therapy and should lose some of their impact. Triggers are going to be harder to work on, but not insurmountable. You can do this.

Make sure you are getting enough sleep, eating relatively healthily, and getting regular (but not excessive) exercise. It sounds trite, I know, but taking care of these basic bodily needs will put you in a much better place as you work on this part of your past and present. Know you’re not alone in this challenge and that what you are doing is pretty courageous.
posted by donut_princess at 5:03 PM on August 7, 2022 [2 favorites]

The most healing therapy for me when dealing with CPTSD was differentiation psychotherapy. It helped me realize that our brains get stuck in “survival” mode when our parents neglect or abuse us as children by internalizing in ourselves all the “bad” qualities our parents possessed (that they project onto us) and becoming whatever our parents want from us (which usually is why we end up adopting the worst traits of our parents and wake up one day like “Who’s life is this?!”). The fact that CPTSD is literally a weird survival mechanism made a light go off, and I was able to properly reconnect with myself.

I also leaned to recognize my “emotional flashbacks” as elements of CPTSD and to take them for what they are: random flashbacks to times when I was made to feel my absolute worst, which I always realized were odd feelings that came out of nowhere but I didn’t know why. I was able to pinpoint my triggers for these flashbacks and learn how to navigate and shut them down.

I’m not sure why but having everything framed as a biological response allowed me to be kind to myself and realize being “broken” is just my body and brain protecting itself in a weird way by keeping me stuck.
posted by Cyber666 at 5:14 PM on August 7, 2022 [7 favorites]

I am so sorry that you are working through CPTSD. It must be so hard to deal with.

Be patient with yourself. Accept that some days you thrive, and some days you just . . .survive.

There is a great little app call "I AM" that might help.

There are some great C-PTSD workbooks that might help.

It can be useful to try a simultaneous "top down" and "bottom up" approach. From the bottom, try a bunch of different modalities that help you get into your body - yoga, meditation, music, dance, massage, repetitive movement. . . try everything! From the top, try on some different philosophies/paradigms/worldviews that might be consistent with the type of trauma you (and your family) went through. The more you can come to accept the "why did/does this happen," the easier it is to move forward.

You might want to try a type of therapy called Internal Family Systems. The book "No Bad Parts" might help. Also, you might want to try trauma-informed yoga, from the approach that yoga is pyschotherapy.

Best of luck in your recovery. DM if questions
posted by tiburon at 5:34 PM on August 7, 2022 [1 favorite]

Oh also, I almost forgot to say that the Dept of Veterans Affairs has an app called PTSD coach which has a bunch of symptom management tools for when you are suddenly feeling upset, anxious, or angry to sort of dial back the intensity of those negative feelings. It’s not a sub for therapy, but it’s really helpful as an addition to treatment.
posted by donut_princess at 6:30 PM on August 7, 2022 [1 favorite]

You might want to look at What My Bones Know by Stephanie Foo. She's a journalist who had complex PTSD and the book details various treatments that she tried to heal it. I found the memoir format accessible and engaging.

Another book that can be useful for trauma is The Body Keeps the Score by Bessel van der Kolk. It is comprehensive, but a lot to get through, at least for me.
posted by tuesdayschild at 8:51 PM on August 7, 2022 [2 favorites]

I have had unbelievably good results with EMDR therapy in treating my C-PTSD, which was my first therapist's specialty. It went so well that when she moved to a new practice, I was able to seamlessly transition to regular old talk therapy with one of her colleagues (who also is trained in EMDR, for those rare occasions when I need it again).

You can search for an EMDR trained therapist in your area here at Psychology Today's website.
posted by LuckySeven~ at 9:06 PM on August 7, 2022

-internal family systems therapy: helps you identify and reintegrate your "parts" which got shattered during abuse as a mechanism to stay safe during scary times; helps you understand your triggers and which "parts" are responding to the triggers
-psychadelics therapy
-healing childhood emotional neglect (book)
posted by erattacorrige at 9:48 PM on August 7, 2022 [1 favorite]

The single biggest thing that helped me with CPTSD (especially dissociation & flashbacks) was creating a trauma timeline with the therapist I was seeing at the time. We did it with physical materials (a long roll of paper for the timeline, with traumatic events written in marker on other sheets of paper, cut out and stuck along the timeline) over multiple sessions, but you could also do it with an online whiteboarding tool like Miro or Mural. My timeline ended up being more about things that did happen rather than things that didn't happen (ways in which my needs didn't get met) but if I were to do it again I'd include more of that stuff too.

