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This may be old news here, but my therapist (an EMDR specialist) had me read The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Bessel van der Kolk. It was spectacular. Van der Kolk was one of the original proponents of the complex PTSD designation. I highly recommend it!

Thank you for the recommendation of "Coping with Trauma." I got the book and have been slowly making my way through it (slowly because it is very dense and frequently triggering). I strongly recommend it! While it might be considered a self-help book, it is more academic in style than is typical of the genre, and does not shy away from detailed discussions of the clinical literature, which means that it speaks perfectly to my personal mindset.

I have such a love of books that I nearly never make notes in them, highlight them, and definitely never dog-ear pages. I have made an exception in this case (though not on dog-earring!)... there are plenty of pages that are over 50% highlighted! And I am less than a third of the way through it!

I am in a chapter on memory, which can be an issue because of the way memories are triggered, often unconsciously, leading to a reexperiencing of the original trauma. I'm going to quote a two-paragraph section:

"As emphasized in cognitive therapy, you can exert some control over your emotional experience by what you think about. This power of thought may be used for good or ill. The power of negative thinking is substantial; negative thinking--and negative remembering--can fuel anxiety or deepen depression. We can spend a lot of what I think of as "mind time" mired in distressing thoughts and memories. It might be a good idea to devote more mind time to positive memories.

"The power of positive remembering is worth cultivating. Good memories should be treasured. Good experiences are deserving of our attention, and they're worth adding to our store of good memories. You can learn to draw your attention to a network of good memories associated with positive feelings such as pleasure, comfort, tenderness, safety, peace, and confidence. As an exercise, try to remember an event that goes with each of these positive feelings. By dwelling on these memories, you can more readily call them to mind."

This is a more sophisticated rendition of one of my Mother's most annoying aphorisms, "Act enthusiastic and you'll be enthusiastic." Annoying as it is in my Mother's version, at least in Dr. Allen's formulation this seems to be sound advice.

So, I took the challenge, but made it more specific. Since central to my current problems is my ability to relate in a healthy way to my wife, I tried to take each of the list of positive feelings and identify a specific memory with her that evokes that feeling.

Pleasure: After far too much time, I found one... but it was from the period when we were dating. I could think of nothing after our marriage, 23 and a half years ago.

Comfort: Same thing.

Tenderness: I stalled here. I cannot think of a single instance of feeling this with my wife.

Safety, peace, and confidence: Having stalled on tenderness, I didn't devote the same amount of effort to these three, but I suspect that I will be unable to find them. I know in particular that I have been laser-focused on safety since this whole recent ordeal started, and no, I don't think I have ever really felt it at all, even leaving off the "with my wife" part. And we have specifically talked about the likelihood that she has made me feel less safe rather than more safe.

I am distrustful of my own memory at the moment, and even more distrustful of the lens through which I am seeing my relationship with my wife. Thus, I don't know that I am confident in assigning meaning to this failure of mine to recall situations where I have felt these things.

But it is, nonetheless, depressing.

Let me add that I think part of my problem is the specific list of positive emotions that are enumerated. The list does not include things like pride, satisfaction, excitement, fulfillment, wonder, gratitude, and many others. For all of those I could easily come up with a specific memory with my wife, many of them very recent, where I felt those emotions.

But not Dr. Allen's list. How deliberately was Dr. Allen's list constructed? Does it mean something that his list I have trouble with, but my list I have no trouble with? Does this distinction mean that I have been valuing the wrong things? Or did he come up with a selection of positives, and unluckily those are the specific ones I can't seem to find, but if he had chosen different but equally-meaningful ones I wouldn't be having this problem? I don't know. A friend of mine suggested that the list seems deliberately constructed from base-level "Maslow stuff."

I am new to understanding that I have CPTSD (my intro is on the Welcome board), and am looking to do some background reading. I bought Complex PTSD: From Surviving to Thriving (Pete Walker), and am only a little way in, but am a little disappointed that it has such an overwhelming focus on childhood trauma (not disappointed that the book exists, of course... plenty of people need a book with that focus!). While yes, I had childhood trauma and dealing with that will undoubtedly be integral to my recovery, I have also had numerous adult long-term and/or recurring traumas, and so I am hoping to find a book that is a bit broader in scope. Any suggestions? Thanks!

