Complex PTSD from Domestic Violence: Persistent Trauma, Big Effects

Key Takeaways:

1. PTSD vs. Complex PTSD (CPTSD): PTSD often results from a single traumatic event, while CPTSD develops from prolonged, repeated trauma, especially in relationships with power imbalances, such as child abuse or domestic violence. 
2. Traumatic Entrapment & Trauma Bonding: CPTSD is linked to "traumatic entrapment," where victims are trapped in unpredictable, dehumanizing environments. Over time, they may develop trauma bonds with their abuser as a survival mechanism. 
3. Recovery Requires Safety First: Healing from CPTSD begins with achieving safety. Effective treatments include trauma-focused psychotherapy (e.g., EMDR, DBT, CPT), mindfulness practices, physical activity, and sometimes medication to manage symptoms.

We all probably know about PTSD—a cluster of symptoms that a person might suffer when they have been through a traumatic event or series of events such as a car crash, a natural disaster or domestic abuse. The symptoms fall into the three categories of:

●               Reexperiencing the event (through intrusive memories, flashbacks, or dreams).

●               Avoiding people and places that trigger memories of the trauma. 

●               Hypervigilance or an exaggerated sense of current threat. (This may include depressive feelings and shame)

PTSD vs. Complex PTSD

Not everyone who experiences a trauma ends up with PTSD. Two people who experience a similar trauma may respond differently. Their responses depend on many factors, including their prior history, their safety after the incident and the support they receive.

For someone to suffer PTSD as a result of domestic violence, the abuse has to be severe. This is significant in the context of child custody cases, say experts, because the diagnosis in children tells us the abuse was severe and the abuser is unfit for parenting.

To diagnose PTSD, clinicians look for exposure to a seriously threatening event followed by effects. Sometimes this is referred to as “The Triple-E of PTSD.”

In recent years, clinicians are beginning to distinguish between PTSD and Complex PTSD (CPTSD). PTSD may occur as a result of a one-time event such as a medical emergency or a car accident. CPTSD may occur when a trauma is extended or repeated over time, especially in the context of an on-going relationship. Child abuse, torture, sex trafficking and domestic violence can all provoke CPTSD. 

Complex PTSD and Traumatic Entrapment

Two things seem to trigger CPTSD. One is the repeated or long-term nature of the trauma. The other is that the trauma occurs in the context of a relationship. That could be a parent-child relationship, a dating or marriage relationship,or the relationship between a captor and a captive. 

“Traumatic Entrapment” distinguishes experiences that produce PTSD from experiences that produce CPTSD. Traumatic Entrapment refers to prolonged captivity with huge power imbalances. The person lives in terror, is frequently dehumanized and the experience is unpredictable. The unpredictability produces anxiety. Some relationships with a domestic abuser are like this.

Trauma Bonding

The longer a person is in this situation, the more likely they are to bond with their captor. This has been called trauma bonding (also known as Stockholm Syndrome). Bonding with the abuser is a protective coping mechanism for surviving an intense interpersonal threat. That is, a captive who pleases and appeases the captor may have a greater likelihood of surviving. Appeasing the aggressor seems to de-escalate the source of threat, at least temporarily. The victim is turning for comfort to the same person who is causing them harm! It feels right at the time.

To be diagnosed with Complex PTSD, a person has to meet the three criteria for PTSD discussed above. Additionally, the person will have two other symptoms. One is difficulty with emotional regulation. That is, their feelings may be “all over the place.” Or they may get angry or sad with little provocations. The second Complex PTSD symptoms involves having,  a negative sense of self, and complications in their relationships.

Treating and Recovering from CPTSD

People need Ssafety before they canis the first requirement for a person to recover from Complex PTSD. That is, when people are repeatedly still traumatized, the trauma is not in the past. The person will be geared up for current danger and unable to recover from past events.

Once safety has been achieved, the following resources can help adults and children:

●      Light exercise helps people reconnect with their bodies. This could be walking, dancing, stretching, jogging, or swimming. Sometimes people with a trauma history have to remind themselves that they live in a body.

●      Yoga and mindfulness, such as meditation, help people to slow down their accelerated nervous systems, reducing anxiety.

●      Trauma-focused psychotherapy such as EMDR, DBT, CPT and trauma-focused cognitive behavioral therapy will provide hope and pathways to recovery. These therapies focus on relieving trauma symptoms. They are more effective for both PTSD and CPTSD than ordinary talk therapy.

●      Counseling, support groups and reading can help a person manage their symptoms. Helpful books can include both related fiction and nonfiction books that discuss traumas and domestic violence. Check out the DomesticShelters.org recommended books for suggestions.

●      Medications for anxiety, depression and sleeplessness can help people who feel they need them, for a time. When ready to stop taking ago without medication, it is important to seek medical advice and taper off very slowly.

The more we learn about trauma disorders, the more we realize how important it is to prevent traumas including domestic violence. AOnce a relationship is over, adults and children need protection from further traumatic abuse once a relationship is over.