Complex PTSD: From Surviving to Thriving

by Pete Walker

Finally, seemingly exhausted, Mario collapsed on the couch, and launched into the first suicidal ideation I had ever heard from him. He had just landed in the pit of the abandonment mélange [depression encrusted with fear and shame] and was sinking to the bottom into a despairing depression of helplessness and hopelessness. This was the real helplessness and hopelessness that had so characterized his childhood.

Chronic emotional abandonment devastates a child. It naturally makes her feel and appear deadened and depressed. Functional parents respond to a child’s depression with concern and comfort. Abandoning parents respond to the child with anger, disgust and/or further abandonment, which in turn exacerbate the fear, shame and despair that become the abandonment mélange.

As practice becomes more accomplished, these feelings and sensations of depression can morph into a sense of peace, relaxation and ease. On special occasions, they sometimes open to an underlying, innate core emotional experience of clarity, well-being and belonging.

I began my journey of learning how to feel by devoting a half hour daily to feeling the sensations of my fear. This was extremely difficult because I had survived my childhood with ADHD-like busyness. I had run daily marathons of activity to keep myself one step ahead of my fear and my shame-saturated depression.

Mindful merging with the subtle emotions and sensations of depression is the finishing tool of deconstructing self-abandonment. Over and over I focused on the sensations of my depression. Occasionally these sensations were intense, but more often they were very subtle. Often it was difficult to resist the urge to fall asleep, and many times I could not.

Feelings of abandonment commonly masquerade as the physiological sensations of hunger. Hunger pain soon after a big meal is rarely truly about food. Typically it is camouflaged emotional hunger and the longing for safe, nurturing connection. Food cannot satiate the hunger pain of abandonment. Only loving support can.

Even after a decade of practice, I still find it difficult to differentiate this type of attachment hunger from physical hunger. One often reliable clue is that the sensation of longing for the nourishment of attachment is usually in my small intestine, while physical hunger’s locus is a little higher up in my stomach. When I can take the time to meditate on this lower abdomen sensation, I often become aware that I am in a low level flashback. Feeling through this uncomfortable sensation typically resolves both the flashback and my false hunger.

over-reacting to emotional tiredness eventually creates real physical exhaustion via a process I call The Cyclothymic Two-Step. The cyclothymic two-step is the dance of flight types or subtypes who habitually overreact to their tiredness with workaholic or busyholic activity. Self-medicating with their own adrenalin, they “run” to counteract the emotional tiredness of the unprocessed abandonment depression.

Eventually however, many exhaust themselves physically, and become temporarily too depleted or sick to continue running. At such times, they collapse into an accumulated depression so painful, that they re-launch desperately into “flight-speed” at the first sign of replenished adrenalin. Survivors with this pattern sometimes misdiagnose themselves as bipolar because of their abrupt vacillations between adrenalin highs and abandonment-exacerbated lows.

There is a healthy way out of this cul-de-sac of misdirected striving. It lies in cultivating self-kindness during those inevitable times when you feel tired, bad, lonely, or depressed. In this regard, the notable AA 12 Step acronym, HALT - Hungry, Angry, Lonely, Tired – can be helpful. Accordingly, I recommend that you focus inside to see if you have flashed back into the abandonment depression whenever you experience a HALT feeling. If you have, you can then work to generate the internal, self-compassionate attention

A child, with parents who are unable or unwilling to provide safe enough attachment, has no one to whom she can bring her whole developing self. No one is there for reflection, validation and guidance. No one is safe enough to go to for comfort or help in times of trouble. There is no one to cry to, to protest unfairness to, and to seek compassion from for hurts, mistakes, accidents, and betrayals. No one is safe enough to shine with, to do “show and tell” with, and to be reflected as a subject of pride. There is no one to even practice the all-important intimacy-building skills of conversation.

Those with Cptsd-spawned attachment disorders never learn the communication skills that engender closeness and a sense of belonging. When it comes to relating, they are often plagued by debilitating social anxiety - and social phobia when they are at the severe end of the continuum of Cptsd. Many of the clients who come through my door have never had a safe enough relationship. Repetition compulsion drives them to unconsciously seek out relationships in adulthood that traumatically reenact the abusive and/or abandoning dynamics of their childhood caretakers.

Just as importantly, the therapist needs to be able to tolerate and work therapeutically with the sudden evaporation of trust that is so characteristic of Cptsd. Trauma survivors do not have a volitional “on” switch for trust, even though their “off” switch is frequently automatically triggered during flashbacks. In therapy, the therapist must be able to work on reassurance and trust restoral over and over again.

When I delve deeply enough into a client’s experience, no matter how initially perplexing or intemperate it may at first seem, I inevitably find psychological sense in it, especially when I recognize its flashback components. In fact, I can honestly say that I have never met a feeling or behavior that did not make sense when viewed through the lenses of transference and traumatology.

Unfortunately, those who take the advice to forgive abuses that they have not fully grieved, abuses that are still occurring, and/or abuses so heinous they should and could never be forgiven, often find themselves getting nowhere in their recovery process.

the possibility of attaining real feelings of forgiveness is usually lost when there is a premature, cognitive decision to forgive. This is because premature forgiveness mimics the defenses of denial and repression. It keeps unprocessed feelings of anger and hurt about childhood trauma out of awareness.

As much as I can forgive myself, that much can I forgive others. What I often forgive in others is an old pain of mine, released from the disgust of self-hate. It is an old vulnerability of mine that I now love and welcome like a bird with a broken wing. Shame and self-hate did not start with me, but with all my heart, I deign that they will stop with me. I will do unto myself as I would have others do unto me.