Complex PTSD Symptoms

Triggers

Triggers for C-PTSD are highly individualized, ranging from sensory reminders of trauma to overwhelming emotions, and can significantly affect daily functioning.
 
By understanding the symptoms of complex PTSD, and developing effective coping strategies, it is possible to identify and manage triggers

Sections:

Re-Traumatization

Retraumatization and trigger are related terms in the field of trauma psychology, but they have distinct meanings.
 

Trigger:

Retraumatization:

Re-traumatization occurs when an individual with Complex PTSD is exposed to new or similar traumatic events that trigger the symptoms of their original trauma. 

This can happen in various ways, such as:

Effects of Retraumatization

Re-traumatization can have significant negative consequences for individuals with CPTSD, including:

The impact of re-traumatization can be extensive. Even if people think they have moved past their trauma, a re-traumatizing event can be massively triggering and put their recovery on unstable ground. 

Some people may struggle to deal with the emotions that resurface and turn to unhealthy coping mechanisms, such as substance abuse, or they may experience elevated levels of anxiety or depression for prolonged periods.

If an individual with CPTSD experiences re-traumatization, it is essential to seek immediate professional help. Therapy can provide support, guidance, and tools to manage the symptoms and prevent future re-traumatization.
 

Managing Retraumatization

No matter the event, re-traumatization can feel like a massive setback in trauma recovery. Some may think that because the re-traumatizing event was not related to the original trauma, they should not be feeling shaken or traumatized by it. 

However, regardless of the trigger, it is important that people do not minimize how it has affected them. It's also important to take the time to process the traumatic event and not feel pressured to be okay immediately.

Re-traumatization can cause a resurgence of trauma symptoms, but you can use several strategies to manage them, such as:

Complex PTSD Triggers

Complex PTSD (C-PTSD) triggers are stimuli or situations that remind individuals of the traumatic experiences they endured, and can be anything that evokes a strong emotional or physical response, including sights, sounds, smells, locations, thoughts, emotions, or physical sensations.

This triggering can manifest as a fight-or-flight response triggered by the amygdala, responsible for processing emotions in the brain. When this happens, a person's brain can perceive that they are in danger, even if they are not. This is known as an amygdala hijack.

When triggered, individuals with c-PTSD may experience symptoms similar to those they experienced during the traumatic event.

Symptoms can include panic attacks, flashbacks, intrusive thoughts, hypervigilance, suicidal ideation, and feelings of detachment (dissociation). 
 
What triggers this response for you will probably look different than what triggers it for someone else. This is largely because a trauma trigger is related in some way to the original trauma.
  

Common Types of Triggers:

• Trauma-Related Reminders
  Anything that reminds someone of the trauma, including sights, sounds, smells, locations, or even certain people or objects.
    
• Internal Sensations
  Physical sensations or emotions that mirror those experienced during the trauma, such as heightened anxiety, hypervigilance, or feelings of helplessness.
    
• Emotional Overload
  Intense emotions, even positive ones, can be triggering if they remind someone of the emotional intensity of the trauma.
  
  
• Social Interactions
  Difficulties with relationships, trust issues, or feelings of abandonment can be triggered by interactions with others.
   
• Anniversaries or Reminders of Events
  Dates, places, or events that mark the anniversary of the trauma or other significant events can be triggers.
   
• Lack of Control
  Situations where individuals feel powerless or unable to control their environment can be triggering.
   
• Shame and Self-Blame
  Internalized feelings of shame or guilt related to the trauma can be a source of distress.
   
• Overstimulation
  Loud noises, bright lights, or crowded places can overwhelm individuals with C-PTSD, triggering a flashback or other symptoms.
   
  

Examples of Triggers:

• For someone who experienced childhood abuse: 
  A touch that reminds them of the abuse, a specific smell associated with their abuser, or even a song that was playing during the abuse.
   
• For someone who experienced domestic violence: 
  A loud argument, a reminder of their abuser, or a feeling of being trapped or powerless.
   
• For someone who experienced neglect or abandonment: 
  Feelings of rejection or abandonment, or even a lack of attention or support. 
    
• For someone who experienced sexual assault: 
  A specific location, a person who looks similar to their attacker, or even a certain type of clothing. 
   
