Recognising C-PTSD after an abusive relationship

When we think about PTSD, our minds might first go to war or frightening events such as a car accident or an attack. While this is all true, it is now understood that an abusive relationship can result in what is known as C-PTSD.


C-PTSD or complex PTSD, is believed to be caused by experiencing repetitive or prolonged periods of trauma or fear, and it can have a large impact on how we view ourselves and the world. When you are in an abusive relationship of any kind, you begin to live in a constant state of hyperarousal and anxiety. The nervous system can become locked in fear mode, keeping us in fight, flight, freeze or fawn responses.

While the relationship itself ended, our mind stays with the past and a belief that we could find ourselves in those terrifying experiences once again.

7 signs of C-PTSD

While it can sometimes be difficult to separate out the things that we feel in C-PTSD, it might be useful to look out for the following signs:

1. Flashbacks

These can come in various forms and can differ in range and intensity. They may be visual images, re-experiencing emotions or feelings from the trauma (like familiar anger, fear or anxiety), intrusive thoughts or internal voices. They don’t always feel like we see them in the movies, and can occasionally be difficult to spot or differentiate from what is reality. They all do, however, force you to relive the frightening events of the past. Often, flashbacks also appear in our sleep as vivid dreams or nightmares accompanied by intense feelings.

2. Hypervigilance and sense of threat

This element of C-PTSD can be stressful and exhausting. Hypervigilance is when you are in a constant state of high alert. You are always on the lookout for real or perceived threats and hidden dangers. In this state, the world can feel like a very frightening place and it becomes difficult to trust. You may become highly attuned to people’s behaviours or emotions in a bid to keep yourself safe. It can cause irritability, jumpiness, difficulty relaxing, and struggles with focus and maintaining attention.

3. Difficulties with emotional regulation

You might find it difficult to control your emotions or feel completely overwhelmed. Your emotions might also feel very intense, particularly anger, sadness, fear, frustration and anxiety. It might be that you cry out of nowhere and with frequency, or you wonder why your responses to things feel so big. This is known as emotional dysregulation and is caused by trauma in general, though particularly if experienced young.

4. Feelings of shame and worthlessness

Even though the trauma isn’t your fault, it can be followed by deep feelings of shame and low self-worth. This can be particularly true of C-PTSD from an abusive relationship, as the abuser will often break down your sense of self. Survivors often experience negative self-talk, insecurity, over-apologising, checking in with others for approval, isolating, fear of rejection and poor body image. This can also show itself in perfectionism.

5. Difficulties in interpersonal relationships

All of this can make it difficult to have interpersonal relationships. After experiencing abuse, it can be very difficult to trust others and allow them to get close to you. A person with PTSD may find it difficult to be vulnerable or be constantly looking out for signs of danger or rejection, along with issues regulating their responses to this.

6. Short-term memory issues

While trauma is often associated with narrative memory and dissociation, it can also impact your working memory. C-PTSD can cause difficulty remembering recent events, conversations, or encounters. It can also cause impairment in daily routine, recalling information, ability to focus and attention. Memory and C-PTSD can vary from person to person and is thought to be linked to the way things are encoded in the brain along with suppression and the continued heightened state.

7. Avoiding triggers

You may find yourself avoiding people, places or situations that remind you of the abuse or abuser, and that causes you to re-experience the trauma. Triggers can take many different forms, and they can really impact your feeling of autonomy and control in your life. While it can feel easier to avoid triggers, it can also cause frustration or a sense of missing out.

If you suspect that you may be experiencing C-PTSD then it can be very helpful to speak with a trauma-informed therapist. They can help you understand it further as well as process what you went through. If you don’t feel ready to talk about the abuse itself, then support can also be offered in terms of soothing techniques and coping mechanisms to ease the responses. C-PTSD can also be linked to drug and alcohol misuse, as they can be used to cope, and for this, there are support agencies that a therapist can signpost you to.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Liverpool L31 & London NW1
Written by Katie Evans, BA(hons), Dip.Psych.
Liverpool L31 & London NW1

Katie Evans is a private practice therapist and public speaker, specialising in gender, sexuality, relationships and abuse. She is also a survivor of narcissistic abuse in a romantic relationship. Her experiences inform her work and her desire to speak out about developing a greater understanding of the trauma caused,

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