Once I am a bit more stable, I think I would enjoy taking on some volunteer tasks. I will keep you posted. Thanks!

Yes, there is a lot of therapy going on. I have a personal therapist (not clear on how up-to-speed he is on CPTSD yet). My wife has a personal therapist. We also have a couples counselor who specializes in sex therapy, but haven't seen her since our daughter came down with SJS. We need to get that going again, but we've had lots of other things on our plates.

I just posted the following to my Facebook feed (here I am sanitizing it to remove names). I would welcome any feedback, either for corrections to my summarized understanding of CPTSD (since I am new to all of this) or any thoughts you might have about my story and how to proceed. Thank you in advance!

Again, with the oversharing. I guess that I am continuing to reach out here because I am feeling so isolated. Other than my wife, I really don't have a local support network of any kind. I have a couple of professional colleagues that I consider good friends, but they are professional colleagues first and foremost. So I have to go with a long-distance support network, and Facebook is tantalizingly convenient. Hence the oversharing. If you don't want to know, then please skip this post.

My wife has read this already, and has told me that I can share this publically. That she is no longer threatened by this type of thing. The feelings I am feeling are mine; they can make her sad and she can worry about how she can help, but she no longer feels any need to cling or try to force feelings or behaviors in others. That I should do what I need to do to get healthy, and that I need a support group beyond just her, though she still wants to be a ballast to help me.

To be blunt, I am in awe of my wife. The feelings I reveal below about her are scary, and it takes one * of a person to not be threatened by such a description. A persistent problem I have been having for the last three months has been feeling as though when we have a disagreement, she is the more "enlightened" one, and it's just up to me to catch up to where she is. That has been horribly invalidating for me, both of my ideas and perceptions, and of my very self-image. But based on how she has responded to this post? Maybe she's completely right. Maybe she *is* the enlightened one. I don't know. It's like the whole "real/not-real" thing in the Hunger Games series. I don't know that I yet trust her to be the authority on that, but I am getting to the point that I am confident that I am not such an authority either. Baby steps.

Oh, and further evidence of how amazing my wife is? She asked to be excluded from seeing this post. Not because she didn't want to see it, but because she didn't want anyone replying to feel like they needed to filter their responses because she would see them. I. Am. In. Awe.

Ok, into the post. Last chance to back out if you don't want to be immersed in oversharing.

Everyone has heard of Post Traumatic Stress Disorder, or PTSD. It is a truly horrifying condition, brought to public attention by military veterans, rape survivors, and many other victims of acute trauma. People with PTSD suffer flashbacks, avoid triggers that remind (too weak a word) of the trauma, have trouble forming social attachments, and have a higher-than-normal incidence of addictive behavior as a maladaptive coping mechanism. These are not in any way exhaustive lists of causes or effects, merely a smattering of examples to give a taste for the condition. There is a large body of scientific research on PTSD, though of course much more is needed.

PTSD has a different flavor, however, when the trauma is long term, even ongoing. In addition to the horror of the trauma, the sufferer must deal with the feelings of hopelessness and helplessness of being unable to escape the ongoing cycle of trauma. Prisoners of war, human trafficking, and long-term domestic abuse are obvious extreme examples, but less acutely severe long term traumas have been shown to produce the same symptoms. Examples include long-term objectification, gaslighting and false accusations, various traumatic domestic behaviors (examples in the parlance include push-pull, splitting, and alternating raging/hoovering behaviors), and long term care for a mentally ill or chronically sick family member.

A key feature of such cases is that the victim, due to maladapted coping mechanisms among other problems, tends to put himself into situations where his learned helplessness prevents escape from other, (often) unrelated chronic traumas. Each time this happens, a new cycle of long-term trauma begins, layering PTSD on top of PTSD. These layers interact with one another, resulting in a complex web of symptoms that are quite difficult to untangle. This type of PTSD is known as CPTSD, where the "C" stands for "complex" (do not confuse this with chronic PTSD, which is a characterization along a different axis). And since treating PTSD involves coming to terms with the originating trauma, complex PTSD is significantly harder to address. Pull on one thread, and dozens of others get pulled along with it.

