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Childhood Trauma Signs of CPTSD: Are You Misdiagnosed With Depression? · RECOVERable: Mental Health and Addiction Experts Answer Your Questions

• 0:13
  SPEAKER_00: PTSD is most often going to come from a single life-threatening event versus CPTSD, where again we have that repeated, prolonged exposure.
• 0:26
  SPEAKER_01: Licensed clinical therapist Amanda Stretcher joins us to unpack complex PTSD and reveal the deep, often invisible ways it impacts our daily lives.
• 0:36
  SPEAKER_01: Am I correct in assuming that it would be easier to remember and maybe even process the bad thing that happened or bad things that happened than the good things that didn't.
• 0:54
  SPEAKER_01: Have you ever felt like you are constantly living in survival mode, even though your life is actually pretty safe right now?
• 1:01
  SPEAKER_01: If you've tuned in today out of concern for yourself or someone you love, you are in exactly the right place.
• 1:12
  SPEAKER_01: We're sitting with trauma expert Amanda Stretcher Lewis to unpack what CPSD actually is and how it silently reshapes our daily lives.
• 1:21
  SPEAKER_01: Amanda, welcome to the set.
• 1:23
  SPEAKER_01: Thank you for having me.
• 1:24
  SPEAKER_01: I'm so excited to be here.
• 1:26
  SPEAKER_01: I'm excited too.
• 1:27
  SPEAKER_01: And this is a really important topic because I think so many people are probably affected by it and have no idea that that's what's going on in their lives, or maybe haven't even heard of it.
• 1:36
  SPEAKER_00: Absolutely.
• 1:36
  SPEAKER_00: I could not agree more.
• 1:38
  SPEAKER_01: We start with a quick lightning round of myth or fact.
• 1:42
  SPEAKER_01: And if you're up for it, I got 10 of them.
• 1:44
  SPEAKER_00: I'm ready.
• 1:45
  SPEAKER_01: Cool.
• 1:45
  SPEAKER_01: First, myth or fact.
• 1:47
  SPEAKER_01: CPTSD is just PTSD with worse symptoms.
• 1:51
  SPEAKER_00: Myth.
• 1:52
  SPEAKER_00: There is some overlap, some commonalities between CPTSD and PTSD, but they are different diagnoses.
• 2:00
  SPEAKER_01: We'll get into why.
• 2:01
  SPEAKER_01: Myth or fact.
• 2:02
  SPEAKER_01: CPTSD usually comes from repeated or ongoing trauma, not just one event.
• 2:08
  SPEAKER_00: Fact.
• 2:08
  SPEAKER_00: CPTSD does have uh a chronicity, a persistence to it, repeated, prolonged exposures.
• 2:15
  SPEAKER_01: Myth or fact.
• 2:16
  SPEAKER_01: You can have CPTSD even if you don't remember every detail of what happened.
• 2:21
  SPEAKER_00: Absolutely.
• 2:22
  SPEAKER_00: And that's one of uh one difference between CPTSD and PTSD is the way that memory may have been encoded.
• 2:29
  SPEAKER_00: So with CPTSD, we're often looking at implicit memory.
• 2:34
  SPEAKER_00: You may not remember the facts or a narrative, a story, start, middle, end, but your body remembers something happening.
• 2:42
  SPEAKER_00: And do you remember how it felt?
• 2:43
  SPEAKER_00: And you remember how it felt.
• 2:45
  SPEAKER_00: Yeah, there's very much a felt sense of what happened in the past showing up in the present.
• 2:52
  SPEAKER_01: Myth or fact.
• 2:53
  SPEAKER_01: CPTSD can look like depression, anger, anxiety, numbness, or relationship struggles.
• 2:59
  SPEAKER_00: Absolutely fact.
• 3:00
  SPEAKER_00: Um, and as a result, um, often people have been diagnosed with um something other than CPTSD in the past because of how some of those symptoms go up.
• 3:13
  SPEAKER_01: Myth or fact, people with CPTSD are just too sensitive or overreact.
• 3:18
  SPEAKER_00: Myth.
• 3:19
  SPEAKER_00: Um, with CPTSD, something very real happened that impacted the nervous system and impacted your sense of self, of relationships, and of the world around you.
• 3:30
  SPEAKER_00: So that's not overly sensitive or dramatic.
• 3:32
  SPEAKER_00: You're responding to something that really happened and really had an impact on you.
• 3:37
  SPEAKER_01: That'll be reassuring to somebody watching.
• 3:40
  SPEAKER_01: Because it's really gaslighty to be told otherwise.
• 3:43
  SPEAKER_01: Myth or fact, emotional neglect can contribute to CPTSD, even if there was no obvious physical abuse.
• 3:50
  SPEAKER_00: Fact.
• 3:51
  SPEAKER_00: Um, with CPTSD, it's not just a something really frightening happening.
• 3:57
  SPEAKER_00: Oftentimes it reflects what didn't happen.
• 4:00
  SPEAKER_00: They're not having been a reliable, safe caregiver there to help you make sense of the world.
• 4:06
  SPEAKER_00: And your body interprets that as danger, as as unsafe.
• 4:11
  SPEAKER_01: Myth or fact.
• 4:12
  SPEAKER_01: CPSD can make safe relationships feel uncomfortable or even threatening.
• 4:17
  SPEAKER_00: Fact.
• 4:17
  SPEAKER_00: Um, with CPTSD, oftentimes the learned patterning of your nervous system responds even when a relationship might actually be safe.
• 4:29
  SPEAKER_00: Sometimes that closeness can feel threatening.
• 4:32
  SPEAKER_00: People in the past who were supposed to be safe weren't.
• 4:36
  SPEAKER_00: Um, and sometimes the cues happening in a safe relationship, they really get run through this old programming and interpreted as dangerous.
• 4:46
  SPEAKER_01: Myth or fact.
• 4:47
  SPEAKER_01: A CPTSD diagnosis means someone is permanently damaged.
• 4:51
  SPEAKER_00: Myth.
• 4:52
  SPEAKER_00: Absolute myth.
• 4:53
  SPEAKER_00: Um the I think one of the an important antidote to or an important aspect in living with CPTSD is learning self-compassion and understanding.
• 5:04
  SPEAKER_00: What happened was a system learned to survive in an unsafe environment that does not mean broken or faulty in any sort of way.
• 5:13
  SPEAKER_00: It actually means the opposite.
• 5:15
  SPEAKER_00: It means your system had a wisdom to it and learned to survive and kept you safe.
• 5:20
  SPEAKER_00: It just might be that what you learned isn't working for you anymore in the present and it's keeping you isolated, lonely, or repeating some unhelpful patterns.
• 5:30
  SPEAKER_01: We'll be talking about how to unlearn it.
• 5:32
  SPEAKER_00: Absolutely.
• 5:33
  SPEAKER_01: Myth or fact, healing from CPTSD means you have to relive every traumatic memory.
• 5:39
  SPEAKER_00: Myth.
• 5:39
  SPEAKER_00: Absolute myth.
• 5:41
  SPEAKER_00: Um, I think um the treatment of CPTSD is so much more complicated than that and can be done without having to relive memory.
• 5:53
  SPEAKER_00: And as we mentioned, um, sometimes you don't even have a clear explicit memory.
