PTSD Awareness and C-PTSD Acknowledgment
It is quite a confusing fact that many people in the kink community, both on the D/s and fetish side, have a history of trauma and abuse in their past. I usually don’t like generalisations but so far I have yet to meet someone who has had a brilliantly safe and healthy upbringing, or hasn’t had a fair share of bad abusive relationships or sexual experiences. Yet, there is a lot of stigma around it and people tend to scream loudly when you make statements like this. Yes, not everyone who has been through trauma will end up in the kink community. There are those who avoid sex altogether, or those that work hard on (pretending?) having an adapted vanilla sex life. But, there is no way to deny that sexual, physical or emotional trauma makes you more prone to seek out more deviant sexual experiences.
I personally do not have an issue with admitting that my own trauma has a lot to do with my involvement in the kink community, a D/s relationship and a BDSM dynamic. I see it as turning a very negative into a positive. My brain is not wired like a healthy and normally functioning brain. It has been taught and conditioned into having certain kinds of needs.
I am fully aware of this. Instead of self-harming, subconsciously seeking dangerous and abusive situations or displaying unhealthy behaviour in relationships, I have turned it into a positive. Of course being in the kind of relationship I am in doesn’t sort my issues. But it makes it easier to deal with them, and the level of danger and destruction that my trauma could cause, is much lower. And that is because certain needs are met, and because there are limits that I cant cross. I am free to roam in a certain framework, and that framework is safe.
PTSD Awareness and C-PTSD Acknowledgment
Now, why am I yet again talking about trauma and mental health? Well, it is PTSD (Post Traumatic Stress Disorder) Awareness Month, so this is the perfect time to talk about these things! I want the focus of this post to be C-PTSD (Complex Post-Traumatic Stress Disorder). There is an important reason for this! For years upon years, professionals have ignored the fact that there is a difference between complex long-term trauma and trauma caused by a single event. Treatments have been similar but those with complex trauma often struggled with chronic and severe issues, while those with PTSD found relief through therapy. Still, all kinds of trauma were pushed under the PTSD-umbrella.
But! Things have changed now! In the new diagnostic manual of the WHO (World Health Organisation), the ICD-11, C-PTSD has officially become a diagnosis! You can not imagine the sigh of relief that has traveled through the therapist community! Therapists have long understood the difference between PTSD and C-PTSD, but psychiatrists and those deciding on diagnostic terms, were only slow to follow. But finally, all of us are seen. Our struggles have become valid in the eyes of professionals. I need to add that the American version of a psychiatric diagnostic manual (the DSM) still does not list C-PTSD as a diagnosis. Hey, but the world does acknowledge our struggles, one country’s ignorance is not going to take away from that.
PTSD and C-PTSD – Similar but Different
Post-Traumatic Stress Disorder became an official diagnosis in the 1980s. Back in the day it had different terms, one of those is the war tremble or war shakes. It was often linked to soldiers returning from war. But it has become apparent that trauma can be so many things and one of the main causes of PTSD in today’s society is sexual assault. What constitutes trauma depends on the individual, it has nothing to do with what is generally seen as severe.
Two people can experience the exact the same thing, one ends up with PTSD, the other one processes the event and can move on from it rather quickly. Events that can cause PTSD are war, a car accident, the death of a loved one, loss, witnessing an accident or abuse, sexual assault, a natural disaster, a fire or physical assault/being the victim of a crime. What is important here, is that it is about a single traumatic event.
Symptoms of PTSD include flashbacks, depression, anxiety and panic attacks, avoidance of places and situations that remind you of the trauma, physical symptoms such as pain, anger issues, dissociation, nightmares/insomnia and nightterrors, intrusive thoughts about the traumatic event, emotional numbness, selective amnesia about the event, paranoia, self-harm and suicidal behaviour, hypervigilance and an inability to emotionally connect to other people.
PTSD can be debilitating, it can have a huge negative effect on someone’s ability to function on a day to day basis. The good news is that treatment for PTSD can be fairly successful, both with exposure therapy, talk therapy, symptoms management and particularly much with EMDR.
What makes C-PTSD different from PTSD? The main difference is that C-PTSD is about complex trauma. Complex in this context means long-term and ongoing trauma. Additionally, it also points towards trauma that has happened in circumstances where the victim is trapped in the traumatic situation, or they felt trapped in the traumatic situation. There was absolutely no way out, long-term. C-PTSD is about interpersonal trauma and therefore always about abuse from another person or a group of people. In contrast to PTSD, it is not about a single traumatic event. Examples of complex trauma are long-term sexual, physical or emotional childhood abuse, domestic violence, human trafficking, ritual abuse or being a prisoner at war.
C-PTSD is very similar to Stockholm Syndrome. A victim is stuck with an abuser and is unable to escape the situation and there is no safe person to turn to. What options does a victim in a situation like that have? They get conditioned to trust their abuser, to think that the abuse and the way things are, are the only way. They might do anything to please the abuser (called fawning, which is one of the automatic reactions to threat) and adapt to the position of the submissive victim.
