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Complex PTSD affects interpersonal relationships, but you can effectively manage the relationship by targeting the root cause. This article explains how and why Complex PTSD affects interpersonal relationships, and what you can do about it. How does complex PTSD affect interpersonal relationships? Complex PTSD sufferers believe they are vulnerable and in constant danger. As they attempt to self-protect, their relationships can become abusive, co-dependent or narcissistic. A healthy relationship is attainable by understanding and addressing the root causes. What makes a relationship healthy? The main ingredients of a healthy relationship are: mutual respect, trust and honesty. When there is mutual respect and trust, people are more relaxed and open to honest communication. With open and honest communications, people are better able to understand each other and develop emotional intimacy as each one feels the mutual understanding and care for each other. Relationship Pyramid Also, with mutual respect and trust, people feel safe and secure. As this security allows us to share our innermost thoughts without feeling threatened, and we can share facts about ourselves without fear of criticisms, rejection or any danger. When we are confident that there is mutual understanding and care for each other, we feel a greater commitment to the relationship’s long-term success. This means that we tend to be more cooperative with each other, and we are usually more willing to make compromises. As the relationship grows, we become more aware of mutual responsibility and accountability towards each other. For example, in a good marital relationship, both husband-and-wife would acknowledge that they each have different responsibilities in the family, and accountable to each other for a smooth running of the family. In case of a business partnership, each party would acknowledge their responsibility to carry out their part of the agreement and understand that they are accountable to the partners protecting their responsibilities seriously. When we feel responsibilities and accountability towards each other, along with mutual understanding and care, we would also become supportive towards each other. For example, in a good relationship, we would expect others to stand behind us in times of trouble. Even in good times, we would expect those really care about us to keep a close eye on us, push us out of our comfort zone and encourage us to grow. But these activities cannot take place unless there is a firm foundation and confidence that is mutual respect and care for each other. Without that firm conviction, these type of communication can easily be misinterpreted as harsh criticisms. As you can see, healthy relationships are built on the foundation of mutual trust, respect, and care. Then, as the relationship progresses, one should feel safe and secure in the relationship, which then leads to open and honest communications. Next comes behaviors such as commitments, cooperation’s, willingness to make compromises, taking responsibilities and accepting accountabilities. DID YOU KNOW? Contrary to popular opinions, relationships cannot be repaired at the top level by insisting on commitments, and responsibilities from each other. These higher level characteristics of good relationships can only come about when the foundation of mutual trust, respect, and care are firmly in place in people’s minds. What makes a relationship unhealthy Now that we have looked at how good and healthy relationships developed from basic foundations to higher level of emotional closeness or intimacy, in the next section we will look at how unhealthy relationships develop. Before we look at the symptoms of complex PTSD and how they affect interpersonal relationships, it is important to first look at what makes a relationship unhealthy and how these unhealthy relationships develop. Although there are many kinds of unhealthy relationships, researchers generally agree that they fall into three main categories, namely: abuses relationship, narcissistic relationship, and co-dependent relationship. DID YOU KNOW? Nowadays, there is so much incomplete information on the Internet and misinformation. If you don't understand the fundamental differences between toxic relationships and relationship issues involving complex PTSD, you can be putting a lot of effort into fixing the relationship just to find that you are barking up the wrong tree. Abusive Relationship While physical abuse and physical violence are easy to recognize, emotional abuse within a relationship can be more difficult to spot. The easiest way to identify an emotionally abusive relationship is to ask yourself if you find the relationship intimidating, controlling and domineering. For example, in an emotionally abusive relationship, there may be frequent humiliation and harsh criticisms. Retaliation, angry outbursts and silent treatment are also common behaviours. These type of relationships can also be very volatile, swinging from excessive expressions of affection to sudden termination of relationships, blaming everyone else for the problem, and