• 5:59
  SPEAKER_00: So it would be hard.
• 6:00
  SPEAKER_00: But we we don't need to know all the details.
• 6:03
  SPEAKER_00: We don't have to sit with and relive.
• 6:05
  SPEAKER_00: Sometimes that can actually be re-traumatizing.
• 6:08
  SPEAKER_00: Um, so treatment doesn't have to look like that.
• 6:11
  SPEAKER_01: Myth or fact, understanding CPTSD can help people move from self-blame to self-understanding.
• 6:17
  SPEAKER_00: Yeah, absolute fact.
• 6:19
  SPEAKER_00: Um, I I think that in the process of learning to live with CPTSD, self-compassion and understanding that there was a you who was in a really unsafe situation and had to learn how to exist in that environment.
• 6:35
  SPEAKER_00: Having compassion for that part of you is such an important part of healing CPTSD.
• 6:41
  SPEAKER_01: Now let's pivot to longer explanations of some of the things we just touched on.
• 6:46
  SPEAKER_01: And I'm going to be asking you the top searched questions on the internet about CPTSD.
• 6:52
  SPEAKER_01: And the first, unsurprisingly, is what is CPTSD?
• 6:55
  SPEAKER_00: So CPTSD stands for complex post-traumatic stress disorder.
• 7:01
  SPEAKER_00: Um, CPTSD is going to be associated with repeated, prolonged exposure to a trauma that is typically interpersonal or relational in nature and that happened during periods of time when the brain was still developing.
• 7:17
  SPEAKER_00: So CPTSD is often associated with events prior to the age of 18, but we know the brain continues developing into our 30s.
• 7:25
  SPEAKER_00: So it's certainly not exclusive to childhood or adolescence.
• 7:30
  SPEAKER_00: Um, with CPTSD, the nervous system learned to exist in an environment that was chronically unsafe.
• 7:40
  SPEAKER_00: And that learning, that programming continues to run in the present, even when that environment has changed.
• 7:47
  SPEAKER_00: CPTSD is really gonna affect a few different areas and often leaves the world feeling dangerous, relationships feel dangerous, and even being yourself can feel dangerous.
• 8:00
  SPEAKER_01: So for talking primarily about children or traumas that happened when we were children, how much of the lasting effects are because you had no options because you're a child?
• 8:14
  SPEAKER_00: Yeah.
• 8:14
  SPEAKER_00: So another piece of CP test is often a powerlessness or a lack of escape from whatever was happening.
• 8:22
  SPEAKER_00: So definitely an important piece when we think about children and adolescents being in an unsafe environment, they're often going to have to learn how to adapt to that environment because they can't just take off and get their own apartment.
• 8:34
  SPEAKER_00: Uh, they they are often trapped in that environment.
• 8:38
  SPEAKER_00: And not just that, but also dependent on those same caregivers that are often enacting, creating the trauma.
• 8:46
  SPEAKER_00: They're they're often dependent on those caregivers.
• 8:50
  SPEAKER_01: So a lot of people are more familiar with PTSD.
• 8:53
  SPEAKER_01: So let's quickly touch on the differences between the two.
• 8:56
  SPEAKER_01: How is PTSD different than CPTSD?
• 8:59
  SPEAKER_00: So PTSD is most often going to come from a single life-threatening event versus CPTSD, where again, we have that repeated, prolonged exposure to trauma.
• 9:13
  SPEAKER_01: The concentration when you talk about CPTSD.
• 9:16
  SPEAKER_01: And the first question everybody asks is what's the C?
• 9:17
  SPEAKER_01: And we've just talked about it, the complex nature of it.
• 9:21
  SPEAKER_01: I'd like to step through some of the others because I think that they are also misunderstood, or it might just be a good refresher for people who do understand them.
• 9:29
  SPEAKER_00: Absolutely.
• 9:30
  SPEAKER_01: So give me a quick summary again on what the C is, what's complex about it.
• 9:35
  SPEAKER_00: So the complexity is reflected in that prolonged exposure, that there's a complexity to how many events may have happened that were traumatic.
• 9:46
  SPEAKER_00: Um, complexity is also gonna show up in the symptoms of CPTSD and the way they really impact total sense of self and ability to be in relationships with others.
• 9:59
  SPEAKER_01: So the P post, does the trauma have to have been in the past for you to have CPTSD?
• 10:06
  SPEAKER_00: Not necessarily.
• 10:07
  SPEAKER_00: You could still actively be in the environment or maybe in a different environment that's very similar to an earlier environment.
• 10:15
  SPEAKER_00: So maybe um childhood, adolescence wasn't safe.
• 10:19
  SPEAKER_00: And now maybe in your 20s, you've landed in a relationship that has domestic violence or or abuse.
• 10:25
  SPEAKER_00: So you could actively be in trauma and be experiencing symptoms of CPTSD at the same time.
• 10:32
  SPEAKER_01: Okay, you said in trauma, which is the T.
• 10:34
  SPEAKER_00: Yeah.
• 10:34
  SPEAKER_01: So let's talk about traumatic and the definition of it.
• 10:37
  SPEAKER_01: And who decides what's traumatic to you?
• 10:41
  SPEAKER_00: Yeah.
• 10:41
  SPEAKER_00: So there's there's so many different um ways that trauma can look.
• 10:47
  SPEAKER_00: And often with CPTSD, something common is when you were in the environment that wasn't safe, that was um life-threatening in some way.
• 10:57
  SPEAKER_00: Um, people involved in that were really minimizing of that and may have said, you know, you're just being dramatic or overly sensitive.
• 11:06
  SPEAKER_00: Um, it was just a joke.
• 11:08
  SPEAKER_00: Um, don't take things so seriously.
• 11:10
  SPEAKER_00: So it can, there's a lot of gaslighting.
• 11:13
  SPEAKER_00: It can be really confusing, but trauma is usually something that involved um an impact to the nervous system and um was was unsafe.
• 11:24
  SPEAKER_01: And as you discussed in the definition, the trauma isn't limited to something that happened.
• 11:30
  SPEAKER_01: It can also be what didn't happen.
• 11:33
  SPEAKER_00: Yes, absolutely.
• 11:34
  SPEAKER_00: Trauma can both be a frightening and unsafe something, or it could be the lack of a safe person to make sense of what happened or what's happening.
• 11:45
  SPEAKER_00: So it could absolutely look like um physical or emotional neglect, not having um the nurturing, the protection, and the guidance that we need when we're little.
• 11:58
  SPEAKER_01: And when someone uses the word trauma, which is used an awful lot more these days than it used to be, it can sound hyperbolic.
• 12:06
  SPEAKER_01: It can sound like, well, it wasn't traumatic.
• 12:08
  SPEAKER_01: And we can say it to ourselves because if we think of trauma as living in a war-torn area and we were whatever, how does that factor into how we're able to heal?
• 12:18
  SPEAKER_00: Yeah.
• 12:19
  SPEAKER_00: So I think it's so important to look at trauma as not just a what happened or didn't happen, but it's the impact that had on the brain, body, and the nervous system.
• 12:31
  SPEAKER_00: So two people could go through a very similar situation and one could develop CPTSD and one could not.
