This post will list and explain five key defining features of Complex PTSD, and point you toward the work of Pete Walker. This of course is not medical advice. Complex PTSD, by the way, is one example of what Johann Hari classes as a psychological cause of depression, within his division of depression causes into social-environmental, psychological, and biological. See my post Non-Pharmaceutical Anti-Depressants and Environmental Causes of Depression: Johann Hari’s Lost Connections.
Why This Topic?
But first, why this topic? There are at least five reasons:
First, I suspect a lot of people out there have Complex PTSD or something like it.
Second, those who have Complex PTSD, and know they have it, may not have the best information about it, and I think Pete Walker’s information is very good.
Third, I suspect that PTSD is most commonly understood in terms of Simple PTSD, yet Complex PTSD has significant differences from the more commonly portrayed “simple” variety.
Fourth, I suspect that many who have Complex PTSD, or something like it, may be unaware of it.
Fifth — this is a big one — general philosophical training and theory tries to address universal human developmental needs, and so does not specifically account for non-universal conditions such as Complex PTSD. Yet such conditions require tending to if one is to progress philosophically. Thus the philosopher or aspiring philosopher who may have Complex PTSD, or any teacher of philosophy, ought to interest themself in Complex PTSD.
In connection with that last point, see my post Philosophy as an Art of Living.
Nomenclature Notes
“PTSD,” of course, stands for Post Traumatic Stress Disorder. Additionally, “Complex PTSD” is shortened to C-PTSD or CPTSD. Sometimes less capitalization is used.
Five Key Features
As Pete Walker puts it, Complex PTSD “is a more severe form” of PTSD. Walker doesn’t explain what PTSD itself is, assuming some understanding of this on the part of the reader. I will assume the same, especially as the useful definitions I’ve found of PTSD in general are lengthy and complicated.
Assuming some baseline understanding of what PTSD is, Walker explains that Complex PTSD is “delineated from” regular or simple PTSD “by five of its most common and troublesome features:”
1. Emotional Flashbacks
2. Toxic Shame
3. Self-Abandonment
4. A Vicious Inner Critic
5. Social Anxiety
Emotional Flashbacks
Emotional flashbacks may be an unfamiliar concept to most readers. Hopefully you are also unfamiliar with the experience. I myself did not know of the concept until encountering Pete Walker’s written works (links to those below). To explain this, consider the most well-known image of PTSD, that of a combat veteran who had one particularly horrific experience. The popular image of a PTSD flashback is probably that of a combat veteran who, hearing fireworks, suddenly re-experiences themself, visually as well as emotionally, re-living the particular horrific experience which caused their PTSD.
Emotional flashbacks are similar but have perhaps three main differences from the more typical, “regular” type of PTSD flashback:
1. They “do not typically have a visual component;”
2. The feelings or emotional experience that is flashed-back to is not that of a single incident, but of a pattern of incidences which compounded over time;
3. They “can range in intensity from subtle to horrific” and can “vary in duration from moments to weeks on end.”
Toxic Shame and Social Anxiety
These are pretty much what they sound like. I’ll just note that the shame is not truly tied to any particular perceived failing, but is categorical. In other words, the toxic shame is not “contingent” shame, but is, unfortunately, “intrinsic” shame. Compare this with the distinction between contingent and intrinsic self-esteem: my post Intrinsic Self-Esteem: What It Is and Why We Need It, and also Steve Grogan’s article Martial Arts Do NOT Boost Self-Esteem.
The Vicious Inner Critic
You could think of this “inner critic” as a set of intense, intractable, self-hating or self-negatively-judging patterns of thought. They are cognitive in their most obvious aspect, but have significant affective (emotions/feelings/impulses) effects and seem to stem from affective experience. The standards by which these inner critic thought patterns judge are extreme perfectionistic standards, and so are unreasonable and unhealthy. (This is not to blame the victim; the inner critic is an affliction, not a flaw.)
Self-Abandonment
Self-abandonment can be understood by analogy with parental abandonment. With regard to parental abandonment, we mean the abandonment of a child by its parent. We don’t, however, mean literally leaving one’s young child by the side of a road in the desert to die. The kind of abandonment meant could be understood as the sorts of neglect which are the passive counterpart to active abuse. In particular, emotional and verbal neglect can be experienced as abandonment. Self-abandonment means, for example, abandoning oneself, as an adult, to the attacks of the inner critic, or even to abuse or neglect by other people.
End / Citations / Links
Quotations are from Complex PTSD: From Surviving to Thriving by Pete Walker.
See my Books / Resources page for info concerning Pete Walker’s books.
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