Healing Invisible Wounds: Understanding Complex PTSD

Healing Invisible Wounds: Understanding Complex PTSD

If you know me, you know that my dog, Sophie is usually with me. She’s a rescue, a Blue Healer mix, and such a love. I am very attuned to her. What does this mean? It means, I can understand what she is communicating to me. She has a certain look for, “I’m hungry,” another for, “I need to go out,” and another for, “When are we going for a walk?” Certain sighs mean, “I’m tired,” and others mean, “I’m bored.” If she is sitting on my feet, it’s because she’s scared. Because it’s easy for me to understand her communication, it’s easy for me to help her get her needs met. This is attunement. When we are babies and small children, we need our caregivers to be attuned to us. We aren’t able to say, “I’m hungry,” or “I need to be held.” When our caregivers attune to us, we feel safe, loved, and cared for, and we can go about the developmental tasks of growing up. But what happens when, for whatever reason, our caregivers are not attuned to us? This can be the beginning of Complex PTSD (CPTSD). When we are are not seen and are emotionally neglected, we experience relational trauma, which is trauma that is invisible.

What is Complex PTSD?

Peter Walker, author of Complex PTSD: From Surviving to Thriving, defines it this way: “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, toxic shame, self-abandonment, a vicious inner critic and social anxiety.” Childhood abuse can cause CPTSD. Most people that experienced childhood abuse understand that their experiences in childhood are the cause of their CPTSD. But what about those clients that come in and say something like this: “No one abused me in my childhood. Sure, my parents weren’t perfect, but whose were? They believed in discipline, and in children being respectful and quiet. My dad would yell when I deserved it. What’s so wrong with that? Why do I struggle so much? Why do I hate myself? Why do I keep finding myself in dysfunctional relationships?”

A Lack of Attunement Can Cause Complex PTSD:

It’s hard to recall our early childhoods, and so many of us don’t have many memories from this time. In order to understand a lack of attunement, we have to think about the everyday experiences of life. I want you to imagine a baby. It could be your baby, a niece or nephew, a grandchild, or any baby you have spent time with. I want you to picture that baby crying. See the baby holding their arms up, in a gesture saying, “pick me up.” Imagine the caregiver ignores the baby, thinking that picking them up will spoil them. Picture the baby being hungry and crying, and getting a pacifier stuck in their mouth. You get the idea? When this happens over and over, the baby starts to get confused. Because there is no attunement, the baby starts to believe that they will never get their needs met. Now imagine a toddler that falls and skins their knee. Ideally, a caregiver would say, “You fell and hurt your knee. I’ll take care of you. Let me give you a hug and a Band-Aid.” From this interaction the toddler learns that when they are hurt, they deserve care and comfort.  But what about the toddler that falls, hurts their knee, and no one notices? Or they get told, “Stop crying! You’re fine!” A belief system starts to form: I don’t matter. I don’t deserve to get my needs met. It’s hard to engage in healthy relationships, to believe you have something to offer in social situations, or to believe you deserve happiness from this belief system. The easiest way to make sense of this as a child is to blame and abandon yourself because it gives you a sense of control. If it’s your fault, you can be different. If you try hard enough, if you are good enough, maybe if you are perfect, someone will see you, and you will be loved and get your needs met.

Healing from Complex PTSD: The First Step:

The first courageous step is to work with the protective force of minimization, the voice that says it wasn’t that bad. The voice that says, You can’t really look at this pain, because that will mean you don’t love your parents. Or, it was a long time ago, so just get over it. Beginning to heal means knowing that contradictory things can both be true. For example, that you were not adequately attuned to as a child, which resulted in relational trauma, and that you still love your parents. Or, that it was a long time ago, and that you are still suffering from your childhood pain. Accepting the fact that although your scars may be invisible they are real, will allow the healing process to begin.

Continuing the Healing Process With IFS:

Healing from CPTSD involves addressing the inner critic, emotional flashbacks, toxic shame, self-abandonment, and social anxiety. IFS (Internal Family Systems) can help. Created by Richard Schwartz, IFS is a way of organizing and working with the inner psyche by breaking it down into parts, or sub-personalities. There are 3 kinds of parts: managers, firefighters, and exiles. Managers and firefighters are protector parts that try to keep us from feeling emotional pain. In the above paragraph, I talk about the minimizer; this is an example of a manager protector. Exiles are the parts of us that hold traumatic memories and painful emotions and beliefs. Often they are young, but parts that experienced traumas in adulthood can be exiles too. A person with CPTSD might have their system organized in this way: Social anxiety is a manager/protector of parts that hold emotional flashbacks and/or toxic shame by keeping them away from people that could trigger those feelings.

Self: The 8 c’s:

In addition to parts, everyone has Self. Self is the core essence of who we truly are when we are not in a part. Some people call it the wise part. Others, my authentic self.  Self embodies qualities fondly known in IFS as the 8c’s; compassion, clarity, connection, calm, curiosity, courage, confidence, and creativity. Connecting our exiles with Self is what facilitates the healing process. In order to do this, we need permission from our protectors. We get our protectors to step aside by honoring them for how they have kept us safe, and listening to their perspective on why they feel they have to do what they do. By offering them compassion and understanding, they create an opening for us to work with parts that need healing.

What Is Internal Family Systems Therapy? - Mendel Toron Psychotherapy Group

 

No Bad Parts:

IFS is a non-pathologizing approach, meaning it doesn’t view any part of the person as inherently bad or dysfunctional. Instead, it sees all parts as trying to help in some way, even if their methods are counterproductive. Therefore, there are no bad parts. This perspective can be empowering and healing for those with CPTSD, as it fosters understanding and compassion.

For those interested in understanding more about IFS, here is a short video of Richard Schwartz, explaining his model: