In this series, we have concentrated on the symptoms of complex post-traumatic stress disorder (CPTSD) and highlighted how each one changes lives.
This article will focus on the final six symptoms:
- Feeling different from other people
- Feeling ashamed
- Feeling guilty
- Difficulty maintaining relationships
- Seeking out or becoming a rescuer
- Feeling constantly afraid
Let’s examine together each symptom and what it means to those who experience them.
The Final Six Symptoms of CPTSD
Let’s take a closer look at the symptoms listed above.
Feeling Different from Other People
Due to the causes of CPTSD, many who are living under its influence feel uncomfortable around other people. It may feel strange or distressing to be with others and one of the reasons is because the survivor feels they are different than other people somehow.
This description isn’t to say that survivors feel they are special than other people, but rather that they feel they don’t fit into any crowd. The loneliness that these feelings of detachment from other people bring is palpable.
One reason survivors feel out of place is they often feel they are damaged somehow and are unlikeable and weird.
Only after working hard with a therapist do people living with complex post-traumatic stress disorder begin to understand, at least on the surface, that they are not damaged goods.
Feeling Ashamed
Often those who live with the diagnosis of CPTSD feel intense shame about their bodies and their appearance. Some even feel they are stupid or crazy. However, none of these beliefs are true.
Survivors are victims of severe and repeated trauma, not monsters who came from nowhere. Their bodies were used or damaged by people who didn’t care about their well-being and the helpless they felt then often translates into shame now.
Then there is the toxic shame that so many people experienced during the trauma. They may have been told they were worthless or worse and harbor those beliefs in their hearts and mind.
Feeling Guilty
It may seem odd to some that victims of trauma would feel guilty. After all, they were not the instigators of traumatic events that caused their CPTSD. Yet, guilt is a quite common emotion among survivors.
Feeling guilty is deeply entrenched in many survivors. There is guilt that they could not stop the trauma themselves when it was happening. There is guilt for the way they sometimes enjoyed the abuse. There is even sometimes guilt because they could not help a sibling or other family member, or friend escape the trauma they were caught up in together.
The reality is that victims of trauma were not responsible for what happened to them, nor were they responsible for the safety of other victims. The people to whom those responsibilities fall are the people who harmed them.
Difficulty Maintaining Relationships
If a survivor manages to find a relationship, often they self-sabotage the burgeoning romance before it has a chance to get started. This is because many of those who live with the effects of CPTSD swing one of two ways; they cling onto their potential mate for dear life, or they push people who care for them away.
Because of the horrific broken trust during prior traumatic events, many survivors feel they must have a mate and will practically paste themselves to anyone who pays them attention.
On the other hand, some survivors find it impossible to trust another person and run away as quickly as possible leaving confused people in their wake.
Seeking Out or Becoming a Rescuer
As adults, most people feel self-reliant and strive to be as autonomous as possible while still maintaining healthy relationships with others. Survivors sometimes have a horrific time of being both autonomous and in healthy relationships as many will seek to be rescued or become one themselves.
For these people, life is a series of either being rescued or rescuing others leading to a life full of confusion and self-loathing as neither position is conducive to a great relationship with someone else.
Unfortunately, this need to rescue or be rescued often leads to situations where the survivor lives in unhealthy relationships where they are not safe.
Feeling Constantly Afraid
Most people can relate to feeling afraid about things that haven’t occurred yet like a wedding or an upcoming speech. However, survivors harbor the fear that borders on terror all day and all night without a break.
It would seem the amygdalae of survivors, because of being exposed to repeated trauma in the past, works overtime to seek out any situation it sees as something to run from.
This makes sense since the amygdala is the portion of the brain that is first to detect a dangerous situation and react with the fight/flight/fawn/freeze response. During the repeated traumatic events that caused the person to experience complex post-traumatic stress disorder, their amygdalae worked overtime trying to deal with the fear caused by the trauma and stayed that way.
How the Symptoms of Complex Post-Traumatic Stress Disorder are Treated
While there are many approaches to treating CPTSD, there are a few types of psychotherapy utilized the most.
Talk Therapy. When people visualize talk therapy, they usually conjure thoughts of a therapist sitting in a chair beside their client who is reclining on a couch beside them.
While lying down and speaking to a therapist is not disallowed, it usually isn’t what happens. Instead, the therapist and client typically sit facing one another at a comfortable distance.
During talk therapy, you will talk with your therapist about a variety of topics including those which trouble you the most.
Your therapist will not give you advice, nor will they give you the answers to your problems.
After all, they are not living in your mind nor are they living your life. Only you understand what you want out of life, and only you can find your answers.
Instead, what a therapist does is guide you, envision if you will a seeing-eye dog. They will warn you the traffic is coming, but ultimately it is you who decides to cross the street or not.
Cognitive Behavioral Therapy (CBT). This form of treatment involves the therapist attempting to help their client identify and change inaccurate thinking patterns which can lead to behaviors that are harmful or ineffective.
Your therapist will help you focus on the current problems in your life which were caused by adverse childhood experiences and how to resolve them today. CBT involves practicing new skills so you can function well in the world.
Dialectical Behavioral Therapy (DBT). DBT helps you learn how to regulate emotions. This form of therapy helps teach new skills to aid you in taking personal responsibility for your behaviors and your overall health. By taking such responsibility, you become more likely to implement the changes necessary to make your life more manageable.
Sand Tray or SandBox Therapy. Although not as well-known as the therapies listed above, sand tray or sandbox therapy isn’t just for kids; it is also an essential form of treatment for adults, as well.
Sand tray therapy helps you construct a microcosm in the sand tray of your life and those connected to it using miniature toys and different colored sand.
By doing this, the choices of objects you use to represent yourself and those around you help you recognize how you see yourself and resolve conflicts within you. It also helps you to gain acceptance of who you are as a human being.
For adults, sandbox therapy provides emotional release and realization of traumatic events in an atmosphere free from threats.
Your therapist asks you to pick objects and figurines to represent the people you are conflicted with and place them in the sand tray.
Then together with your therapist, you can work to understand the reasons you chose each figurine and the positions you have placed to understand better the truth behind how you feel about the people represented and any emotions you have attached to them.
Sandbox therapy can be potent, especially when you and your therapist begin to rearrange the symbols. Doing this together suddenly gives you a deeper understanding of how you see the people in your life and allows you to feel a sense of power over them.
Drama Therapy. Another immensely powerful tool therapists can use is drama therapy. This type of treatment involves a specially trained therapist who understands not only how to utilize trauma therapy but also can recognize when someone is getting into emotional trouble while using it.
Drama therapy is done in a group of people with whom you have been in group therapy before and have acquired trust. The therapist will ask you to relate a scenario you have been working on in private therapy and to choose people from the group to represent the other people involved.
Managing Your Recovery from CPTSD
There are no magic tricks or rabbits to pull out of a hat when it comes to healing from the effects of CPTSD. However, that doesn’t mean healing cannot happen. Recovery does and will occur, but it requires steadfastness in the heart and a lot of guts to accomplish.
But hey, you’ve already survived the original traumatic event, this should be easier than that for someone as strong as you.
Below are three ways to survive psychotherapy to heal from CPTSD.
Setting Recovery as a Goal for Treatment.
Although co-occurring problems may exist, it is vital for your trauma-informed therapist to help you understand they will get better as you work through what happened in your past.
The other symptoms or disorders, such as depression and anxiety, are not the overarching concerns, but rather effects from working on your recovery from complex post-traumatic stress disorder.
As many understand, the expectation is recovery.
Focus on Your Strengths Rather Than Your Illness.
Many skills can be learned to cope with childhood trauma, and a trauma-informed therapist will work with you to use them.
Your therapist may ask you questions to help you think and keep focused on the future such as, “What are some of your accomplishments which make you feel proud?” By using positive language, your therapist will help you recognize you are capable of coping well even with tough experiences.
Try and do any assignments your therapist may offer you. Doing homework greatly speeds up the process and offers you new insights into yourself.
Learn Resiliency
Resiliency’s best described as the ability to overcome challenges of all types—including tragedy and personal crises—and bounce back stronger than before. Most of us who have survived childhood trauma is already very resilient.
However, we often overreact or do not respond appropriately when faced with problems in our adult lives. Your trauma-informed therapist can help you understand some fundamental concepts such as how life is not fair, or how life is not easy.
Once you have these lessons under your belt, events such as life changes, struggles, and death take on a new perspective, as they are just parts of life that all humans share.
My Parting Words on the Symptoms of Complex Post-Traumatic Stress Disorder
As someone who herself struggles with the symptoms of CPTSD and another more severe mental health condition, I can attest that the challenging work in healing will pay off in the end.
I still have days when I do not feel well, and sometimes I wonder “why me” and feel the effects of the disorder.
However, I know in my heart because of my experiences, that the clouds will part, and the sun will shine again in my life.
I have learned that since I am still here, after all, I have been through that there must be a special purpose in my life. The same can be said for you.
Don’t ever, ever give up the fight. Reach, stretch, jump, and grab your dreams because they are a force for good in your life. Never believe you aren’t worthy of life because the fact you are still breathing proves that wrong.
If you take nothing more from this piece, please remember, there are others out there in Internet land who understand and have been where you are.
You are not alone.

My name is Shirley Davis and I am a freelance writer with over 40-years- experience writing short stories and poetry. Living as I do among the corn and bean fields of Illinois (USA), working from home using the Internet has become the best way to communicate with the world. My interests are wide and varied. I love any kind of science and read several research papers per week to satisfy my curiosity. I have earned an Associate Degree in Psychology and enjoy writing books on the subjects that most interest me.