This designation of CPTSD has not yet made it into the Diagnostic and Statistical Manual of Mental Disorders, or DSM. It is not well-studied, and there is little consensus about how it is to be handled distinct from standard PTSD, other than that there are notable differences. Most work that has been done on it focuses on childhood abuse/neglect, which form the largest fraction of sufferers, and thus this body of literature emphasizes the impacts on missed emotional developmental milestones, an important but hardly comprehensive component of CPTSD.

So in summary, CPTSD shares some features of standard PTSD, but has important distinct features that are only beginning to be explored in the scientific literature.

I have been diagnosed with PTSD, and after reading a lot of material on the subject, I am convinced that it is of the "complex" variety. Childhood emotional abuse with some physical abuse mixed in set the stage. A year-and-a-half emotionally-abusive sexual relationship in college with a domineering, manipulative partner added another layer, or set of layers. Individual but repeated near fatalities of my wife and daughter (medical conditions, hospitalizations, surgeries, attempted suicide, etc.) added further trauma. Long term care of a mentally ill family member (in this case my daughter, who will almost certainly be diagnosed with BPD when she is of age) is a specifically listed cause for CPTSD. Trying to get tenure in academia ought to be a specifically listed cause in and of itself, and I already failed to achieve that goal at one institution. All of these are "chronic or long-term exposure to emotional trauma over which the victim has little or no control and from which there is little or no hope of escape." And then there are the long-term marital problems between my wife and me that placed me in a position of feeling like my input into our decisions as a couple wasn't valued, where I felt I had to isolate myself from my external support network, and much more, again placing me in a position where I felt little-to-no control and no hope of escape.

I do not blame my wife for any of this. She was dealing with insecurities of her own. But the effects on me have been profound, and while I don't hold her to blame, the way our relationship evolved added many further layers to my CPTSD.

I have developed a plethora of coping mechanisms to manage my condition, though I didn't know at the time that this is what I was doing. Ensuring that I was in complete control of my emotions. Stuffing emotions that I couldn't deal with down into boxes. Committing myself to the relationships that mattered to me (i.e., my wife) with such single-minded devotion that I felt I could ensure that they would be there for me when I finally felt like I couldn't go on myself. Most of these, and many other, coping mechanisms are maladapted, and are specifically listed on websites devoted to CPTSD. But until Monday I didn't know to look there.

In late July, my world fell apart. My wife announced that she couldn't live with our lack of a sex life, and so she wanted to open up our relationship to outside sexual partners. There were reasons why our sex life was nonexistent, and the fault lay with both my as-of-then unidentified CPTSD and with her insecurities. She claims that her request resulted from her finally getting over her insecurities. She was finally able to accept me as I am (someone not particularly interested in sex), and so she was trying to let me be that person while still getting her own needs met. And all of this revelation on her part came catalyzed by online highly-sexual flirting with a mutual friend (who was also married).

But everything about this was wrong (this paragraph is the "triggered" interpretation, and so is completely negative; I recognize rationally that this triggered interpretation is likely distorted). I have never been asexual; sex had become something that I exhibited avoidance behavior toward because of CPTSD responses to my wife's insecurities. She was not finally accepting me for who I am; she had a picture of who I am that was based on her insecurities and the bad habits we had fallen into because of twenty four years of bad interactions, and was pigeonholing me into that false picture. She was not getting over her insecurities; she was deciding that self-actualization/confidence meant that she should decide that the things she thought were "bad" about herself were ok to live with instead of trying to fix them, especially with respect to her attitudes toward me. And I had been stuffing our problems down in order to deal with more urgent matters (our daughter's mental health, other physical health issues, career issues) secure in the idea that we were going to be able to come back to them when our daughter was out of the house, I had tenure, and so on. We are three years away from that, after an *investment* (in my view) of 24 years. And now, after that investment, she gave up on me, so that one measure of security I felt was gone. I have had plenty of moments of feeling powerless prior to late July, as I outlined above, but nothing came close to this. My world, as I said, completely fell apart. This was not just trauma, it was a complete rewriting of the meaning of my last 24 years, turning what I had viewed as 24 years of difficult but worthwhile investment into 24 years of trauma, culminating in a massive emotional slap in the face. And in the midst of all of this, I am supposed to be working toward tenure at my new institution, and our daughter got Stevens Johnson syndrome, the condition that nearly killed my wife in 2003.