then a sudden guilt trip would bring them back to excessive expressions of affection. In extreme cases, some may resort to using money or suicidal threats as a means of control so that the other person would do as they wish. It is also common to prevent access to support network, such as: family, friends, counsellors, and medical professionals. Now, if you’re having a hard time in your relationship with someone who has complex PTSD, before you jump into conclusion that your relationship is toxically abusive, let’s have a look at the causes of an abusive relationship. DID YOU KNOW? Contrary to popular opinions, research has shown time and again that the abuser in the abusive relationship does not necessarily lack anger management skills, self-discipline, or suffer from any mental health issues per se. Instead, it is a conscious personal choice to hurt, control and dominate other people. Do I hear you ask: Just why would someone want to hurt, control and dominate other people? There is currently no definitive answer, but research has certainly identified a few recurring themes. Top on the list is when someone unjustly feels they are entitled to something when in fact they are not, then they feel hurt, which they then interpret as justification to mistreat others. For example, a person may believe that a romantic relationship entitled him to exclusive access to his marriage mate. So when someone befriend his marriage mate, he may feel his right is violated, and therefore a violent retaliation is justified. Note that the abuse, in this case, was not acting impulsively as if he lacked anger management skills. Also, he did not act without self-discipline as such, because it genuinely believed violent retaliation, in this case, is justified. TOP TIP The root cause of abusive relationship is faulty reasoning on personal entitlement leading to irrational justification of abusive behavior. Even so, you may identify with some of the characteristics of an abusive relationship. But do not despair. The root cause of these symptoms are very different in the case of complex PTSD sufferers, and the solution to the problems are very different too. Narcissistic Relationship In this type of relationship the person in question are typically described as in love with themselves. However, a more accurate description would be in love with the ideal image of self. Fundamentally, narcissists have such low opinion of themselves that they are totally absorbed in creating and maintaining a false image of themselves. So, we can say that their behavior is a result of overcompensation for their low self-esteem . There are several ways narcissists try to compensate for their low-esteem and make themselves look bigger. For example, during a conversation, they may hijack, interrupt and dominate the conversations so much so that no one else can get a word in. This would enable to have an inflated sense of self that they are so brilliant that everyone else just wanted to hear what they have to say about any topics. In turn, it helps them to feel “I am not so small after all”. Other times, narcissists may make great efforts to appear to be very entertaining, hospitable and charming. However, because these are not motivated by genuine care, these efforts are very difficult to maintain in the long-term. Even so, by proving themselves to be popular amongst friends and family, it helps them to feel valued and entitled to special treatment. Still other times, narcissists may deliberately choose to break well-known rules and intentionally push the boundaries of right and wrong. Research has shown that these kind of behaviour driven by a false sense of superior self-image and believe that “I do xxx, Because I can”. The key difference between narcissistic behaviour and low self-esteem in general is that narcissists see the imaginary superior self image as an unmistakable, unchallengeable, absolute reality. TOP TIP Narcissistic behaviors are overcompensating actions caused by an extremely unbearable sense of worthlessness. Again, you may identify with some of the descriptions here. However, there is a fundamental difference between genuinely believe that one is greater than anyone else and what actually happens in the case of complex PTSD sufferers. Co-dependent Relationship At the other extreme of narcissistic behaviour is codependency. Instead of imagining and believing that one is more important than others to compensate for their low self-esteem, a codependent person accepts their low self-worth and neglect their personal needs. Instead of having a balanced view of self-care and caring for others, a codependent person typically forgoes their own personal need in order to care or please other people. Although caregivers often sacrifice their own personal needs, they are not dependent on their caring actions to give them a sense of respect, value and self-esteem. With a strong sense of insecurity and lack of self-worth, a codependent person may take extreme measures to be people pleasers in order to avoid conflicts. So that they can feel secure and be sure that they will be in trouble, they often resort to taking on far greater responsibilities