Could someone help me understand Pseudodementia as it is related to depression
To be honest, I had never heard the term pseudodementia before you wrote asking for help. I have a great link to share with you.
https://www.gulfbend.org/poc/view_doc.php?type=doc&id=15336&cn=231
I will keep doing research on this topic and write something soon to help everyone who has this syndrome. I’m sorry I’m not more help right now. Shirley
I was diagnosed with bi-lateral temporal lobe epilepsy.
I did not remember being abused until about about 15 yrs ago. I was diagnosed as having cPTSD. I do dissociate. There are about 5 or 6 “different” parts in me.
In order to “make myself behave”, I’ve used “god” to “punish” myself. I thought my abuser was “god.” I then was diagnosed with Religious Scrupulouslity. A subset of OCD.
I have a team of Dr’s. My neuropsycholgist + trauma therapist work together with me.
I just didn’t understand what people meant when they told me I am punishing myself.
It’s as though the other parts of me try to torment me.
I would like a kind comment, maybe just some insight.
On Dec 12, 2034, my sister committee suicide. We had the same abuser.
What can I do to help myself if I can’t access a trauma trained therapist? I meditate, read, and research, and would love recommendations for further reading material. Thank you for your article, it resonates with me and left me wanting more – have you written more? Thank you for your time.
Hello, and thank you for your comment. I’m so glad my writing could help. I’ve written a book called The Storm in Your Brain Called Complex Post-Traumatic Stress Disorder that is full of information that I’ve shared on the blog here. Also, there are more pieces to read here on this blog that can help you. Be certain to seek out a therapist, even if they are not trauma-informed because the symptoms of CPTSD can be severe. Although trauma-informed care and training are growing in the U.S., it has not hit the potential it could have in helping people. Please take good care of yourself and keep reading our blog! I’ve included the link below to my book.
BOOK
There are organizations that provide free therapy. Rape Response is one in our area. Possibly there is a place like that in your area.
Keep calling and reaching out. These type of people and organizations enjoy helping, it makes therapy believable. Kindness begets kindness.:)
Hey Julia, I would personally recommend that you reach out to NAMI (https://www.nami.org/Home) in your area, they are a great resource. They have amazing online support groups on a variety of topics as well, and everything is free. I offer a lot of free resources on my website as well, all geared towards complex, childhood, and sexual trauma, one of my most popular pages being the Self-Healing Video Library that you can access here: https://www.littlewavecoaching.com/self-care-videos
Like Shirley so beautifully said, remember that you are not alone. Keep reaching out, as we are all in this together, and wonderful sites like the C-PTSD Foundation allow us to know and feel that more than ever before.
I seriously thought everyone had the ‘six symptoms’ and the feelings were normal for everyone.
How could you not think everyone had the symptoms. I thought so too because it was my normal. Thank you for commenting. Shirley Davis
I believe this site has very good indited content blog posts.
Very helpful. I will use this with my new therapist. I am at the closure part of my CPTSD. It’s unfortunate at the time I was an infant and occurred daily until I was 7. This will always be a part of my psychological foundation. The awareness, and process I have to know it’s not me. It’s them! I will never take responsibility for their inexcusable behavior. I have insight, tools and closure! Thank you
The Dr’s around the area I live at are not taking new patients. I want and need help so badly. I am struggling every single day of my life.
Hey Cat,
Many forms of support for CPTSD can take place online, just as successfully as in person, thanks to Zoom and other platforms. I was hesitant at first, but I now recognize that telehealth is a valuable alternative, when local resources aren’t available.
Hello Mrs./Miss/Ms. Shirley Davis, I want to say “Thank You” so much and from the bottom of my heart sincerely! Everything that you have said has been me and my life (I have been living in pure hell, living in a prison of and within myself)! It has been sososososososo hard and extremely a lot to deal with and grasp and the…”why me”. You said it all, straightforward, exactly and to the point head on. I really needed this so much because all I have been thinking about is wanting to die and I have tried to kill myself several times (but, God won’t take me)! I was on line trying to research of how to become and advocate and typed in something else and it lead me to you. I pray to GOD that my life’s past will stop haunting me and it is extremely hard and yes I am also a rescuer as well (toxic people), I try to avoid people at all cost and it just seems as God places these types of people in my life and paths. I am tired of this and this life and I want better mental health, life and living. I told my son that if my life does not change by the time I get to the age of 55 years old, that I will kill myself and I mean that and meant that. I am going on 52 in October and if by 55 my life has not changed I will end my life if not before, but I am trying to hold on. Everyday is a struggle for me just to live and seriously! And because of you right not and the insights of this website it has given me hope to hold on because, I was tired of fighting to try. Now that I have more information and understanding my mental issues, I will return to therapy and use this as a guide to tell my story alike in which you did! The website like that I originally Googled was Psychology Today (psychology today.com) “Understanding PTSD” 10-Common Patterns seen in unresolved relational trauma. I really, really, really like to say thank you so much and this is something that I will be sharing with so many people, but it has to begin with me first (not really like that)…but making those steps to get the additional help. Thank You