• 12:39
  SPEAKER_00: It's just how that person's system took in whatever happened.
• 12:44
  SPEAKER_00: Um, and so I think that's so important when it comes to the treatment and healing, is we do have to be able to expand that definition and to really understand if something happened, whatever it was, and it impacted your system in a certain way, there's there's trauma there.
• 13:01
  SPEAKER_00: There's CPTSD there.
• 13:04
  SPEAKER_01: So the SD.
• 13:05
  SPEAKER_01: Why is CPTSD considered a stress disorder?
• 13:08
  SPEAKER_00: So it's considered a stress disorder because of this impact on the nervous system and and what it asks of the brain, the body, and the nervous system.
• 13:18
  SPEAKER_00: Um, someone with CPTSD is often going to be left in really like a kind of a constant state of threat or hypervigilance.
• 13:27
  SPEAKER_00: And that is really exhausting on the system.
• 13:31
  SPEAKER_01: What percentage of people who have CPTSD do you think know they have it?
• 13:35
  SPEAKER_00: I don't have an exact number, but I think a lot of people go miss or or undiagnosed.
• 13:41
  SPEAKER_00: Um, I think that piece of where the environment likely wasn't very validating of what was happening at the time can really leave someone with this um this chronic like self-doubt and self-blame.
• 13:55
  SPEAKER_00: Um, that belief that something must just be wrong with them.
• 13:59
  SPEAKER_00: So I think there's a lot of people walking around not realizing I have people show up in my office all the time and they're not showing up saying, hey, you know, I think something really traumatic happened to me.
• 14:11
  SPEAKER_00: They're showing up saying, there's something wrong with me.
• 14:14
  SPEAKER_00: I am broken and I need fixing.
• 14:17
  SPEAKER_00: Um, so I think there's a lot of people who really don't realize.
• 14:21
  SPEAKER_00: And and I think also it can be hard to sit with, to sit with the fact that your caregivers, maybe your parents, that your childhood wasn't safe, that's really heavy.
• 14:33
  SPEAKER_00: So I think there's that piece also of it, it can be hard.
• 14:38
  SPEAKER_00: I like to tell my clients um often that acknowledging that CPTSD is in the picture doesn't mean we have to blame or attack or say your parents, your caregivers did something wrong or were bad.
• 14:53
  SPEAKER_00: Uh, but we do have to be able to have like kind of take an honest look to get really curious about what did things look like for you growing up and how might that be impacting you in the present.
• 15:05
  SPEAKER_01: My heart is breaking thinking of children in a situation where they're not safe.
• 15:09
  SPEAKER_01: And on top of that, it's often the people who are supposed to be keeping them safe.
• 15:15
  SPEAKER_01: So who do they turn to?
• 15:17
  SPEAKER_01: And secondly, the if nobody's acknowledging it, does one start to question their own perception of reality?
• 15:24
  SPEAKER_00: Absolutely.
• 15:25
  SPEAKER_00: Um, I I think it can lead someone leave someone feeling really lonely.
• 15:29
  SPEAKER_00: And again, that faultiness of gosh, like if if it I think this is happening, but I'm being told it's not happening, I I must be delusional.
• 15:39
  SPEAKER_00: I must be wrong.
• 15:41
  SPEAKER_00: I must need to figure it out on my own.
• 15:43
  SPEAKER_00: So there's there's a lot of internalizing what's happening with CPTSD.
• 15:49
  SPEAKER_01: Okay, so the next most asked question is what causes CPTSD?
• 15:54
  SPEAKER_00: When we look at the causes, I think we can look at um kind of the overarching areas.
• 15:59
  SPEAKER_00: Again, we're gonna have that repeated, that prolonged, persistent aspect of the trauma.
• 16:06
  SPEAKER_00: It's gonna be interpersonal, relational in nature.
• 16:10
  SPEAKER_00: It's gonna have happened during periods of time when the brain was developing.
• 16:13
  SPEAKER_00: And again, there's often that sense of powerlessness or um a lack of ability to escape the environment.
• 16:22
  SPEAKER_00: So some of the ways, some of the causes of CPTSD could look like environments that were abusive.
• 16:29
  SPEAKER_00: So emotional abuse, uh, verbal abuse, um, physical, sexual abuse.
• 16:37
  SPEAKER_00: Um, it could look like having witnessed or experiencing domestic violence.
• 16:42
  SPEAKER_00: Um, it could look like growing up in an environment that was chronically dysfunctional, dysregulated, or really unstable.
• 16:51
  SPEAKER_00: So maybe one or both parents were struggling with addiction or untreated mental health issues.
• 16:59
  SPEAKER_00: I think an area that I work a lot is with attachment injuries.
• 17:03
  SPEAKER_00: Um, so it may have looked like um going chronically like unseen or unheard in a family system.
• 17:10
  SPEAKER_00: There may have been parentification or that emotional neglect.
• 17:16
  SPEAKER_00: So there just wasn't a safe someone to go to.
• 17:20
  SPEAKER_00: An example could even be maybe in a family system, one sibling had uh some sort of chronic health issue that required a lot of time and attention from the parents.
• 17:30
  SPEAKER_00: And that maybe left another sibling alone, expected to kind of take care of themselves, be really independent from a really young age, and they didn't have anyone to help them make sense of what was happening.
• 17:45
  SPEAKER_00: Uh there can be so many different causes, kind of complex causes for CPTSD.
• 17:51
  SPEAKER_01: You raised a, you used a couple of terms I just want to define, including parentification.
• 17:55
  SPEAKER_00: Yeah.
• 17:56
  SPEAKER_00: So parentification is gonna be when one parent treats a child in the family more like a parent.
• 18:04
  SPEAKER_00: So that child ends up having um being expected to hold some of the emotional baggage of the parent.
• 18:12
  SPEAKER_00: They're treated maybe even more like a friend or a confidant.
• 18:15
  SPEAKER_00: They're given, um, expected to maybe take care of younger siblings.
• 18:20
  SPEAKER_00: There's just a lot of um expectation and responsibility placed on someone that's not really developmentally appropriate.
• 18:29
  SPEAKER_01: And you use the term relational, if you, you know, that the these wounds are relational or that the trauma is often relational.
• 18:35
  SPEAKER_01: What do you mean by that?
• 18:36
  SPEAKER_00: Yeah.
• 18:37
  SPEAKER_00: So it means the trauma came from a relationship.
• 18:41
  SPEAKER_00: So it may have been parent to child, um, sibling to sibling, some sort of caregiver to to the child or adolescent, or in in later relationships, in an intimate relationship, uh a dating, or even within a marriage.
• 18:56
  SPEAKER_00: Um, so there's there's this element where the trauma involved another person doing or not doing something that was needed.
• 19:07
  SPEAKER_01: So I've been thinking inside the house, inside the family, listening to you, but would bullying at school also fall under this?
• 19:15
  SPEAKER_00: Absolutely.
• 19:15
  SPEAKER_00: Yeah, that is definitely another cause of CPTSD, especially again where there was no one safe.
• 19:22
  SPEAKER_00: So maybe bullying happened at school.
• 19:24
  SPEAKER_00: You went home and mentioned it to your parents, and your parents didn't validate and didn't do anything.