• For someone who experienced war: 
  Loud noises, crowds, or even the sight of military uniforms.
    

Understanding and Managing Triggers:

• Identify Triggers
  Recognizing what triggers C-PTSD symptoms is the first step in managing them.
  
  
• Develop Coping Strategies
  Learning healthy ways to cope with triggers, such as deep breathing, grounding techniques, or mindfulness exercises, can help reduce distress
   
• Seek Professional Help
  A therapist can help individuals with C-PTSD identify and manage their triggers, and develop a plan for recovery.
    
• Create a Safe Environment
  Creating a safe and supportive environment can help individuals with C-PTSD feel more secure and less vulnerable to triggers.
    
• Limit Exposure
  If possible, limit exposure to triggers that are particularly distressing.
   
• Practice Self-Compassion
  Being kind and understanding towards oneself can help individuals with C-PTSD cope with difficult emotions.

Most Common Triggers in Relationships

Complex Post-Traumatic Stress Disorder (C-PTSD) can manifest in various ways within relationships, and certain triggers can exacerbate symptoms and disrupt the dynamics between individuals.
 
  
9 common triggers of CPTSD within relationships:

1. Abandonment and Rejection

Individuals with CPTSD may have experienced repeated abandonment or rejection in the past, which can make them hypersensitive to any signs of perceived abandonment or rejection in their current relationships. This can lead to anxiety and fear of being abandoned or rejected, causing difficulties in trust and emotional intimacy.

2. Flashbacks and Intrusive Memories

Certain situations or behaviors of a partner may trigger flashbacks or intrusive memories related to past traumatic events. These flashbacks can be distressing and make it challenging to stay present in the current relationship.

3. Attachment Issues

CPTSD can lead to attachment difficulties. Some individuals might become overly dependent on their partners for a sense of safety and security, while others may avoid emotional closeness altogether due to a fear of vulnerability.

4. Hyperarousal and Hypoarousal

CPTSD can result in heightened or dulled emotional responses. Hyperarousal may manifest as extreme emotional reactions, anger, or irritability. Hypoarousal, on the other hand, can lead to emotional numbness, detachment, and a lack of responsiveness, which can create distance in the relationship. 

5. Difficulty Trusting

Trust issues are common in individuals with CPTSD. They may have been betrayed or manipulated in the past, leading to a general mistrust of others. This lack of trust can affect building a healthy and secure relationship.

6. Conflict Resolution

The fear of conflict or confrontation due to past experiences can make it challenging for individuals with CPTSD to engage in healthy conflict resolution. They might withdraw or become passive-aggressive rather than openly addressing issues.

7. Boundary Violations

In cases of interpersonal trauma, boundaries are often violated. This can result in difficulty setting and maintaining boundaries in current relationships. Individuals may struggle to assert their needs and may become enmeshed or codependent.

8. Self-Worth and Self-Esteem Issues

Trauma can profoundly impact self-worth and self-esteem. Individuals with CPTSD may feel unworthy of love or may seek validation excessively, which can strain relationships.

9. Triggers from a Partner's Behavior

Certain behaviors or personality traits of a partner can act as triggers for someone with CPTSD. For example, a partner's anger, criticism, or controlling behavior may remind them of their past abusers and cause significant distress.

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Coping with CPTSD Triggers

Triggers can reawaken the trauma, making it crucial to identify and manage them effectively.

Coping with Complex PTSD triggers requires strength, commitment and bravery.

Imagine: A disturbing memory pops into your mind while you are trying to focus on work. Or a body sensation distracts you, turning a pleasant conversation with a friend into a chore. Or your body reacts with fear or anger to loved ones, even when your head knows they are trustworthy. 

That's because one of the most troubling parts of having Complex PTSD (C-PTSD) is the struggle with disruptive symptoms.

One of the hallmarks of Complex Post Traumatic stress disorder is the presence of intrusive symptoms such as:

• Memory flashbacks
• Nightmares
• Physical and emotional reactivity to triggers
• insomnia
• Hyper-vigilance
• Heightened startle reactions 
• Dissociative symptoms including alterations in memory and profound feelings of detachment
• Emotional numbing
    

A trigger is an event or situation that stimulates a trauma symptom.

