Complex PTSD: From Surviving to Thriving

by Pete Walker

In assisting others to manage flashbacks, the most common help I offer is to encourage them to challenge the alarmist and perfectionistic programming of the inner critic.

One of my client’s drasticizing sounded like this: “My boss looked at me funny when I came back from my bathroom break this morning and I know he thinks I’m stupid and lazy and is going to fire me. I just know I won’t be able to get another job. My girlfriend will think I’m a loser and leave me. I’ll get sick from the stress, and with no money to pay my medical insurance and rent, I’ll soon be living out of a shopping cart.” It’s disturbing how many drasticizing inner critic rants end up with an image of homelessness. What a symbol of abandonment!

Recovering requires being able to recognize inner-critic catastrophizing so that we can resist it with thought-stopping and thought-correction. In this case, I reminded my client of the many times we had caught his critic “freaking out” about every conceivable way his life could go down the tubes. I then encouraged him to refuse to indulge this process, and to angrily say “no” to the critic every time it tried to scare or demean him.

Advanced flashback management, then, involves learning how to manage the disconcerting experience of falling asleep feeling reasonably put together and waking up in a flashback. Typically this occurs because a dream has triggered you into a flashback. If you remember the dream, you can sometimes figure out why it triggered you. With growing mindfulness you may even understand which events from the previous day triggered your dream.

With undetectable triggers, I find that it is most helpful to see a flashback as a communication from the child that you were. The child is reminding you that he woke up feeling desolate innumerable times in that house that was not a home. He woke up daunted by the prospect of once again having to reenter the poisonous milieu of your family. The child is now asking you to meet his unmet need of having someone to go to for comfort when he wakes up feeling wretched. It is as if he is saying: “See! This is how bad it was – this is how overwhelmed, ashamed and miserable I felt so much of the time.”

Years ago, I customarily responded to awakening in flashback with hypochondriasizing ruminations about my health: “What’s happening to my energy? Something must be seriously wrong with me. I feel like death warmed over. That ache in my back is probably a tumor. I lost two pounds this month. I just know its cancer! I wish I could just die and get it over with.”

Because of a great deal of practice, I now quickly realize that hypochondriasizing means that I am in a flashback. Accordingly, I work to shift the focus of my thought processes to the theme of generating love and kindness to the child within me.

Discerning the trigger of a flashback is a slippery slope. Seeing the trigger can often rescue us from blaming and hating ourselves for the flashback, but there is not always an identifiable trigger. In such situations, looking for the trigger can quickly deteriorate into self-pathologizing vivisection. This slippery slope can quickly become a cliff as we plummet deeper into the abyss of the flashback.

The process of self-support needs to trump the healthy urge to “figure it ALL out” at such times.

Sometimes, as described above, the best understanding you can achieve is an overarching one that your inner child is feeling profoundly abandoned. She is cowering from a humiliating attack from your critic and needs for you to switch gears and demonstrate that you will care for her no matter what.

Good moods sometimes inexplicably deteriorate into bad ones. As novelist, David Mitchell wrote “Good moods are as fragile as eggs… and bad moods as fragile as bricks”.

I try to make my default position turning to myself and my inner child with unconditional positive regard as much as possible.

When your recovery matures sufficiently, you realize that much of the emotional pain of your flashbacks is appropriate but delayed reactions to your childhood abuse and neglect. You process your feelings in a way that resolves flashbacks, and also builds an increasingly healthy, sense of self. This, in turn, leads to an ongoing reduction of the unresolved childhood pain that fuels your emotional flashbacks. Flashbacks then become less frequent, intense and enduring. Eventually, you learn to invoke your self-protective instinct as soon as you realize that you are triggered. As flashbacks decrease and become more manageable, the defensive structures built around them (narcissistic, obsessive-compulsive, dissociative and/or codependent) are more readily deconstructed.

Facilitate grieving the death of feeling safe. Abuse and neglect beget sadness and anger. Crying releases fear. Venting anger in a way that doesn’t hurt the person or others creates a sense of safety.

A prevailing climate of danger forces the child’s superego to over-cultivate the various programs of perfectionism and endangerment listed below. Once again, the superego is the part of the psyche that learns parental rules in order to gain their acceptance.

The inner critic is the superego gone bad. The inner critic is the superego in overdrive desperately trying to win your parents’ approval. When perfectionist striving fails to win welcoming from your parents, the inner critic becomes increasingly hostile and caustic. It festers into a virulent inner voice that increasingly manifests self-hate, self-disgust and self-abandonment. The inner critic blames you incessantly for shortcomings that it imagines to be the cause of your parents’ rejection. It is incapable of understanding that the real cause lies in your parents’ shortcomings.

Hypervigilance is a fixation on looking for danger that comes from excessive exposure to real danger. In an effort to recognize, predict and avoid danger, hypervigilance is ingrained in your approach to being in the world. Hypervigilance narrows your attention into an incessant, on-guard scanning of the people around you. It also frequently projects you into the future, imagining danger in upcoming social events. Moreover, hypervigilance typically devolves into intense performance anxiety on every level of self-expression.

The critic-driven child can only think about the ways she is too much or not enough. The child’s unfolding sense of self [the healthy ego], finds no room to develop. Her identity virtually becomes the critic. The superego trumps the ego. In this process, the critic becomes increasingly virulent and eventually switches from the parents’ internalized voice: “You’re a bad boy/girl” to the first person: “I’m a bad boy/girl.” Over time, self-goading increasingly deteriorates: “I’m such a loser. I’m so pathetic… bad... ugly…worthless…stupid...defective.” This is unlike the soldier in combat who does not develop a toxic critic. This process whereby the superego becomes carcinogenic is a key juncture where ptsd morphs into Cptsd. The cruel, totalitarian inner critic is a key distinguishing feature of Cptsd.