• 19:30
  SPEAKER_00: They said it's probably no big deal.
• 19:33
  SPEAKER_00: Uh suck it up.
• 19:35
  SPEAKER_00: Uh, you know, guess you need to learn how to defend yourself.
• 19:38
  SPEAKER_00: Uh, no one, no one was there to help create a safe container or to give protection.
• 19:43
  SPEAKER_01: I have so many questions.
• 19:45
  SPEAKER_01: You're gonna notice overlap between your answers and these questions because people who are searching don't know what other searches have happened, and we just want to make sure we're answering them all.
• 19:53
  SPEAKER_00: Yeah.
• 19:54
  SPEAKER_01: What are the signs and symptoms of CPTSD?
• 19:57
  SPEAKER_00: Yeah.
• 19:58
  SPEAKER_00: So we can look at the signs and symptoms in two layers.
• 20:02
  SPEAKER_00: So the first layer is the layer that may overlap with PTSD, which more people might be familiar with.
• 20:09
  SPEAKER_00: So with that layer, we have a re-experiencing of the past in the present that could look like um nightmares, that could look like flashbacks, just a sense of what happened then is happening now.
• 20:22
  SPEAKER_00: There could be avoidance.
• 20:24
  SPEAKER_00: Um, and there could be this ongoing sense kind of stuck in fight or flight, stuck in this constant state of threat or like a hypervigilance.
• 20:36
  SPEAKER_00: Then we have the complex layer we can look at.
• 20:38
  SPEAKER_00: With that layer, we're often gonna have um difficulty regulating emotions.
• 20:44
  SPEAKER_00: So emotions might feel really big, overwhelming, hard to come back from.
• 20:49
  SPEAKER_00: Or on the other end of the spectrum, um, we might someone might experience um disconnection from or numbness to emotions.
• 20:58
  SPEAKER_00: The same person could experience both.
• 21:01
  SPEAKER_00: With CPTSD, we're also gonna see um a really persistent sense of shame, of worthlessness, uh self-blame, that sense that you are um like defective somehow.
• 21:15
  SPEAKER_00: And then we're also typically gonna see difficulties in um difficulties in trust, in closeness, in sustaining relationships, because that that early relational imprint was that relationships might not be safe.
• 21:32
  SPEAKER_00: Um so relationships are gonna be difficult.
• 21:35
  SPEAKER_01: So I'm hearing you say all those things that can be the result of CPTSD.
• 21:42
  SPEAKER_01: And I'm thinking how many people are walking around with a pile of them with no diagnosis.
• 21:50
  SPEAKER_01: And it's like this harm just follows them.
• 21:53
  SPEAKER_00: Yeah.
• 21:53
  SPEAKER_01: I didn't mean to smile while I said that either.
• 21:55
  SPEAKER_01: I don't know why I did.
• 21:56
  SPEAKER_00: Yeah.
• 21:57
  SPEAKER_00: Yeah.
• 21:57
  SPEAKER_00: I think for a lot of people, they may relate, they may notice themselves in this and and realize, oh my gosh, is is this why?
• 22:05
  SPEAKER_00: Like I've been carrying this.
• 22:07
  SPEAKER_00: There's that internalization of um assuming that there's something wrong with you, um, that we Maybe stop talking to people about it, just assume and try and fix it in some way for yourself, which is just exhausting.
• 22:22
  SPEAKER_00: I think of like what some of this kind of more clinical version might actually look like for people.
• 22:29
  SPEAKER_00: Um, someone with CPTSD may realize as soon as they walk into a room, they're always scanning the people around them.
• 22:37
  SPEAKER_00: Um, they're really making themselves responsible for what everyone is thinking, feeling, making sure everyone's having a good time, making sure everyone else is okay.
• 22:48
  SPEAKER_00: Someone with CPTSD may be so good at identifying the wants and needs of others and meeting those, but have no idea what their own wants and needs are.
• 22:59
  SPEAKER_00: It can make decision making feel paralyzing because you're so worried.
• 23:03
  SPEAKER_00: What is everyone else going to think and feel about this decision I'm gonna make that you lose what you need for yourself?
• 23:09
  SPEAKER_00: There's often people pleasing is kind of a popular term.
• 23:14
  SPEAKER_00: Um, and so I think with a lot of people with CPTSD, they notice this just really wanting to keep everyone pleased around them, which is not possible.
• 23:25
  SPEAKER_00: We we can't keep everyone happy.
• 23:27
  SPEAKER_00: So that's where the shame shows up.
• 23:29
  SPEAKER_00: I'm trying so hard to keep everyone around me happy.
• 23:32
  SPEAKER_00: And yet they don't always seem happy.
• 23:34
  SPEAKER_00: So I, gosh, I must, I must just be doing something wrong.
• 23:37
  SPEAKER_00: I'm so bad at this.
• 23:39
  SPEAKER_00: Um that's I think that's some of what it might look like.
• 23:41
  SPEAKER_00: And I I think a lot of people can relate to that.
• 23:45
  SPEAKER_01: And it's a strange twist to think, you know, some of us are walking around saying, I'm so insightful, I'm so tuned in, I'm so empathetic, I'm an empath, whatever they might think.
• 23:57
  SPEAKER_01: And then to realize, oh, that might all be a trauma response is really, you know, eye-opening.
• 24:03
  SPEAKER_00: I I think so.
• 24:04
  SPEAKER_00: And so sometimes when I sit with my clients, I like for us to look at at, you know, those things aren't all bad if we can find the like authentic you in there where you genuinely do care about the people around you.
• 24:17
  SPEAKER_00: Um, but being able to separate that from the trauma response where you make yourself overly responsible for that.
• 24:25
  SPEAKER_00: So we we don't have to take that identity away completely.
• 24:28
  SPEAKER_00: I think there can be such a a beauty in um in some of these if we can find a way to do them in healthy ways with boundaries, one of my favorite words.
• 24:39
  SPEAKER_01: Ooh, we'll talk about boundaries.
• 24:40
  SPEAKER_01: Let's talk about boundaries right now.
• 24:42
  SPEAKER_01: So let's talk about the role of boundaries for someone who has CPTSD, whether or not they know it, and who has come to be a people pleaser to keep themselves safe.
• 24:53
  SPEAKER_00: Yeah.
• 24:54
  SPEAKER_00: Boundaries can feel so hard because it feels like they go against everything that you learned.
• 25:00
  SPEAKER_00: And so for a lot of people with CPTSD, starting to learn boundaries can can just feel so scary.
• 25:06
  SPEAKER_00: Like if I do that, I think everyone around me is gonna leave.
• 25:09
  SPEAKER_00: If I don't fill this role taking care of everyone, um, I'm gonna end up alone.
• 25:14
  SPEAKER_00: And that's really scary.
• 25:16
  SPEAKER_00: But boundaries are so important.
• 25:19
  SPEAKER_00: Um, I when I think about boundaries, I think how loving they are.
• 25:23
  SPEAKER_00: They're loving for the people around us, and they're just so loving for ourselves all.
• 25:28
  SPEAKER_01: So explain that because it's a very different way of looking at it than a lot of us think.
• 25:32
  SPEAKER_01: It's like you, and it's also the difference where like you can't and I won't.