I am in full-on CPTSD now. Everything is a threat. I am completely helpless and trapped. Everything I have been working for is about to slip from my grasp. The one person I thought was my rock, despite the problems we had, is anything but. The smallest trigger sends me into emotional flashbacks.

Listing symptoms down the range of CPTSD characteristics (http://outofthefog.website/toolbox-1/2015/11/17/complex-post-traumatic-stress-disorder-c-ptsd), I have co-dependence, doormat syndrome, hypervigilance, clouded perception, avoidance, blaming, catastrophizing, "control-me" syndrome, denial, dependency, depression, escape to fantasy, fear of abandonment, relationship hypervigilance, identity disturbance, learned helplessness, low self-esteem, panic attacks, perfectionism, selective memory/amnesia, and tunnel vision. I am a puddle of symptoms. And I am paralyzed because of them.

There is a lot going on here other than my relationship problems with my wife. But those problems are the most immediate, at least now that my daughter is out of medical danger. Most proximate. I have to figure out if, particularly given her new-found strength and independence, she can be my strongest ally and cheerleader, as she says she wants to be, or if she herself is too much of a trigger. In the reelings of my mind, I vacillate from being 100% confident one way to 100% confident the other, to recognizing that I am oscillating between such extremes and so in reality I'm just completely confused. I don't have a local support network other than my wife. I feel isolated from my long-distance support network, especially when several of the people I have reached out to just don't seem to get it. And I have no idea if I should be throwing myself at my wife for her support, support that I desperately need, or should distance myself from her to both avoid the triggers and build up my own ability to self-support. I'm just feeling utterly lost and hopeless.

As a new member (I introduced myself on the Welcome board a few days ago), I am somewhat overwhelmed by the amount of resources available. I see that within the books board, there are a number of short descriptions or reviews of the books that are available through Amazon on this website. Has anyone considered including with the Amazon links these short descriptions and/or reviews? That would help separate out books that aren't appropriate for a particular person, for example (e.g., a book focusing on childhood trauma may not be appropriate for someone whose traumas came as an adult). Just a thought.

Thank you both for the welcome! It means a lot to know that there is a forum where I can go for support.

I've been working my way through the site's glossary, and I think I may be even worse off than I thought, because even just reading some of the definitions is triggering me. Reading about hoovering, for example, just set me to hyperventilating, because I really don't want to believe that this is what my wife is doing, and yet I so strongly fear that it is. Clearly I'm going to have to pace myself...

Hello. I am new to the forum, and am somewhat intimidated by the amount of information here. I am trying to make my way through it, but because I am so in need of community right now, I thought I would go ahead and post a tentative hello.

I have just (yesterday) been diagnosed with PTSD, and after some reading I am fairly confident that it is CPTSD.  I am a 45 year old male professor. There are numerous traumas, including an abusive upbringing, a year-and-a-half emotionally-abusive sexual relationship while in college, two family members (spouse and daughter) who have had multiple life-threatening incidents (illnesses, surgeries, suicide attempts, etc.), a very challenging daughter who once she is of age will almost certainly be diagnosed with BPD (though now is described as having emotional disregulation), a failure to get tenure at my previous institution, and a spouse that has been controlling and (it could be argued) emotionally abusive. My spouse and I have been having trouble for the last few months. She has reached a point where she has lost a lot of her insecurities that led to the controlling and (arguably) abusive behavior, which is a good thing, but the way this came to a head was that she asked to open our marriage to outside sexual partners, which sent me into a tailspin, right when I am in the midst of trying to get tenure at my new institution.

I still love my wife dearly, and am convinced that she loves me dearly, but every misstep of hers I reflexively see as a threat, and I am not sure how I can start to trust her again. I have nearly no local support network, because we only moved here two years ago, and I am horribly socially introverted. I am feeling lost and not sure how to proceed. Any advice on where to start in sorting through all of the information on this website, or anything else for that matter, would be most welcome. I have a therapist and a psychiatrist. I have opted to not change my medications based on the new diagnosis; after all, the increase in symptoms I am seeing are perfectly explainable by the increased stress between my wife and me plus a two-week hospitalization of our daughter with the same condition that nearly killed my wife back in 2003, so I don't think my reactions are *horribly* disproportionate to the local stressors. Though maybe they are. I don't know.