The Smoldering Embers of Complex PTSD
By Jesse B. Donahue 2024 ©

The metaphor of smoldering embers nicely depicts my experience of day-to-day life. No smoke is coming from my ears, but hiding and avoiding social experiences are efforts to control a threatening fire. C-PTSD (Complex Post Traumatic Stress Disorder) always smolders within my brain, and when the right outer or inner experiences are touched upon, the ever-present smoking embers burst into flame. It seems that fuel, stepping into the emotional theater with others, is all that is needed to ignite a potential flaming disaster, a psychological-emotional crisis.

I am perpetually vulnerable to a debilitating state of mind that has eluded my understanding, perplexed me, and tortured me for most of my life



Putting the descriptive metaphor aside, I am perpetually vulnerable to a debilitating state of mind that has eluded my understanding, perplexed me, and tortured me for most of my life. Along with it, for me, comes severe depression, free-floating anxiety, and obsessive-compulsive efforts to find ways of calming the anxiety that threatens to devour me. Panic attacks, phobias, deluded-magical thinking, and addictive indulgences in sedating ingestions, including “obsessive” activities, are distracting, and/or dissociative experiences. Distraction is found in overeating, smoking, reckless over-indulgence of alcohol and drugs, and seeking the titillating pinnacle experiences of orgasm. Behavioral “rituals” can serve the purpose of distracting one’s focus from the pain caused by burning embers. The flames of pain are ever present, just waiting to burst into a secret fire. The “Secret” is our inner pain, which we attempt to hide from the outside world.

I carry a personal demon. This Demon leaves me feeling lonely, alienated, jealous, and distortedly different from all others. There is a constant subconscious threat of annihilation anxiety internally present – a state of impending doom. Extreme hypervigilance and arousal are the ongoing experiences of life. My emotions are dysregulated. What are others really thinking about me? Do they see how unlovable I am because of my being so different (toxic shame), as I feel?

What is the problem with allowing one more diagnosis to give clarity to a clinician’s diagnostic endeavors?



The American Psychological Association (APA) decided not to acknowledge C-PTSD in the current DSM manual (DSM-5) of recognized psychological disorders. That means the myriad of recognizable diagnoses satisfactorily covers the experiences of one who suffers from C-PTSD. Most modern theoreticians also recognize C-PTSD as (Developmental Trauma Disorder), yet it is not an official “diagnosis” either. (I think I prefer Developmental Trauma Disorder better than C-PTSD). As a student of psychology, it strikes me that my symptoms fit within the diagnosable categories of so many known disorders. Having a multitude of symptoms is typical of C-PTSD. For the sake of argument, I pick C-PTSD as a diagnosis. This diagnosis houses virtually all the symptoms with which I must contend. As we are all unique, there are some comorbid diagnoses I have as well. What is the problem with allowing one more diagnosis to give clarity to a clinician’s diagnostic endeavors? As a layperson, I don’t understand, and perhaps many therapists would agree with me. Is there a political consideration lurking somewhere in the denial of C-PTSD as an approved diagnosis? After all, the World Health Organization (WHO) recognizes C-PTSD as a diagnosable condition.

When I write, my thoughts take on the direction of my subconscious. It is also clear to me that writing is a distraction. I can focus my attention, similar to a ritual, on my inner thoughts, lay them out on the written page, and at the same time use them as a distraction from the threatening fire. If I am wholly engulfed in the distraction of the working ritual, the beast is often held at bay. The corollary is that when flames have begun to take over my moment, the interest and inspiration to sit down and write is blocked by the overwhelming inner trauma dramatically consuming me. I cannot focus or find my reasoning. My inspiration is crushed. When the psychic trauma is reexperienced in a C-PTSD flashback episode, I lose who I am and become a person psycho-emotionally enflamed in the moment, desperately trying to find escape.

C-PTSD is not listed as a diagnosis in the DSM-5, as I mentioned. If it is going to be accepted as an official diagnosis, it will have to wait for the DSM-6. I have read that it cannot be included in an update of the DSM-5. Therefore, those of us with the condition of C-PTSD can only wait with hope. It would be nice to be officially listed, thus legitimizing our experiences. C-PTSD is an interpersonal Trauma disorder that is created and established by long-term exposure to traumatic experiences, both physical and emotional. Its range of possible symptoms is considerable. There is a significant number of diagnoses that research psychologists think may have their basis in trauma. Perhaps this developing understanding of trauma may be one of the reasons for the delay in the authoring of the DSM-6. I envision the possibility of “Trauma” as a basis of psychological disorders in general. New understanding with “Trauma” as a diagnostic basis, incorporating specific features associated with structuring a more definitive diagnosis. Time will tell.

Photo by Clay Banks on Unsplash

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