• 25:36
  SPEAKER_01: You know?
• 25:37
  SPEAKER_00: Yeah, yeah.
• 25:38
  SPEAKER_00: I I really think that boundaries teach the people around us how it is okay or not to be in relationship with us.
• 25:46
  SPEAKER_00: It really equips the people around us with information about ourselves, which is actually so connected.
• 25:52
  SPEAKER_00: For me to say, hey, I don't appreciate when you do that.
• 25:56
  SPEAKER_00: And so I'm gonna have to set a boundary there.
• 25:59
  SPEAKER_00: It lets you learn and know something about me and lets you, if you're someone who's kind of safe to be in relationship with, do something different.
• 26:08
  SPEAKER_00: Um, it it says, you want to know me better and you wanna know how you can be in relationship with me better.
• 26:14
  SPEAKER_00: And so there can actually be closeness that comes from that.
• 26:19
  SPEAKER_00: If we learn one another and our needs and we're mutually respecting those as best we can, we're trusting one another to communicate when those boundaries have been crossed.
• 26:29
  SPEAKER_00: I think we're gonna feel so much closer.
• 26:31
  SPEAKER_00: But again, for someone with CPTSD, that can be a hard sell because it feels really scary.
• 26:37
  SPEAKER_00: Um, and we kind of have to experience that safety in relationships to start to learn something different might be possible.
• 26:48
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• 26:51
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• 26:57
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• 27:01
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• 27:04
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• 27:10
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• 27:11
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• 27:20
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• 27:27
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• 27:35
  SPEAKER_01: It's like little, little snippets, you know, they kind of, you know, where where they grew up and those kinds of things and maybe holidays, but chunks of it are gone.
• 27:43
  SPEAKER_01: Is that just because some people have bad memories, or can that be a symptom of CPTSD as well?
• 27:48
  SPEAKER_00: It can be a little bit of both.
• 27:49
  SPEAKER_00: Um, as humans, we we are not always uh the best keepers of our histories, but oftentimes like losing large chunks of time or really not remembering things could reflect CPTSD.
• 28:03
  SPEAKER_00: Our system really works in service of survival and in service of keeping us safe.
• 28:08
  SPEAKER_00: So if something um really scary or a need wasn't met, if if something like that happened, sometimes our brain um kind of walls that off to protect us.
• 28:21
  SPEAKER_01: So why might someone with CPSD first experience it as depression, hopelessness, shutdown, low self-worth, or the belief that life is just harder for them than for other people for some reason?
• 28:32
  SPEAKER_00: I think there's there's that internalization that starts to happen when there wasn't anyone safe to start to make sense of the world with at these really important periods of time, then um the the person's brain uh system starts to try and make sense of it on its own.
• 28:52
  SPEAKER_00: Um, and it the sense it often makes is I must be the problem.
• 28:57
  SPEAKER_00: There's something wrong with me.
• 29:00
  SPEAKER_00: Um and I think that can then show up as um especially hopelessness.
• 29:06
  SPEAKER_00: If if we think also about the powerlessness, the the lack of ability to escape that comes with a lot of the causes of CPTSD, that can really carry over into later in life.
• 29:18
  SPEAKER_00: Someone can really feel like they've lost choice, they've lost a sense of agency, lost a sense of empowerment.
• 29:25
  SPEAKER_00: Um, and so it's gonna show up as this kind of cluster of depression, of hopelessness, helplessness, of worthlessness, of almost like um, I must deserve this and this must be how it's always going to be.
• 29:39
  SPEAKER_00: I don't think that anything different could ever be possible because I've never seen anything different.
• 29:45
  SPEAKER_01: That all sounds like depression.
• 29:47
  SPEAKER_01: So are people with CPTSD often misdiagnosed with depression?
• 29:52
  SPEAKER_00: It is common for people with CPTSD to be um misdiagnosed.
• 29:58
  SPEAKER_00: And and the two don't necessarily have to be mutually exclusive.
• 30:02
  SPEAKER_00: Someone certainly could have both diagnoses, but there may be more people out there than they realize that what better accounts for their symptoms is this bigger umbrella of CPTSD.
• 30:16
  SPEAKER_01: I'm thinking of people who have been diagnosed as treatment resistant for treating depression.
• 30:24
  SPEAKER_01: And maybe they're treating the wrong thing.
• 30:26
  SPEAKER_00: I think that's uh that's a really great point.
• 30:28
  SPEAKER_00: I think of um sometimes we're not asked about some of those earlier experiences.
• 30:35
  SPEAKER_00: So if we've got someone who's internalized what happened, especially if that environment minimized and kind of contributed to them being blamed, and then we're never really asked, um, well, what happened when you were growing up?
• 30:48
  SPEAKER_00: Or we are asked and we say, everything was fine because I kind of don't remember a lot.
• 30:54
  SPEAKER_00: And because my parents told me I should be grateful and I had a good childhood.
• 30:59
  SPEAKER_01: I had a roof over my head.
• 31:00
  SPEAKER_00: I had a roof over my head, I had everything I needed.
• 31:04
  SPEAKER_00: Um, so surely trauma didn't happen to me, then it can go so missed in in that way and be misdiagnosed as depression and and how much that then kind of perpetuates the diagnosis.
• 31:18
  SPEAKER_00: So now I'm being treated for depression, it's not really working.
• 31:22
  SPEAKER_00: I'm gonna keep going back to that learning I have of there's something wrong with me.
• 31:27
  SPEAKER_00: Yeah.
• 31:27
  SPEAKER_00: This should be working and it's not.
• 31:30
  SPEAKER_00: Why, why am I this way?
• 31:32
  SPEAKER_01: It's interesting because I do a depression podcast as well.
• 31:35
  SPEAKER_01: And last week interviewed someone who was just diagnosed with CPTSD by his primary care physician, by the way, after years of therapy.
• 31:44
  SPEAKER_01: How interesting.
• 31:45
  SPEAKER_01: Yeah.
• 31:45
  SPEAKER_01: And he feels like this load has been lifted from him.
• 31:49
  SPEAKER_01: And now he understands that that trauma caused or was a contributing factor to his depression, and he can accept it better and understands why the meds haven't worked.
• 31:59
  SPEAKER_01: And he he called and said, like, I gotta do a follow-up because I I need people to know they might be looking in the wrong place.
• 32:06
  SPEAKER_00: Yeah.
• 32:06
  SPEAKER_00: Oh, I'm so excited for him.
• 32:08
  SPEAKER_00: Yeah, to me too.
• 32:09
  SPEAKER_00: To have found that out and to to feel again, it sounds like more empowered by that to understand, to have compassion for himself and to have probably a better direction to go in in what he may need.
• 32:22
  SPEAKER_00: There could be some overlap in the treatment of depression and CPTSD, but there are certain things CPTSD is gonna need that that hopefully he can access now.
• 32:32
  SPEAKER_01: I like it too.
• 32:33
  SPEAKER_01: So, what might CPTSD look like in someone who is high functioning, responsible, funny, or the strong one?
• 32:39
  SPEAKER_00: Yeah.
• 32:40
  SPEAKER_00: So I see a lot of people in my office who look that way outwardly, but internally they feel so overwhelmed by all of that.