than is reasonably required of them. For example, in addition to normal caring responsibilities, a codependent person may become so controlling that everything has to be done their way. They may also take upon themselves to protect others from any perceived harm regardless of the actual chances of them happening. When the codependent person’s instruction is not adhere to, there is an abnormal fear of being blamed if anything was to happen. Because their self-worth and self image is intrinsically linked with being helpful and caring, there is a disproportionate need to be praised, approved and given recognition. Along with this is also a lack of appreciation for their own personal needs and a sense of guilt when they need to be assertive. The problem with codependency is that the co-dependent person can be so intensely focused or obsessed with the relationship that it becomes controlling and suffocating for others. Now that we have discussed the major types of unhealthy relationships, do you recognize some of these issues in your relationship with complex PTSD sufferers? Let us now focus on complex PTSD and look at the root cause of these issues. How to deal with relationship difficulties in Complex PTSD? The key symptoms of complex PTSD are: re-experiencingavoidance hypervigilancenegative self-conceptaffective dysregulation, anddisturbances in relationships Complex PTSD and abusive relationships Behind the abusive appearance is my complex PTSD haunting the little child in me, making me bury my head in the sand, and I grief for my loss. Is it safe to admit I'm scared? Will you stil respect me if I tell you the truth? Will you be there for me? Complex PTSD is caused by long-term and repetitive or multiple traumas in one’s life. As complex PTSD sufferers continued to be tormented by flashbacks, intrusive memories, and nightmares, it is only natural that they would show avoidance behaviors. However, seeking to avoid any things or places or sound or smells that could possibly remind them of the traumatic events is extremely tiring. For example, as complex PTSD sufferers continue to battle with the re-experiencing symptoms through avoidance, they also feel an intense sense of loss and grief. This is especially true when they perceive that others without a traumatic history could enjoy all kinds of things in life, while they have to actively avoid certain things in order to prevent re-experiencing the traumas, it can feel as though some kind of right or entitlement to pleasures in life has been violated. While the complex PTSD sufferer can do nothing about his past, anyone or anything in his present life that interferes with his perceived happiness would be aggressively dealt with. There is almost a strong sense of “never will anyone take advantage of me again”. However, after an outburst of anger, it is not unusual for the complex PTSD sufferer to feel guilty about their behavior. This is especially true when they realize that if it was not for their traumatic history, they would most probably behave rather differently. This realization can give them an intense sense of guilt, worthlessness and insecurity. As a result, they may give up on the relationship or feel the need to rescue the relationship by being controlling and dominating. Although this may sound similar to those of an abusive relationship, the underlying psychological reasoning is not entirely disproportionate and unreasonable. True Companions Open New Possibilities For Each New Day TOP TIP The key to handling this kind of relationship issues with complex PTSD sufferers is to address their loss and grief in a very positive way. By learning and acknowledging the triggers and the associated avoidance behaviors, you can then discuss the feeling of loss with the complex PTSD sufferer. For example, does the complex PTSD sufferer finding difficult to go shopping because of the crowd? Or does he actively avoid watching the news because it could be triggering? Consider simple gestures of opting to do your shopping online instead of going to the busy shops or choosing to read newspapers either online or in print to avoid graphic details of war scenes. When you acknowledge the freedom that they have lost, you can suffer the loss with them. By doing so, you will help them to see you as a true companion who really understands their feelings. TOP TIP By gaining their trust and helping them to feel secure in your presence, you now have the basic foundation for the relationship to grow. The most notable progression in this relationship with a complex PTSD sufferer is their willingness to volunteer and self disclose the issues that are bothering them. This does not necessarily mean they would talk about the traumas themselves, although sometimes they do but at the very least, they would openly admit that they are struggling with aspects of their past and how they wish things would be different. Resolving seemingly abusive behaviors in a relationship with Complex PTSD sufferers With this and honest communication, you will get to see their inner battles, come to understand their emotions, and most importantly what are their hopes and goals for the