31: Complex PTSD

I recently realized just how many of my mental health struggles actually relate back to one thing. Trauma. I would argue that most Autistics sadly experience some level of trauma in their lifetimes. Many of us experience prolonged and repeated exposure to trauma and the results can be devastating. For us, we deal with Complex PTSD, or C-PTSD.

I cannot state enough: astronomical content and trigger warnings for this piece. Take care of you, please!

I’m honestly still learning about C-PTSD and how it affects me. It’s complicated, but to summarize incredibly briefly: PTSD is often related to one event. Complex PTSD stems from multiple traumas, and/or longterm trauma. Although many people know about PTSD because of veterans with the disorder, anyone can have PTSD from a wide range of traumatic events and experiences. Symptoms can include: depersonalization, derealization, dissociation, panic and anxiety attacks, flashbacks, loss of sense of reality or time, emotional deregulation, memory loss and issues, and more.

For the longest time, I knew that I suffered from some level of PTSD. But my misunderstanding of the condition in general– coupled with lots of dissociating and blank spaces in my memory– meant that I didn’t really understand just how severe mine was. In a recent therapy session, one phrase really struck me:

“I feel like I spend so much of my time thinking ahead and planning for the future in order to avoid reliving my past.”

Those were words that I spoke, but it felt like someone else had said them. It still feels that way, if I’m honest. But it was a big moment, and I said it. (You know something you said was important when your therapist pauses the session to jot it down…) Since that revelation, I can’t stop seeing how my trauma influences my present by forcing me to live in the future, all while seeking to avoid the past.

For example, my perfectionism and wildly unrealistic high expectations for myself largely come from a need to try to protect myself. Maybe if I plan out the perfect conversation, I won’t get yelled at or bullied. If I prepare excessively for a medical procedure, maybe I won’t have a panic attack or be belittled by the doctor. If I take all the right medication and exercise, maybe an ovarian cyst won’t make me blackout again. If I know more about earthquake safety maybe I will not freeze during another large one. If I can just be perfect, nothing can go wrong. Easy, right?

Even if I arguably did something “perfectly,” when the result is more trauma… I blame myself. “I should have said this instead of that. I looked weak so they didn’t believe me. I didn’t think ahead far enough and predict this outcome. I’m a child and need to grow up.” To me, a bad interaction or event or failure is 99% always my fault. I am at fault for additional trauma because I didn’t try hard enough or plan well enough. Its never the fault of someone else or even a general situation or event. It’s ridiculous, but it is so very hard to break free from. I literally torment myself. Or rather, C-PTSD does.

Flashbacks are horrible: I am out of my body and back in that car when I got hit hard enough to be pushed across several lanes. I remember the song on my CD skipping in the dashboard. I remember shaking in shock–that didn’t just happen. I wasn’t just hit… Is the other person okay? Am I okay? I don’t see any blood…

But more devastating to me are the “flash-forwards“. My brain will anticipate all sorts of dangers in extreme detail. Again, I am out of my body and feel like I am actually there. I see it all in full color in my brain and I live it. I have seen my loved ones die so many times, experienced trauma after trauma… and although I know it’s not real, on some level it is. I “experience” it.

The weirdest thing is that so many of the symptoms my body and mind attempting to protect me. Dissociation, panic attacks, fixation, compulsions, flashbacks… they are often my brain trying to protect myself in some weird way. It’s this highly sensitive security system that has faulty wiring and trips at minor stresses. And unfortunately, I don’t seem to have much control over it at all.

And the difficulty is that any stress can trigger any part of my C-PTSD’s wildly messed up security system. I have trauma from so many different incidents throughout my life: car accidents, large earthquakes, sheltering while in Japan when missiles were being tested by North Korea, assault, countless medical traumas, terminal illness and death of loved ones, living in Japan during the 2011 earthquake and tsunami, extreme physical pain and sickness, bullying and power harassment, extreme life-shifting events, etc. But they don’t just stay in their own lane and section of my brain. Oh, no. Medical trauma can trigger flashbacks of car accidents or power harassment. News of another large earthquake can cause flash-forwards of losing loved ones to random accidents.

In fact, any extreme stress can trigger symptoms in any or all of those categories for me. It doesn’t have to be a particular related trigger to set me off. Any extreme stress can. COVID-19 is one reason I have realized just how bad my C-PTSD is, because it’s a bunch of triggers all wrapped up into one, tied with a big-old stress bow. And the unfortunate thing is, it’s all related. C-PTSD affects anxiety, depression, ideation, sensory overload, and more.

The stresses of the world today have triggered my C-PTSD into a realm I didn’t know existed. I dissociate more than ever. This is when my mind goes completely blank and I leave my body for a time. Sometimes I am aware it’s happening, sometimes I’m not. Sometimes I know how much time has gone by, often I do not. I’m getting better at recognizing when it happens, but sometimes I just have to let myself drift…

My flashbacks and flash-forwards come often and in stunning detail. Breaking through those flashes takes extreme effort many many times before I am able to reorient myself. Something that I still don’t have a full grasp of is the memory loss of C-PTSD. There are very large chunks of my life that I simply don’t remember. It’s odd to me that those memories are gone while the technicolor traumas remain… That’s a rabbit hole I’m not quite ready to go down yet.

What’s Helped So Far

1) Therapy

C-PTSD is something I have only really begun to work on in therapy. One thing that helped me pre-COVID was “Worst- and best-case scenarios are not nearly as common as okay-case scenarios.” That helped me a lot to remember that things are often just meh. Not traumatic, not elating. Just meh. In light of COVID, I’m struggling to use this particular skill, but I have hope for using it again in the future…

2) Music Therapy

I haven’t been able to see my music therapist in a very long time, but one thing he taught me is using a particular song to help guide my brain out of flashbacks and flash-forwards. When I am very stuck in loops of horrors, I will hum or sing this song and it will help me transition out of that cycle. Music is the key to jumpstart happier parts of my brain to allow me to break free.

3) Knowledge and Acknowledgment

Just knowing that C-PTSD is an actual, valid thing is huge. Learning about flashbacks and dissociation and having a name for those things. Being able to read more and connect the dots and recognize triggers. Understanding why things are happening and how to start helping myself. Seeing others talk about their experiences. As always, this is why I am sharing my inner world for all the internet to see. Because if just one person finds light in my words, it’s all worth it.