Complex trauma changes who you are to your core. Everything you are, the way you think about yourself, about the world, about other people, is impacted by the trauma you have been through. This makes relationships, functioning professionally or even on a day to day basis, extremely difficult. One major difference to PTSD here is that someone with C-PTSD denies or minimizes their trauma. They push away what has happened, they might idolize their abuser(s) or blame themselves instead.
CPTSD is defined by all the symptoms of PTSD but has quite a few additional symptoms, like: emotional flashbacks, toxic shame and self-blame, an inability to maintain healthy relationships, self-hatred, low self-confidence, a constant search for a saviour, a lack of belief in the world or meaning, chronic hopelessness and suicidality, learned helplessness, reenactment and a tendency to repeat the traumatic bond, denial of trauma, emotional dysregulation, fawning behaviour and a severely hurt inner child.
As it may have become evident by now, C-PTSD and the complex trauma you have been through, defines you. It impacts everything that you are, all the decisions you make, the relationships you seek, the way you look at yourself, the world and the future. This is what makes it more difficult to treat than PTSD. You need to not only process the trauma, you need to unlearn behaviours, you need to recondition your mind, you need to actually accept that you have been through trauma.
There are not a lot of therapy options that work for C-PTSD (which I personally think is one of the reasons why professionals have been reluctant to add the diagnosis to any manuals), and it is often about difficult long-term treatment that involves different forms of therapeutic approaches. You can not be cured from C-PTSD, but you can unlearn behaviours and process the trauma, which makes it easier to live with the illness.
My own Experiences
I am diagnosed with C-PTSD. Additionally, I am also diagnosed with Bipolar Disorder, Dissociative Identity Disorder, Generalized Disorder and Social Anxiety. My mind is a fun playground of fuckery, basically. The C-PTSD gives me a whole lot of symptoms and behaviours that I find difficult to control. It makes me feel like there is something inherently wrong with me and that that is my own fault.
My trauma involves sexual, physical and emotional abuse during childhood and my teenage years (age 2 or 3, to about age 14/15). One of my main abusers was my father, but there was a group of men who systematically abused me for years. I don’t remember a lot from it (fortunately!) but whenever the flashbacks hit me, it becomes extremely confusing because I feel like I had no prior knowledge or memory of those things. Also, I don’t remember if I was being sold and prostituted or if it only was the sadistic nature of my father to force me to go through those things. Later on, during my teenage years, I got sexually abused at the scouts, and at school by a group of jocks, for months. In addition to all of that, I have also been bullied, for many years, at school, and by peers. Summarizing, the years that were supposed to be about preparing me for life, that were supposed to be about being cared for and taught life skills, were filled with moment after moment of abuse and breaking my body and mind.
The Dissociative Identity Disorder has blessed me with amnesia, so fortunately, I don’t remember much of the worst trauma I have been through. Most people with DID also have C-PTSD. The C-PTSD has given me some very frustrating behaviour that I know comes from a conditioning of my mind during my formative years, but that I am unable to change.
I think everything is my fault, not only the abuse, but also when things go wrong in my life. I am unable to stand up for myself and I instead try to soothe the person that hurts me. The emotional flashbacks are overwhelmingly terrible. I don’t trust people, I feel helpless in any kind of problematic situation and I freeze instead of dealing with things. It is like I become a hurt animal, that is trying to hide, whimpering and waiting for death. I have huge avoidance issues. I have no hope for the future and I don’t believe in that I can change my life for the better. I am constantly on edge, I have nightmares, don’t sleep more then three to four hours a night and going out of the house feels like going out into a warzone. Constantly apologizing is my thing. I hate myself most of the time, and I am so ashamed of what has happened to me and who I am. I am chronically suicidal and more often than not, I have very self-destructive urges that are similar to a need to reenact.
As I have said in earlier posts on mental health on this blog: I am aware of all of those things and behaviours and I have become much better at controlling my actions and reactions. A lot of my small improvements are linked to my relationship with my Master and the safety he provides for me. I am currently not in touch with any professionals (don’t have insurance at this point) so that leaves me with the difficult task to handle my mind’s weirdness on my own.
Is there even Hope?
The issue with C-PTSD is that there is no easy fix. You yourself need to work hard to break the conditioning in your mind, and to change the behaviours that are protective tools for you. You behave in the way that you do, so you can keep yourself safe. It seems rather unfair, that the only goal that most therapists set with C-PTSD is an improvement in one’s quality of life. First you have to suffer through complex trauma for years, which messes up your life in adulthood. And then you are supposed to have the energy and motivation to work hard on getting better (when you hate yourself, deny the trauma, have no hope and feel incredibly helpless), knowing that you will never be okay. Only better. Where is one supposed to find the motivation for that?