• 32:50
  SPEAKER_00: Um, they have a sense almost that that idea of imposter syndrome, right?
• 32:55
  SPEAKER_00: They say, yeah, maybe I show up that way, but if only they knew inside I am I'm an absolute mess, or I'm I'm like one step away from losing all of that.
• 33:05
  SPEAKER_00: If I don't keep this up forever, um, I'm it could all fall apart.
• 33:10
  SPEAKER_00: So I think there's a lot of burnout that can go hand in hand with that also, with um almost this mask that's worn that doesn't show what's happening underneath.
• 33:21
  SPEAKER_00: Um, and that is is just absolutely exhausting to maintain.
• 33:25
  SPEAKER_01: So we talked about the overlap with uh diagnosis like depression, but I would think that if you are walking around thinking, like I I just I'm no good at this life thing, that that might also be directly connected to addictions.
• 33:39
  SPEAKER_00: Yes.
• 33:40
  SPEAKER_00: I I think addictions um often have roots in trauma.
• 33:45
  SPEAKER_00: It's another way that the you maybe learned to kind of create some distance from the way that you're feeling, a way to numb, to disconnect, to to dissociate.
• 33:57
  SPEAKER_00: It for some people, it may help feel like they can perpetuate that that mask when they've got substances or even behavioral or process addictions, eating disorders or disordered eating can be really common with CPTSD and um sex and love addictions.
• 34:15
  SPEAKER_00: I think there can be a lot of overlap with that as well.
• 34:20
  SPEAKER_01: It makes sense.
• 34:21
  SPEAKER_01: How do emotional dysregulation and CPTSD overlap?
• 34:26
  SPEAKER_00: Emotional dysregulation was one of those aspects of this complex layer.
• 34:31
  SPEAKER_00: Someone may notice they range from uh really big, really overwhelming emotions to feeling numb and disconnected from emotions.
• 34:40
  SPEAKER_00: There likely with CPTSD was that lack of guidance in the environment that showed someone how to have an emotion safely, how to process and contain and be supported with that emotion.
• 34:54
  SPEAKER_00: If we learned um certain emotions are good or bad, then we may try really hard to cut off from those emotions, but it's gonna show up anyway.
• 35:06
  SPEAKER_00: Um, I use the word hijacking a lot.
• 35:08
  SPEAKER_00: It can almost feel like um certain emotions can hijack things um with CPTSD.
• 35:15
  SPEAKER_01: Which kinds of emotions are most commonly in that category?
• 35:19
  SPEAKER_00: Yeah.
• 35:20
  SPEAKER_00: So um anger, maybe an emotion that hijacks.
• 35:24
  SPEAKER_00: Uh sadness can be really overwhelming, can hijack.
• 35:28
  SPEAKER_00: Um, shame is is really overwhelming.
• 35:31
  SPEAKER_00: Um, kind of unhealthy guilt and shame um are some of the emotions that that can really hijack fear as well.
• 35:38
  SPEAKER_00: Oh, I would think.
• 35:39
  SPEAKER_00: Yeah.
• 35:39
  SPEAKER_00: Fear, panic, even um, that's gonna be a big emotion.
• 35:43
  SPEAKER_00: Anxiety.
• 35:43
  SPEAKER_01: Also anxiety.
• 35:44
  SPEAKER_01: No, that's not an emotion.
• 35:45
  SPEAKER_01: Yeah.
• 35:45
  SPEAKER_00: Anxiety as well.
• 35:47
  SPEAKER_01: This question, the answer has been sort of woven through a lot of your previous questions, but I want to pull it out separately.
• 35:53
  SPEAKER_01: Why does CPTSD affect self-worth and relationships so much?
• 35:58
  SPEAKER_00: Yeah.
• 35:59
  SPEAKER_00: So um it really affects self-worth and relationships because we're saying here that that CPTSD doesn't just affect the way you feel, it really shapes the way you connect with people around you.
• 36:13
  SPEAKER_00: So what happens here is present-day relationships can really activate that earlier learning from relationships.
• 36:23
  SPEAKER_00: We take in cues and it's like they're run through those old networks that got formed.
• 36:30
  SPEAKER_00: So our present-day relationship may actually be safe to be in, but we're interpreting cues in a very different way and feeling unsafe.
• 36:41
  SPEAKER_00: Um, so there's often this hypervigilance in relationships, constantly scanning for tone of voice changes, facial expressions, anything outside of the person's norm that says, oh gosh, I think they really are.
• 36:55
  SPEAKER_00: They're disappointed in me.
• 36:56
  SPEAKER_00: They're mad at me.
• 36:57
  SPEAKER_00: Um, they're not feeling good about something, and I've got to get in there and fix it.
• 37:02
  SPEAKER_00: There can also be this uh sense that getting too close to someone isn't safe.
• 37:09
  SPEAKER_00: So there could be these kind of barriers that you put up in relationships, and um that can be really lonely.
• 37:18
  SPEAKER_00: Um if there's a part of you wanting closeness but afraid of it, uh, then we can end up feeling really lonely in relationships.
• 37:26
  SPEAKER_01: You used the word trapped about the complex part uh in childhood.
• 37:31
  SPEAKER_01: This sounds like you're defining a different kind of trap or one that has just come along with you.
• 37:37
  SPEAKER_00: Yeah, there's very much um a stuckness in that.
• 37:41
  SPEAKER_00: Uh again, I like I want closeness, but I'm I'm afraid of that.
• 37:45
  SPEAKER_00: So now I'm I'm trapped in this cycle of hypervigilance.
• 37:49
  SPEAKER_00: I'm I'm trapped in this place of fear that's really gonna negatively impact my ability to be close and to sustain relationships.
• 37:59
  SPEAKER_01: Well, I just want to say we are going to get to the treatment part in the second part.
• 38:03
  SPEAKER_01: So don't don't lose hope here.
• 38:04
  SPEAKER_00: Yeah.
• 38:05
  SPEAKER_01: How can someone tell the difference?
• 38:06
  SPEAKER_01: Somebody's who's watching or listening to this now, between something is wrong with me, like life just isn't working the way it's supposed to, and something happened to me that my body and brain adapted to.
• 38:17
  SPEAKER_00: Yeah.
• 38:18
  SPEAKER_00: Um, I I think as we get to that part, um finding finding people who are safe.
• 38:25
  SPEAKER_00: Maybe it's a a therapist who you can really sit down and get curious.
• 38:30
  SPEAKER_00: Um, if any of my clients end up listening to this, they're they're gonna laugh because you're used to that phrase.
• 38:35
  SPEAKER_00: Curious is on my my bingo board.
• 38:38
  SPEAKER_00: Um, I think it it is if we can move out of that self-blame and really get permission to get curious of what all has happened across my life and how might that be impacting me in the present?
• 38:54
  SPEAKER_00: How is that showing up in even maybe even my posture and how I carry and hold myself?
• 39:00
  SPEAKER_00: How is it showing up in my felt sense?
• 39:02
  SPEAKER_00: What's happening in relationships?
• 39:04
  SPEAKER_00: I think some things people can kind of look for also are um if you ever notice that you don't always feel like your adult self, um, that's something to get extra curious.
• 39:16
  SPEAKER_01: I'm curious what you mean by that.