An added burden that many people living with C-PTSD bear, is that their bodies have learned to expect relationships to be dangerous. So that means that complex trauma therapy itself can become a lot more complicated.

Cultivating Resilience: 5 Steps To Help Cope With Triggers

1. Know what your triggers are. Knowing what situations are likely to trigger you can help increase your sense of control.
    
2. Have a specific plan to regulate yourself. Once you know what your Complex PTSD triggers are. Come up with coping plan. Think about what exactly you can do to regulate yourself.
    
3. Tell your loved ones. Let the important people in your life know what you are doing and ask for their support. For example, one of my clients is a yoga teacher. She told her boyfriend and her parents that when she is triggered, she is going to step out for 15 minutes while she practices asanas and calming breathing techniques. So they don't worry, she also agreed to return in 15 minutes, even if it's only to tell them she needs more time.
    
4. Use your tools. Once you come up with a specific tool, then it becomes a matter of practice. Implement your calming techniques.
    
5. Get into therapy with a Complex PTSD (C-PTSD) specialist. They can guide your towards full recovery. Remember, if you have complex PTSD, traditional forms of therapy are likely to be inadequate.
    

Engaging in self-monitoring can help identify potential triggers that may contribute to the reactivation of symptoms. Keeping a journal or making note of emotional and physical responses to various stimuli can provide valuable insights into the specific triggers that affect you personally.

Grounding techniques can be very helpful in managing triggers and reducing anxiety. These techniques involve connecting with the present moment by focusing on the senses, such as feeling the ground beneath your feet, noticing the sounds around you, and taking deep breaths.

Self-care activities, such as exercise, meditation, or creative outlets, can also provide emotional support and help alleviate symptoms.

The Downward Spiral

When you experience a stressful event, your ANS responds with sympathetic nervous system mobilization into the fight-or-flight response. This process aims to protect you and help you reestablish safety.

If you can't resolve the stressful situation or are facing a life-threatening event, you will resort to an earlier set of evolutionary mechanisms maintained by the dorsal vagal complex (DVC). This parasympathetic branch of your vagus nerve puts an abrupt, unrefined brake on your sympathetic nervous system by promoting immobilizing defensive actions such as fatigue, depression, or dissociation-consider concepts like fainting or feigning death.
 

Managing  CPTSD Triggers After Narcissistic Abuse
 

Complex PTSD triggers are like a surprise reaction. Because that's what it feels like when you're hit with emotion that you didn't expect to feel.

Example:

So, you're deciding on a place to go for some breakfast with your partner. And they suggest a cafe you've not been to in ages – in fact you've not been there since you were with your narc ex.

The mere mention of that place has got you flustered. Your heart's pumping, you feel stressed and now you're crying. WTF?

You're talking about breakfast and now you're sad? 

Well, that's what complex PTSD triggers are: Unexpected past reminders that trigger an extreme reaction from you.

Worse yet, you can be unaware you're experiencing them.

Like me, minding my business, picking a place to eat breakfast and then BOOM! I'm a crying mess.

So, how does this 180 happen?
 

Complex PTSD triggers are: people, places, things, situations, boundaries, senses, dates, dreams or connections that remind you of a past trauma. And your response to it is either a physical or emotional one.

So a fast heart rate when you see your ex. Seeing them is a reminder of all the painful memories you went through and it's making you feel anxious. It's triggering you.

These heightened reactions make you feel unsafe in your body and unable to function.Especially when your triggers are unpredictable and not clear yet. 

Complex PTSD and Narcissistic Abuse

Narcissistic abuse is a repeated cycle rather than a one-time traumatic event. So, you experience spells of mental strain due to someone else's manipulative control. This is especially harmful to your psyche.

Post Traumatic Relationship Syndrome

You might've heard it referred to as post traumatic relationship syndrome (PTRS). Like C-PTSD, the trauma follows from being in a harmful relationship.

PTRS can make you feel like relationships aren't safe or reliable. And this can mess with your mental health even after the relationship is over.
 