I still struggle with the lasting effects of being raised by people who weren't capable of meeting my needs when I was a child, particularly when it comes to confidence and self-esteem, but I no longer get stuck in dissociative states or frozen by emotional flashbacks. Those things have gone from happening multiple times daily to almost never, or only if I'm having a particularly hard time emotionally in general.

Reframing my mental health issues from "I have severe, intractable, treatment-resistant depression with no known cause" to "I have CPTSD from being raised in a household that was totally emotionally unsafe by people with their own untreated and unacknowledged trauma who had no concept that they were responsible for creating a warm, nurturing and inclusive family culture if they wanted good relationships with their children" has been absolutely huge for me overall. I've gone from being someone who assumed they'd be severely mentally ill for basically their entire life, to someone whose challenges skew much closer to the 'normal' range of mood and anxiety issues that most people deal with. I'm basically content, despite the general existential challenges of being a person. I can go days at a time without remembering that I was severely mentally ill from the ages of 12 to 27, and that in those days my problems felt like a life sentence.

I really hope this diagnosis & journey helps you find a similar path.
posted by terretu at 9:05 AM on August 8, 2022 [10 favorites]

Nthing EMDR. I've found it extremely, life-changingly helpful.
posted by Ink-stained wretch at 10:19 AM on August 8, 2022 [1 favorite]

The Un-Fun thing about C-PTSD, is that it is ill-defined (in a clinical sense), and does not have many any evidence based treatments, partially because while it is a good descriptor for certain constellations of mental health problems, it is not a formal diagnosis. If you go to a psychologist for a full psychological evaluation, they can't actually say 'you have CPTSD, because it is not an official diagnosis (hopefully, yet). The biggest issue with this is that there isn't a good framework for what will work for treatment.

There are lots of good recommendations in this thread of things to try, but, they may not work for you. It is extremely hard to do so, but try not to get discouraged when something doesn't work. This is a hard thing to get right. Also note, that certain things, at certain times can be counterproductive.

Getting hooked up with an experienced trauma therapist that specializes in trauma-related therapy (not just one that claims to be like, 'trauma informed': because that kind of experience is just self reported. Don't rely on places like Psychology Today to list this accurately) is really hard, but one of the better, reliable steps to take. A 'regular' therapist can be extremely helpful dealing with depressive symptoms for example, but a since the depressive symptoms generate from such a fundamentally different place, the interventions that they may suggest or attempt with you, may not work very well, at all, or even be counterproductive. I personally find CBT and DBT modalities extremely counterproductive for CPTSD treatment, and where alot of regular therapists kind of default to when you show up (YMMV, obviously, which is just kind of my point).

Asking point blank questions of practitioner such as "Do you have experience helping individuals experiencing PTSD/CPTSD issues reach full remission?" and seeing how they answer those direct questions can be very helpful. Ask your current therapist specifically for recommendations of practitioners that specialize in the care you need; their personal networks (should) be more robust than yours.
posted by furnace.heart at 11:02 AM on August 8, 2022 [2 favorites]

Nthing EMDR, talk therapy is great and helpful, EMDR is on another level for issues of this complexity. Pretty mind-blowing to be honest.
posted by Sreiny at 1:04 PM on August 8, 2022 [1 favorite]

I have to say that getting evaluated and diagnosed and therefore reframing my mental health from "I am depressed and anxious and a failure and I can't seem to make it better" to "I actually have CPTSD" has made a world of difference. I have made more progress in the six months since than I have in 20 years before hand. Absolving myself, for the lack of a better terms, of the consequences of the foundational trauma I suffered has changed my life.
posted by lydhre at 4:53 AM on August 9, 2022 [3 favorites]

Don’t let it upset you too much that it isn’t a formal diagnosis yet in America, it is in Europe in the ICD-11.
posted by catspajammies at 10:37 PM on August 9, 2022