• 39:18
  SPEAKER_00: Yeah.
• 39:18
  SPEAKER_00: So maybe um if you think about any time conflict happens with someone you're close to, someone with CPTSD may notice they suddenly don't feel um their age.
• 39:29
  SPEAKER_00: They suddenly feel, oh gosh, I feel like 12-year-old me right now, or like eight-year-old me right now.
• 39:36
  SPEAKER_00: Um, that's sometimes a space to get kind of curious about it.
• 39:39
  SPEAKER_00: It may mean there's like this emotional flashback happening.
• 39:42
  SPEAKER_00: Your body is remembering something.
• 39:45
  SPEAKER_00: Um, and I think too, if you kind of consistently feel like your reactions in different situations are disproportionate.
• 39:53
  SPEAKER_00: Like when you do get to take a step back and kind of zoom out and look at the situation, you say, I'm not sure why I reacted there.
• 40:02
  SPEAKER_00: I actually think that person was trying to help me or I actually think that was okay.
• 40:08
  SPEAKER_00: That's another place.
• 40:09
  SPEAKER_00: Instead of that perpetuating the shame and the self-blame, that can be another great place to really try to get curious about of instead of why do I keep doing that?
• 40:19
  SPEAKER_00: I wonder why.
• 40:20
  SPEAKER_00: Why does it seem like my reactions aren't always proportionate to what's happening?
• 40:26
  SPEAKER_01: You help people with this.
• 40:27
  SPEAKER_01: You are a therapist.
• 40:29
  SPEAKER_01: Can you give us sort of a walkthrough how someone might first present when they come to your office, a little bit about the process, although we'll be talking about treatment in the second part too, and what they're like when they understand the impact the past has had on them and that they don't have to carry it into the future?
• 40:46
  SPEAKER_00: Yeah.
• 40:47
  SPEAKER_00: So I think a lot of people start in that place of still really kind of fused with that self-blame and shame.
• 40:56
  SPEAKER_00: They're they're showing up and they're saying, you know, why do I keep ending up in the same relationships that aren't working out for me?
• 41:04
  SPEAKER_00: Why do I keep overreacting all of the time?
• 41:09
  SPEAKER_00: Why do I feel so exhausted and burnt out?
• 41:12
  SPEAKER_00: Like I am just stuck in fight or flight.
• 41:15
  SPEAKER_00: I hear that a lot.
• 41:16
  SPEAKER_00: Why am I just stuck in this hypervigilance?
• 41:19
  SPEAKER_00: Like I'm always waiting for I'm expecting something to go wrong.
• 41:22
  SPEAKER_01: Is that always being afraid?
• 41:24
  SPEAKER_01: Is that the same?
• 41:25
  SPEAKER_00: I think fear can be a part of that, but fight, flight, fight or flight can also show up in just like a overfunctioning a lot.
• 41:34
  SPEAKER_00: Like I'm I'm always doing, I'm always feeling like I have to do.
• 41:37
  SPEAKER_00: I have to anticipate what needs to get done.
• 41:39
  SPEAKER_00: I have to stay out ahead of everything.
• 41:42
  SPEAKER_00: Um, so sometimes the person may not in that moment even realize there's fear necessarily, as much as they realize that that pull to people please, to do, to, to overfunction.
• 41:53
  SPEAKER_00: Um so if we start there, when when someone shows up, here's where the curiosity comes in.
• 41:59
  SPEAKER_00: Um, I think the this treatment process starts to look like let's get really curious about what you're experiencing and let's let's see if we can really listen to it, if we can get asked, get kind of get curious about um where might we have learned that?
• 42:16
  SPEAKER_00: Is that familiar?
• 42:17
  SPEAKER_00: Is is a really great starting place.
• 42:20
  SPEAKER_00: Uh so this happened in your relationship maybe yesterday or this week.
• 42:24
  SPEAKER_00: Um, but where does that, does that feel familiar at all?
• 42:27
  SPEAKER_00: Does that remind you of anything?
• 42:29
  SPEAKER_00: And sometimes that's a place where people start to recognize, well, yeah, I think that's how I felt a lot growing up when I think about it.
• 42:38
  SPEAKER_00: Um, and then there can kind of be this process of trying to connect with, trying to see what kind of picture can we paint of of a younger you and what they might have been experiencing or what they might have been missing.
• 42:52
  SPEAKER_00: Um, and can we get an idea of what it looks like to um to kind of process that, to help give those parts of you something that they may have been missing?
• 43:03
  SPEAKER_00: And I think a big piece is also learning to anchor into safety in the present.
• 43:08
  SPEAKER_00: If we're walking around constantly scanning for and assuming danger, then a really important part of that process is gonna be learning to find safety in relationships, in yourself, and whatever environment that you're in is really an important part of the process.
• 43:26
  SPEAKER_01: So in this middle part we're in, and we'll still move to the other, does realizing the connections between the way you're behaving and reacting and anticipating now is connected to what happened in the past.
• 43:39
  SPEAKER_01: Does that generally make your clients relieved to know there's a reason or sad to know there's a reason?
• 43:47
  SPEAKER_00: A little bit of both.
• 43:49
  SPEAKER_00: Um, I I think in this kind of middle portion, um, oftentimes grief really is a part of that process.
• 43:57
  SPEAKER_00: It's kind of grieving for what was needed that didn't happen, or you know, what frightening thing did happen.
• 44:04
  SPEAKER_00: It I think sadness often really coexists with relief.
• 44:09
  SPEAKER_00: So there there can be a feels good to know that.
• 44:13
  SPEAKER_00: It's not me.
• 44:14
  SPEAKER_00: I'm not crazy or broken that that something happened, but now I kind of have to sit with the sadness of something happened.
• 44:22
  SPEAKER_00: Maybe, maybe there are things that that I have to take a look at in a different way.
• 44:26
  SPEAKER_00: And that's there's that's really heavy.
• 44:28
  SPEAKER_00: There's definitely a heaviness to that.
• 44:30
  SPEAKER_01: Am I correct in assuming that it would be easier to remember and maybe even process the bad thing that happened or bad things that happened than the good things that didn't?
• 44:41
  SPEAKER_00: I I think they're both hard in different ways.
• 44:45
  SPEAKER_00: Like to say that that something bad happened is is really difficult.
• 44:51
  SPEAKER_00: Is we've learned all these adaptive strategies by this point, usually to kind of avoid acknowledging that, because those bad things are really overwhelming.
• 45:01
  SPEAKER_00: Um at the same time, like acknowledging that there were things that were needed that didn't happen, um, that can be really difficult to sit with as well, to say, um, gosh, there was a little me who needed someone to give them a hug can be really sad.
• 45:20
  SPEAKER_00: And I think can can kind of activate something emotionally in a different, really heavy way.
• 45:27
  SPEAKER_01: And in a previous episode we did on ACES with Dr.
• 45:30
  SPEAKER_01: Christine Bethel, um, she talked about the bad things, the aces, the adverse childhood experiences, and how they're countered by positive experiences.
• 45:39
  SPEAKER_01: So if something bad is going on in the house and there is a sibling or another parent or a grandparent or teacher or somebody saying, wow, that's that's a lot, that's hard, that's scary, it has a different impact on you than if everybody's saying, yeah, everything's fine.