future. Because their hopes and goals for the future are self-motivated and internally driven (i.e. not externally imposed), there will be a level of self-commitment towards achieving these. By you expressing your commitment, support and absolute confidence in his success, your relationship will continue to progress towards emotional intimacy. Complex PTSD and narcissistic relationships If you find your relationship with a complex PTSD sufferer is more of the narcissistic type, this is most likely to be during the denial stage of complex PTSD. As explained in the article “complex PTSD if left untreated”, it is not unusual for survivors of multiple traumas to mask and suppress their painful feelings. Typical methods include: workaholism, obsessive pursuit of excellence, or other types of distractions as well as addictive behaviors. The key difference between complex PTSD and narcissistic personality disorder is that a complex PTSD sufferer is fully aware of the methods they are using to mask and suppress the painful feelings. This is fundamentally different from a narcissistic person who genuinely believes in the unrealistically inflated image of self. TOP TIP If there is a way for complex PTSD sufferers to be able to enjoy life without the risk of re-experiencing their traumas, they would happily do so. So if you are noticing narcissistic behaviors in complex PTSD sufferers, do not be quick to assume they are self-centered or somehow in love with themselves. The major challenge for complex PTSD sufferers is that they have spent the lives in surviving, they simply do not know how to live differently and not be bothered by intrusive memories, flashbacks, and nightmares. DID YOU KNOW? Complex PTSD sufferers often need help to identify self-soothing activities that work for them. Why not try out different stress-diffusing hobbies and activities together? For example, you may wish to explore doing silly things with Play-Doh, pottery, paintings, and drawings. You made right taking a relaxing walk in the park or by the seaside. Some people also find meditation and mindfulness helps. Others may prefer a vigorous workout in the gym or a good long swim in the sea, or just relaxing either in a spa or hot tub or just a hot bath home. Whatever the situation might be, the goal is to find activities that one can do to wind down and relax without fear of re-experiencing past traumas. By recognizing and legitimizing a genuine fear of re-experiencing past traumas, you show that you care and respect their feelings. As you go on to express your support and confidence in finding something that will work, you are also expressing your commitment to the relationship and that together you can be strong. Resolving seemingly narcissistic behaviors in a relationship with Complex PTSD sufferers Again, notice that the strategy here is to focus on the root cause of the issues, and from there we rebuild trust and respect. The moment that you establish a firm conviction in the minds of complex PTSD sufferers that you understand them, care a lot about them, and are committed to helping them through the challenges of having suffered complex PTSD, your relationship will automatically grow. Complex PTSD and codependence relationships I'm the most caring person in the world! I won't do a thing that may risk your displeasure, no matter the cost. Because behind my capable caring mask is a very insecure child... Displeasing someone could mean great danger. I just can't tolerate the fear. If you identify elements of codependency in your relationships with a complex PTSD sufferer, then the key things to note is that such behaviors stem from extremely low self-worth. It is also important to note that and the individual may not even be aware of how and why they behave such a way, and genuinely believe that they are just being helpful and caring. Complex PTSD sufferers develop a special kind of hypervigilance that is not seen in single trauma PTSD, namely: extreme vigilance against upsetting or displeasing people. Throughout their lives, they have learned that saying no to people or demanding their personal rights to be respected can be a very dangerous affair. They may even learn to feel it is wrong to want such rights and develop an intense sense of guilt even just at the thought of it. Having little or no self-worth, along with the guilty feelings discussed above, complex PTSD sufferers may have very little regard for their feelings, opinions and even physical needs. Instead of the natural and normal care for self without being selfish, complex PTSD sufferers may focus on caring for someone else instead. By doing so, they can fill the self-identity void with a sense of “I’m a caring person”, and “I have my worth because of what I do for others”. Self-identity, self-worth and security are fundamental human psychological needs. When complex PTSD sufferers take on a caring role to fill these voids, they can become obsessed with it so much so that others may find it suffocating. And because such psychological needs are so fundamental to general well-being, complex PTSD sufferers would vehemently defend their actions as being selflessly caring. Even