Lisa Curtis, LCSW, CASAC, HWC

Variations on the Theme of PTSD: A Brief Look at c-PTSD, Betrayal Trauma and Intimate Partner Trauma

You likely learned in elementary school that no two snowflakes are the same, each flakes being a little bit different than the others. The shape and structure of those lovely bits of frozen water falling from the sky are determined by a number of factors including the humidity in the air, the atmosphere around it, and the wind it faces as it floats down. Just as each snowflake is unique so too are the storms that bring them in; often mixing and matching what kind of precipitation we get. Trauma is a little bit like those storms and snowflakes; there are a number of factors that go into the making of a traumatic situation and it is important to know we can encounter any or all of those component parts at different points in our lives. Learning to name what kind of injury has been sustained goes a long way towards healing.

Trauma is most commonly defined in the dictionary as being, “a deeply distressing or disturbing experience” as well as being a “physical injury.” A good start but not entirely complete. What’s missing from this basic explanation is the fact that these deeply distressing or disturbing experiences can come from combat situations, childhood abuse, a significant physical injury, an unmet expectation at the hands of an intimate partner or institution, to name a few.

To make it even more confusing, they all have different names to describe what happened, oftentimes interlacing with each other. To help us further clarify, let’s take a quick look at each of these options. 

Post traumatic stress disorder is the overarching term used to describe many of the symptoms which are experienced by those who have lived through a horrific situation, sometimes a discrete event and frequently, multiple events. It is often used to describe events that were terrifying or dangerous in nature. Examples of an experience would be the witnessing of a murder or other unexpected death, a car accident or a major natural disaster such as a tornado.

Often, in the case of PTSD, what separates out those who are impacted by the event from those who seem to be less effected, is how one frames the event and what kinds of support they are given around the situation. Individuals who are given appropriate and helpful interventions as early as possible do better than those who continue to experience stress long after the initial situation. And, because we all bring our history with us when these tragedies occur, how much exposure to stress we’ve had in the past, plays a role. Everyone walks away from the situation with a very different experience. In keeping with my analogy of snowstorms, no two situations are alike.

Complex PTSD (c-PTSD) is thought to be the result of trauma that is experienced early in life, although that’s not a necessity. The defining characteristic of complex PTSD is that the the trauma is longer standing in nature and involves the lack of ability to escape the situation. Situations where one is held against their will or not in a position to stop it would be one of the most useful markers.

Examples of c-PTSD include domestic violence, children who are brought into cults by their parents, individuals forced into a human trafficking situation or repeatedly witnessing violence. These are traumas which are often premeditated, caused by other people and planned.

Intimate partner trauma is the abandonment experienced within an intimate relationship, often as a result of one party’s repeated affairs that are either or sexual or emotional in nature or financial duplicity. This also applies to relationships that are impacted by the substance use of the partner and domestic violence situations.

Betrayal trauma is most often defined as being trauma which is experienced at the hands of a person or institution in whom a person has put their faith and trust in. This is, at its core, the sense of safety, security and confidence being shattered by a person or persons where it was felt it was safe to ‘lean in’ them. Betrayal trauma also covers a wide range of experiences; from non-consensual sex, being in a compromised relationship with a therapist, not having the support of a system such as the military, or feeling that the legal system is further victimizing the survivor.

One of the most devastating consequences of betrayal trauma is that the very systems and institutions that are relied upon for safety, security and healing are often the sources of this emotional and physical assault. 

There are specific criteria for the diagnosis of PTSD, including but not limited to emotional dysregulation, flashbacks, intrusive thoughts, aversion to triggers of the event or situation, physiological reactions to either internal or external cues, difficulties allowing oneself to feel positive emotions such as happiness, joy or pleasure and a general distrust of the environment. 

Although it is important to know there are well documented criteria for such a diagnosis, it is also critical to acknowledge that for some individuals and situations the criteria may fall short, leaving one to believe that perhaps their experience wasn’t “bad enough” to warrant treatment and support. This could not be further from the truth. As with many other difficult to articulate issues, the key to getting a good diagnosis and team around you, is being willing to persistently seeking the support you deserve. 

Trauma, left untreated, will not resolved on its own. Instead, like a snowstorm that stuck around longer than expected, the consequences will pile up, ultimately causing far more damage. Also like a heavy snowfall, it often requires a variety of tools and techniques to treat the problems caused by the trauma so that healing can happen with the most effective means available. 

Just as there are no two snowflakes or snowstorms that are the same, I would encourage you to know there are as many treatment options as there are snowflakes. Trauma, and its residual impact on an individual and family, is best approached at the speed that feels most comfortable to all, and with the tools that best fit the situation. Any experience that is deeply disturbing in nature can not be filled in quickly and covered over but rather must be slowly, carefully, attended to for the most complete healing. Those who are seeking to restore what was lost, grow from their new vantage point and share, if they wish to, their strength, deserve nothing less than the best options available. 

If you have any questions about this, or any other post, please don’t hesitate to drop me a note at lisacurtis445@gmail.com I will do my best to get back to you as quickly as possible.