• 45:53
  SPEAKER_01: I don't know what's wrong with you.
• 45:55
  SPEAKER_00: Yeah, very much.
• 45:57
  SPEAKER_00: Um, those can be some protective factors.
• 46:00
  SPEAKER_00: Um, and those can also be resources when we're in this, in the work of CPTISD, those may be things we pull from also to visit and to check in with.
• 46:10
  SPEAKER_00: Um, so maybe this was happening in the home, but it exactly that maybe there was a teacher at school who felt different, a grandparent, like maybe there was someone else who was giving you some of what you needed, and that really matters.
• 46:24
  SPEAKER_00: And and we can try and remember and be with that also.
• 46:29
  SPEAKER_01: So you we're sticking in the middle here for a while.
• 46:31
  SPEAKER_01: So you brought up adaptive strategies.
• 46:33
  SPEAKER_01: What are common adaptive strategies that someone who experienced traumas in youth or childhood and is currently has CPTSD, whether they uh have been diagnosed or not?
• 46:46
  SPEAKER_00: Yeah.
• 46:47
  SPEAKER_00: So some of those adaptive strategies, there can be so many.
• 46:51
  SPEAKER_00: Um, but it's gonna look like um some of the people pleasing, the taking on.
• 46:57
  SPEAKER_00: I've learned to take on other people's emotions.
• 47:00
  SPEAKER_00: Maybe I've learned to uh cut off from, to ignore my own wants and needs, because there's there's no place for that.
• 47:08
  SPEAKER_00: Um adaptive strategies may look like avoidance.
• 47:13
  SPEAKER_00: It could look like really withdrawing or kind of shutting down during conflict to try and stay safe.
• 47:20
  SPEAKER_00: Um, or it could look like more of a flight response.
• 47:25
  SPEAKER_00: So, as a part of that avoidance, uh, when things get hard, I leave, I take off to keep myself safe.
• 47:31
  SPEAKER_00: Sometimes there may be this kind of freeze, even a dissociative response of kind of shutting down, I may um kind of mindlessly doom scroll or um really try and like check out and numb sometimes.
• 47:48
  SPEAKER_00: I think this is where addiction, substance use, or other behavioral or process addictions maybe learned adaptive strategies to try and help the system feel better.
• 47:59
  SPEAKER_01: So when you brought up not being in tune with your own needs and wants as a result of the childhood traumas, it never occurred to me before that may be because that wouldn't have protected you and you just focused on the outward potential threats or real threats.
• 48:17
  SPEAKER_00: Yeah, absolutely.
• 48:18
  SPEAKER_00: And and not just not protected you, it may have landed in harm.
• 48:22
  SPEAKER_00: If if you needed something and you asked for it and you asked the person who wasn't safe, they may have actually actively harmed you for having that need.
• 48:32
  SPEAKER_00: They may have minimized it and said, um, you don't need that, that you're not important, or or they may have punished.
• 48:39
  SPEAKER_00: There could have been physical abuse in response for needing something or or rejection and abandonment, could have just been completely left, said, Oh, you need that, but I I'm not gonna give that to you.
• 48:51
  SPEAKER_01: So the last part we'll finally move to that.
• 48:53
  SPEAKER_01: So by the time someone leaves your therapy, and and we'll get into the therapeutic parts in the next section, but by the time someone leaves, what is different in their understanding of themselves, life, relationships?
• 49:07
  SPEAKER_01: What can change?
• 49:08
  SPEAKER_01: What can improve?
• 49:09
  SPEAKER_00: I think as someone kind of progresses, there's so often this self-compassion that really takes root and grows.
• 49:18
  SPEAKER_00: This ability to really feel for that younger you and not be so fused with them and to feel so much compassion for that past you and the present you.
• 49:30
  SPEAKER_00: Um, as different situations arise and and things happen, there's so much more access to, oh gosh, I want to do something different there, but I understand why I did what I did and I have compassion.
• 49:44
  SPEAKER_00: Um, that's not mutually exclusive from accountability necessarily.
• 49:48
  SPEAKER_00: There's often so much more choice.
• 49:51
  SPEAKER_00: There's um a feeling less trapped in less hijacked by I always respond this way and I have to keep responding this way.
• 50:00
  SPEAKER_00: There's a sense of slowness of okay, I can slow down and I can make a choice about how I want to respond instead of react.
• 50:10
  SPEAKER_00: Here are some of the really, really big changes that I see.
• 50:14
  SPEAKER_00: Um, and just that that sense of safety within self and in relationships.
• 50:20
  SPEAKER_00: There's more of a an openness, a willingness to be vulnerable, which is scary for anyone, but especially with someone with CPTSD.
• 50:30
  SPEAKER_00: So there's there's such a a growing, a growing willingness to be vulnerable and um to take risks and relationships.
• 50:38
  SPEAKER_01: Is there something you hear from clients when their time with you as a therapist for all things CPTSD is ending, that they're leaving?
• 50:49
  SPEAKER_01: And is there something common that they say in terms of what's different now as a result of having received therapy?
• 50:56
  SPEAKER_00: Yeah.
• 50:57
  SPEAKER_00: Yeah.
• 50:57
  SPEAKER_00: Um, I think something common um that I hear is they just feel like there's so much more possibility where where things felt so limited and so stuck before.
• 51:08
  SPEAKER_00: I think as we do the work, one of the biggest things I hear is the sense of gosh, so much more feels possible now than it did before.
• 51:18
  SPEAKER_00: I don't feel stuck or bound to those patterns anymore.
• 51:23
  SPEAKER_00: It feels like I have choice and agency and like I have, I'm so much more empowered now.
• 51:30
  SPEAKER_01: So if somebody's listening to this thinking, uh-oh, you know, or yay, you know, whatever the reaction might be, like I think this is me.
• 51:36
  SPEAKER_01: I think you're talking about me, or I think you're talking about my partner, child, friend, whomever, what should they?
• 51:43
  SPEAKER_01: What's the next step?
• 51:45
  SPEAKER_00: Um, I look for a trauma-informed therapist.
• 51:48
  SPEAKER_00: And not just trauma, but a CPTSD informed therapist, I think could be a really great neck, a really great next step for them.
• 51:58
  SPEAKER_01: You look that up.
• 51:59
  SPEAKER_01: It's it may or may not be listed on their website, but you can call and ask, do you have specific training in?
• 52:04
  SPEAKER_00: Yeah, that would be a great question to ask a therapist.
• 52:08
  SPEAKER_00: Is you might say, hey, I I think I'm I'm thinking I'm relating to CPTISD.
• 52:13
  SPEAKER_00: Is that something you have experience working with?
• 52:16
  SPEAKER_00: And if so, what might that look like in the room with you?
• 52:20
  SPEAKER_01: Excellent.
• 52:21
  SPEAKER_01: So today we explored CPTSD, defining it, looking into its causes and some of the symptoms.
• 52:27
  SPEAKER_01: In part two, we will continue this discussion and how CPTSD affects relationships to ourselves and others, why those of us with it can experience dissociation, shame, and self blame, as well as how CPTSD is diagnosed and treated.
• 52:43
  SPEAKER_01: Please join us.