though it may feel as if the complex PTSD sufferer is controlling and manipulative in the name of care, dealing with this head-on is likely to cause much hurt and damage your relationship. Yes, it is not unusual for complex PTSD sufferers to mix up the idea of selflessness with codependency. That is why if you were to tell them that they are controlling and manipulative in the name of care, and they would only feel very hurt and may even accuse you of being unappreciative. Instead, focus your energy on helping the complex PTSD sufferer to rebuild a healthy self-image and a balanced view of self. For example, a discussion of their personal rights at everyone take for granted may be helpful. One quote that made a huge impact on me when I was struggling with this concept was: “you are not required to set yourself on fire to keep others warm”.Unknown "You are not required to set yourself on fire to keep someone else warm". Yes, true self-worth depends not on how much I care for others, but how much care I give to myself. Because I am worthy of care just like everybody else. As complex PTSD sufferers were surviving through their multiple traumas, they have learned to forgo or neglect the personal needs. Years of deprivation often means that complex PTSD sufferers no longer know what is perfectly within their rights and they should stand up for. For example, you may want to discuss questions such as what does it feel like if you need to: ask for what you wantsay no to unreasonable demandsmake yourself care a priority before fulfilling someone else’s preferencerefuse to be responsible for someone else’s actions and behavioursstandout as unique and different from popular opinionsexpress your true feelings about something that has just happened By exploring questions such as these, a window of opportunity may open up to you to see the inner emotional battles that complex PTSD sufferers are going through. Through these discussions, you will come to understand that it is not their intentions to be controlling and manipulative. Instead, it is their lack of self-identity, self-worth, and security that are causing the problems. Resolving seemingly codependent behaviors in a relationship with Complex PTSD sufferers A kind and understanding conversation about their feelings can help them to re-examine their emotional reactions to different situations in life. It may well be the first time ever in their lives to notice that others stand up for their rights without suffering great pains. It may also be that they now realize they need to learn how to be assertive without being aggressive. By expressing your unwavering support and commitment in helping them to develop the skills, you will win their respect and trust as well their commitment to work along with you. What about those with Aspergers and Complex PTSD? Does it make any difference? In terms of interpersonal relationships with complex PTSD sufferers as discussed above, whether one has Asperger’s or not makes no difference. This is not to say Asperger’s syndrome does not play a role in social interaction and communication difficulties. But because we are dealing with the problem from the ground up, and helping the complex PTSD sufferers to further develop their interpersonal skills, it will automatically address the social interaction and communication difficulties caused by Asperger’s syndrome. Whether it is Asperger’s syndrome or complex PTSD, one of the most notable recurring themes in the therapy or treatment process is assistance in raising social awareness. By helping them to understand how their own emotions and psychology in tracks in an everyday social situation, they can grow to see how and why problems arise. They can also learn how to avoid common pitfalls. Resolving seemingly difficult behaviors in a relationship with Complex PTSD sufferers I hope you have enjoyed reading this article, and I would love to read your comments too. Related Questions How to explain complex PTSD to someone who doesn’t have it? You can do this by stating: you have survived multiple life-changing traumas,the ill effects live on,(if you wish) say it can be unhelpful to discuss the traumaexplain what is helpful switch focus before getting triggered What c-ptsd treatment options are there? Typical options are: Talking therapy and psycho-education: Living skills for C-PTSDEye Movement Desensitization and Reprocessing (EMDR): Reduce sensitivity to past memoriesMedication: Anti-depressants for mood control What are the stages in complex PTSD recovery? The 3 stages of Complex PTSD recovery are: Stablization: Building distress tolerance skills, self-harm management and self careTrauma-processing: Recognizing what happened, address the guilt and shameRebuilding life: eg. family, friends, career etc Complex PTSD and attachment disorder, are they the same? The key differences between complex PTSD and attachment disorders are: complex PTSD symptoms such as re-experiencing, avoidance and hypervigilant are not symptoms of attachment disorderattachment disorders are identifiable before age 3-5, whereas Complex PTSD tends to be diagnosed during adulthood Time Saving Infographic Summaries