Complex PTSD Triggers in Relationships

If your last relationship resulted in C-PTSD, it'll take you some time to rebuild trust with a new partner. The betrayal of coming to terms that someone you love was, in fact, hurting you is fucked up. It makes you lose faith in people and question everyone's motives.

When you enter a new relationship, partners can spark complex PTSD triggers. You're learning to trust someone new and yourself, which can take time.

I was still dealing with pain and hurt from my last relationship when I started my current one. But I was lucky to have a partner who was understanding and patient while I worked through it.

It took me months before I opened up to him about everything. I wanted to be sure that I could trust him and have a safe space to be vulnerable. But before I did that, I was hiding a lot of unusual behaviours.

I had a hard time trusting anyone and was afraid of someone betraying me again. So I worried a lot that this new relationship was fake. And I didn't realise at the time that all this anxiety was a response to my triggers.
 

Spotting Complex PTSD Triggers in Your Life

I experienced a lot of complex PTSD triggers. Yet, I've come through the worst and have a good grasp of my mental health now. And you can too.

Don't get me wrong, I still have my 'unexpected moments'. But I understand it a lot more, and I know how to process my emotions.

As cliché as it sounds, time's a healer. I wish there was a quick fix with C-PTSD, but there isn't. So all I can tell you is this:

▪️Know your triggers and learn how to manage them.

I know that sounds so simple when the reality isn't. But, when you experience similar reactions over and over, you'll start to pick up on clues. You'll notice your patterns of behaviour.

▪️Write those wobbly moments down, every time. Detail what happened and how you felt. Document the date and notice the frequency of your triggers. It'll also help you see your progress when things lessen over time.

That's exactly what I did and I've listed the triggers below. It'll help you recognise yours and make your emotions feel less like a mystery.

🔵 🩷 Love

Learning about emotional and narcissistic abuse cycles gives you all this new jargon. So you become aware of what love bombing is. And when someone new romances you, it feels relatable. Because everyone's lovely at the start, so how do you know if its the real deal?

Like first dates with new partners, wining and dining you. That can feel love-bomby. You know, the elaborate dates, the attention, all of it can trigger suspicions.

It certainly made me question if my partner's kindness was genuine. Or whether it was just to hook me in.

You can get obsessed with red flags, super hypervigilant of every detail. I overthought all my actions, always protecting myself against any perceived threats.

It takes a while to relax into new relationships. But you'll know their intentions are good if they stay consistent and the pace feels comfortable.

🔵 🗺️ Places

Places can prompt a lot of avoidance. You'll think:

"If I just stop going to places I went with my ex, I won't get reminded of him".

But, that's a limiting way to live. You're eventually going to have to ease into facing your fears, rather than run from them.

My partner happened to gift me a night away together to the SAME place my ex took me to. And I freaked the fuck out! My paranoia made me think I was reliving the last relationship, that I was being love-bombed yet again. I mean, what are the chances?

Of course, that wasn't why. It was just a coinkydink, a birthday getaway with no strings attached!

But, when you're in the midst of working yourself up, it takes full control of your thinking power. So it's hard to see sense. It's like all your negative thoughts keep the trigger alive by encouraging the symptoms to stick around.

And it's moments like these when you need a tool to calm the mind down.

🔵 👥 People

New people can make you feel on edge, because your narcissist ruined trust for you. You're now fearful of being taken advantage of. So it makes sense to look for hints of narcissism in anyone new you meet.

Unknowingly being involved with a narcissist makes you doubt your perception of people. I worried that I was a terrible judge of character and vulnerable i'd meet someone toxic again. It made me analytical of people, always searching for any red flags in their character.

Mutual friends are reminders of your old life with your ex. So they make you nervous because you're apprehensive they'll mention your ex – not ideal when you're going no contact. But on the other hand, when your hurt goes unacknowledged, it equally blows.

So if those friendships no longer make you feel comfortable – and more of a nervous wreck – you need a clean break from them. Because as disheartening as it is, if you can't be your true self around them, the friendships won't feel authentic to you. And you'll only delay your healing in the end.

🔵 📺 Movies and TV

TV shows about cheating or emotional abuse can be triggering – especially when they feel relatable to your experiences. If you're hypersensitive like me, you'll feel empathy for anyone in a situation like yours. Seeing familiarities of your relationship played on-screen flashes you back to that time.

