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  • Writer's pictureSamantha Ardoin

Complex PTSD

Updated: May 18, 2022

Creating a sense of safety between client and therapist is even more fundamental when complex trauma is in the picture.

When I went to therapy for the first time, I had no idea what was going on with me. I was a teenager at a prep school at the time, and I found the high-intensity, highly competitive environment overwhelming. I noticed many of my peers faced depression and anxiety, but my desires to hurt myself and others, or escape the situation entirely, seemed more extreme than theirs. The intensity of my emotional responses alone were overwhelming, and I was not finding much support from my teachers, peers, and other mentors, who continuously told me to take it to therapy. For a long time, therapy felt disorienting. "What is even the point of this?" I wondered. "I just come here and cry? How is that helpful?" For a long time, therapy was not very helpful. Yet, I dutifully went from age 14-18, hoping for some relief. While the relationship with my high school therapist was not particularly deep or meaningful for me, it was an introduction to having a space in which I could express emotions without facing negative consequences. I didn't fully "trust" that therapist with everything, but I could at least trust her to stay calm while I expressed emotions.

I had not experienced even one extreme event where I felt my life had been in danger, and yet throughout my entire life I did not recall feeling safe.

In college, I continued to struggle with intense emotional experiences. Returning to therapy again, at 19 or 20, I still found myself frustrated with the experience, but able to lean in a little more, and then a little more. By "lean in," I mean that I showed up even when I didn't want to, and I gave my old therapist a chance. Even if I found myself hiding things from her, I started to actually notice this phenomenon, and feel curious about it. Internally, I wondered why it was that I could feel myself talking, while another part of me was hiding far behind my words, invisible to her.

I then came to understand there were underlying health issues contributing to my psychological suffering. I also came to understand and accept that my family of origin had not actually been the "idyllic" picture of harmony that I had believed it to be in my high school years, and I started to share with my college therapist the moments of anger, sorrow, and loneliness that I felt in my younger years.

When I was still in college, I started to become interested in becoming a therapist myself. I read the book The Body Keeps the Score and learned about trauma. I found myself especially curious about complex trauma, and the more and more I read about it, the more I realized it reflected my situation accurately. I had not experienced even one extreme event where I felt my life had been in danger, and yet throughout my entire life I did not recall feeling safe. I recalled continuous fear of disapproval and rejection from my family. I recalled long periods of time without talking to anyone about my emotions. I recalled how during times of stress I would fear that my family would "give me away" or put me out on the street, despite my family never having threatened to do this, and often becoming very upset when I suggested they might do this.

If you have Complex PTSD, you need time and space to develop a long term therapeutic or mentorship relationship with someone who understands how to build trust and safety with you.

After moving to Boulder, Colorado in 2017, I then sought out therapy once again. This time, to fulfill the requirement of my Masters program. I found that finding someone who appeared confident in their capacity to support me, and who also appeared non-threatening to me was incredibly important. Though many of my peers attested that "the therapist you dislike is the one you need the most," I deeply felt that I needed someone who reminded me of someone in my life who had been safe, non-threatening, playful, loving, and creative.

At first, I thought I was just interested in having a male therapist because that sounded like an interesting experience, but later I came to accept that because of my childhood experiences, masculine-presenting people simply register as less threatening than feminine-presenting people. For many people, the opposite is the case.

I think having the self-compassion to recognize my own need for comfort, and actively respond to that by creating a comfortable environment (by surrounding myself with those who seem safe), was an important step in my own growth process.

I needed someone who reminded me of someone in my life who had been safe, non-threatening, playful, loving, and creative.

l also found that someone with similar interests and values meant more to me than someone with similar identities. When I was able to connect with my therapist around shared values, life experiences, and interest in books and tv shows, I was able to feel safer and more emotionally held. I could feel like we lived in the same world. Plus, when I found that my (white male) therapist was OK with (and could keep up with, and be respectful of!) the marginalized identities I held, that allowed me to feel safer with others who did not share the same identities.

I continue to see the therapist I've been seeing for the last 5 years, and I continue to find that the safety I find in that primary attachment figure has allowed me to expand my capacity to feel safe with other people as well. This has also allowed me to be more open and creative.

My time in therapy has taught me how to better differentiate my anxiety about being hurt in relationships from true danger signals. I have been able to let various mentors and supervisors into my life in a more open way, receiving teachings with more clarity and less defensiveness (although I am not perfect).

When I met my current (romantic) partner three years ago, the internal compass that I had learned to refine and trust through my time in therapy allowed me to see that the relationship was safe. I was able to stay with someone I trusted and cultivate something new, rather than running away out of fear. I was also able to base my relationship on mutual respect and desire rather than the fear of missing out or the fear of being alone.

Complex PTSD exists on a spectrum. The trauma spectrum can range from brief stressful experiences all the way to development of acute PTSD, C-PTSD, and the breakage in sense of self that can occur in complex trauma situations can lead to further structural dissociation such as in what have been labeled personality disorders and dissociative disorders. Traumatic experiences can also cause or exacerbate mood disorders such as Depression or Bipolar Disorder, and other psychological issues, and vice versa. I have ADHD, and the interplay between my ADHD and Complex PTSD has been a challenge to manage as well.

While therapy is not for everyone, and there are other ways to heal from our past experiences, people with Complex PTSD and related experiences of trauma tend to benefit from long-term therapeutic care where they can experience a sense of continuous safety, security, and respect from their therapist.

While there have definitely been ruptures with my therapist, and sometimes he does challenge me in ways that feel difficult, the foundation of trust and security that we have built together over time allows for rupture, change, growth, and renewal. The challenges become growth points, rather than a rationale for ending the relationship. The relationship has room for growth, and is a co-creative artistic exchange.

I hope that I can hold that space for movement and growth for others at least as well as it has been held for me.

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