1. Perfectionism. My perfectionism arose as an attempt to gain safety and support in my dangerous family. Perfection is a self-persecutory myth. I do not have to be perfect to be safe or loved in the present. I am letting go of relationships that require perfection. I have a right to make mistakes. Mistakes do not make me a mistake. Every mistake or mishap is an opportunity to practice loving myself in the places I have never been loved.

2. All-or-None & Black-and-White Thinking. I reject extreme or over-generalized descriptions, judgments or criticisms. One negative happenstance does not mean I am stuck in a never-ending pattern of defeat. Statements that describe me as “always” or “never” this or that, are typically grossly inaccurate.

3. Self-Hate, Self-Disgust & Toxic Shame. I commit to myself. I am on my side. I am a good enough person. I refuse to trash myself. I turn shame back into blame and disgust, and externalize it to anyone who shames my normal feelings and foibles. As long as I am not hurting anyone, I refuse to be shamed for normal emotional responses like anger, sadness, fear and depression. I...

4. Micromanagement/Worrying/Obsessing/Looping/Over-Futurizing. I will not repetitively examine details over and over. I will not jump to negative conclusions. I will not endlessly second-guess myself. I cannot change the past. I forgive all my past mistakes. I cannot make the future perfectly safe. I will stop hunting for what could go wrong. I will not try to control the uncontrollable. I will not micromanage myself or others. I work in a way that is “goo...

“God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know t...

5. Unfair/Devaluing Comparisons to others or to your most perfect moments. I refuse to compare myself unfavorably to others. I will not compare “my insides to their outsides”. I will not judge myself for not being at peak performance all the time. In a society that pressures us int...

6. Guilt. Feeling guilty does not mean I am guilty. I refuse to make my decisions and choices from guilt. Sometimes I need to feel the guilt and do it anyway. In the inevitable instances when I inadvertently hurt someone, I will apologize, make amends, and let go of my guilt. I will not apologize over and over. I am no longer a victim. I will not accept unfair blame. G...

7. “Shoulding”. I will substitute the words “want to” for “should” and only follow this imperative if it feels like I want to, unless I am un...

8. Over-productivity/Workaholism/Busyholism. I am a human being not a human doing. I will not choose to be perpetually productive. I am more productive in the long run, when I balance work with play and relaxation. I will not try to perform at 100% all the time. I su...

9. Harsh Judgments of Self & Others/ Name-Calling. I will not let the bullies and critics of my early life win by joining and agreeing with them. I refuse to attack myself or abuse others. I will not displace the criticism and blame that rightfully belongs to my dysfunctional caretakers onto myself or current people in my life. “I care for myself. The more solita...

10. Drasticizing/Catastrophizing/Hypochondriasizing. I feel afraid but I am not in danger. I am not “in trouble” with my parents. I will not blow things out of proportion. I refuse to scare myself with thoughts and pictures of my life deteriorating. No more home-made horror movies and disaster flicks. I will not turn every ache and pain into a story about my imminent demise. I am safe and at peace.

11. Negative focus. I renounce over-noticing and dwelling on what might be wrong with me or life around me. I will not minimize or discount my attributes. Right now, I notice, visualize and enumerate my accomplishments, talents and qualities, as well as the many gifts that life offers me, e.g., nature, music, film, food, beauty, color, friends, pets, etc.

12. Time Urgency. I am not in danger. I do not need to rush. I will not hurry unless it is a true emergency. I am learning to enjoy doing...

13. Disabling Performance Anxiety. I reduce procrastination by reminding myself that I will not accept unfair criticism or perfectionist expectations from anyone. Even when afraid, I will defend myself fro...

14. Perseverating About Being Attacked. Unless there are clear signs of danger, I will thought-stop my projection of past bullies/critics onto others. The vast majority of my fellow human beings are peaceful people. I have legal authorities to aid in my protection if threatened by the f...

After enduring many, many more elaborations of this process, Dmitri became entrenched in the ultimate abandonment catastrophization [#10]: “No wonder I don’t have a partner or any friends; who could tolerate being around such a loser” [#2: He actually had two good friends].

As ongoing neglect and abuse repetitively strengthen the critic, even the most innocuous, self-interested thought or musing can trigger a five alarm fire of intense emotional flashback. To maintain the illusive hope of someday winning parental approval, the child’s perfectionistic striving escalates, and may become obsessive/compulsive. Even an imagined mistake can then initiate a flashback.

Parental contempt is the key piece of the emotional abuse that creates toxic shame. Toxic shame is the emotional matrix of the abandonment depression. It is also the glue that keeps us stuck helplessly in flashbacks. As such, toxic shame is the affect or emotional tone of the inner critic. Shame besmirches us as it emotionally intensifies each of the 14 assaults described above.

For me, the strongest evidence of this occurs when I am on my own and trying to do something difficult. If I make a mistake or do not accomplish my task as efficiently as possible, I often feel very anxious as if I am being watched and criticized.

Our parents were such formative and formidable presences in our developing life, that we have strong representations of them in our psyches. These representations include their beliefs and condemnation about us. Until we work on shrinking their influence, our internalized parents exist in our psyches as the key controlling force of our lives.