But in times of despair, it can also feel relieving. It normalises your experiences and makes you realise you're not alone in your situation. And if you watch someone conquer all the shit they went through – that's encouraging!

🔵 📆 Dates

The time of year can also affect you – especially if a lot happened.

You could have a terrible New Year where you found out your partner cheated on you. Stonewalling you when you confronted them and ignoring you for days after. Finally dumping you by text the day before your holiday to Bali (whilst you're also dealing with a broken elbow). Sound familiar?

That's a lot of bad memories to relive the following year. And I did, my emotions ran high in January. And the following year was no different. I was tearful and I had a negative outlook on the new year; I definitely had the blues. But can you blame me?

When something memorably bad happens, it's like you give it a mental anniversary. So when you're clinking your way into the New Year and reflecting on the last, you'll remember "Oh yeah, I got dumped a year ago".

The painful memories attach themselves because specific dates trigger your complex PTSD; whether you're conscious of it or not. Take anniversaries, for example. They might resonate with you in the future – especially if they coincide with a bad memory of that day. Like your partner being aloof and spoiling the day. Classic.

So when the date comes back around again, you'll likely recall the same upset.

🔵 💬 Not replying to text messages

Being ignored feels horrible. And if you're used to the silent treatment, you'll I fear it happening again. So things like your partner taking a long time to respond between messages, start breeding your intrusive thoughts. Hello anxiety 👋🏽.

It's totally normal that your partner could be busy and might not have their phone on them. But hours of silence, no little text advising they're busy – that's avoidable. So, explain to your partner what you need. Tell them why it hurts, let them understand. Because if they're one of the good ones, they'll want to do their best to put your mind at ease.
 

▪️Keep a diary of triggers and emotional responses.

Jot down whenever you feel extreme emotional responses and you'll start spotting and understanding your triggers more.

It's a great way to track your progress and see the time between incidents; you'll notice how infrequent your triggers become. And seeing the improvements will feel like you're getting a hold of your C-PTSD.

Once you become aware of your triggers, you'll learn how to cope with them. It's scary in the beginning when you don't know what's causing the emotional reactions.

So when you get a diagnosis, you don't feel as insane, you become aware of your reactions instead. You learn to sit in them and feel what you need to; you gain perspective over your emotions.

 https://salltsisters.com

SOURCES:

CPTSD Workbook, Arielle Schwartz PhD/ CPTSD Treatment Manual__CPTSD: From Surviving to Thriving, Pete Walker__www.verywellmind.com/what-is-complex-ptsd__psychcentral.com/ptsd/complex-posttraumatic-stress-disorder-symptoms#common-triggers__goodtherapy.org/dissociation-c-ptsd-role-of-detachment-in-complex-trauma___crappychilhoodfairy.com/cptsd-behaviors-like-narcissism__Crittenden, P. M., Heller, M. B. (2017). The roots of chronic posttraumatic stress disorder: Childhood trauma, information processing, and self-protective strategies. Chronic Stress, 1, 1-13 https://journals.sagepub.com/doi/10.1177/2470547016682965__Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, 34, 119–138. https://www.annualreviews.org/doi/10.1146/annurev-publhealth-031912-114409__Lawson, D. M. Treating adults with complex trauma: An evidence-based case study. Journal of Counseling and Development, https://onlinelibrary.wiley.com/doi/abs/10.1002/jcad.12143 Sar, V. (2011, March 7)__Developmental trauma, complex PTSD, and the current proposal of DSM-5__European Journal of Psychotraumatology, https://www.tandfonline.com/doi/full/10.3402/ejpt.v2i0.5622__Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. Therapeutic assessment of complex trauma: A single-case time-series study. Clinical Case Studies, 12, 228–245. https://journals.sagepub.com/doi/10.1177/1534650113479442__https://www.verywellmind.com/agoraphobia-101-2584235__Avoidance Behavior, Written by Silvi Saxena MBA, MSW, LSW, CCTP, OSW-C/Reviewed by Raiy Abulhosn MD__ https://psychcentral.com/pro/complex-ptsd-and-the-realm-of-dissociation

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