Complex Trauma Disorder? I hardly know her!

Grinding Glass: A Facets article on coming to terms with complex trauma

Nov 20, 2023

A girl in a pink sweater cringes away from the camera in fear.

The year is 2022 and Joscelyn is insisting to a friend, “There’s no way I have PTSD. I’ve never experienced any real or serious trauma, you know?” This is when the deadpan narrator voice comes over and ironically explains, “Joscelyn did, in fact, have PTSD.”

I wouldn’t be surprised if some of you have a similar experience, thinking you really can’t claim to have PTSD and downplay what you went through thinking it’s melodramatic to describe it as “trauma.” Especially for those of us that don’t have any specific, acute moments of trauma, like being physically hit or sexually assaulted. Nothing we went through really maps directly onto that kind of PTSD. So we all must just be inherently broken, terrible monsters that don’t deserve anything good, right?

That’s what I told myself too, anyway. Funny thing is, I had worked and volunteered as a crisis counselor and support group facilitator for years. I had been educated thoroughly on what trauma is and how to support those who have PTSD. I had even sat on the phone with people as they struggled with flashbacks or other manifestations of trauma, and I was utterly convinced I couldn’t have PTSD of any sort. I mean, how could I have PTSD?

While I had some tough times due to not being able to grow up fully as myself as a trans person, I never experienced any physical abuse, never went to war, and couldn’t really point at any specific moments in my life I would have said something “traumatic” happened. So, clearly, in my professional opinion as a counselor, trauma couldn’t be the problem and I was just a broken girl. Case closed.

Except...well, when I actually did finally tell people about some of the things that happened to me over the years, they would look shocked or upset, and offer their sympathies. Huh, that’s weird, those are just things that happened. Just facts about my life, you know?

But then there was something I started to notice that felt eerily familiar: most of my closest friends and found family were survivors of trauma and had PTSD of one flavor or another. I had already gone through this with discovering I was trans after being “a really passionate ally” and with ADHD when I found myself relating a bit too hard to those ADHD memes.

So, um, there was definitely a pattern. 😅

Patterns

I still didn’t quite accept it though until a close friend suggested to me one day, “Um, don’t take this the wrong way, but maybe it would help to look up the symptoms of complex PTSD?” Thus, did I express one of my many insistent denials that I didn’t have trauma – after all, I know what PTSD is! I don’t have those symptoms, so nah, can’t be that!

Chewing on it later though, I thought, “Well, I don’t actually know what’s different about complex PTSD compared to other varieties, so maybe I should read up a bit, so at least I can better understand and support those with it.”

An example of one of the many articles I read is one from healthline. Most start with some boilerplate descriptions of the symptoms of PTSD, leaving me room to still be like, “Ah, yeah, see, yep, I clearly don’t have CPTSD either.” But then, when I read about the symptoms of CPTSD, my internal monologue went something like this:

“Lack of emotional regulation”

…huh, well, I generally think I manage okay, but I know sometimes I have trouble managing my emotions, especially as transition has gone on. But that’s more just an ADHD thing probably...

“Changes in consciousness…include…feeling detached from your emotions or body, which is also called dissociation”

…um, okay, yes, that has happened repeatedly. I spent most of three decades dissociating from my body and gender...hmmm…

“Negative self-perception - you may feel guilt or shame, to the point that you feel completely different from other people.”

…I…uh…okay, but I am uniquely terrible and should feel guilty and bad about existing...for reasons. Sure, I would tell anyone else don’t be so unfair to themselves, but I’m completely different from other…ooooh…okay…huh...

“Difficulty with relationships”

…yes, yes, I have difficulties with trust that have been with me my whole life because of neglect from my father coming in and out of my life unpredictably as a child…okay, you got me.

“Loss of systems of meaning…you might lose faith in some long-held beliefs you had or develop a strong sense of despair or hopelessness about the world.”

…like when I was 13 and lost my faith, when all systems of meaning I was raised with stopped making sense, when my memories kinda become an icky, jumbled mess? It’s not like the entire universe began to feel fundamentally absurd and pointless, leading to an existential crisis during my first confrontations with puberty…fuck, okay….um…okay, feeling a bit called out here… 😅

I kept reading. Article after article, an academic paper or two, blogs of people living with cPTSD...and it began to come more and more into focus. Eventually, I spoke with my bestie, who lives with cPTSD, and told him about all the things I had been chewing on. He looked at me with a wry smile, “Hun, that sure sounds like PTSD to me.”

In the show “Feel Good,” Mae Martin’s character finds themselves breaking down while visiting their girlfriend’s friend who is giving birth in the other room. A doctor finds them and talks to them, saying it sounds like what they are going through is PTSD. Mae cracks a joke to deflect, as usual, but then describes that they are struggling with memories and feelings that are like a cupboard crammed full with random, mismatched tupperware and lids, and it’s all tumbling out whenever they open the cupboard.

This is what it was like for me too. There wasn’t a simple linear story for me to tell, but all these disconnected memories and feelings that kinda tumbled out together if I tried to talk about or reflect on these things. That’s because this is exactly what trauma does to memory.

Trauma, memory, and loss

The way trauma is shown in a lot of TV shows and movies isn’t very accurate. There’s no repressed memories being recovered via hypnosis. It’s also not like a scene in a movie you can perfectly recall. Trauma happens when our stress response systems are overtaxed by our experiences. This leads to some aspects of our memories getting chiseled deep into the pathways of our brain leading into the fight/flight/freeze/fawn system, while other aspects are completely dissociated or lost, leading to jumbled up information that often comes to us out of order.

For example, when I think of my memories from 12 to 14, most of it is just this icky, dark feeling – like sticking my hand to a pile of rotting muck. There are a few memories that I recall specific details of, but often I can’t remember if I was 14 or 12 in that memory or whether it came before or after those other memories. Just a bunch of mismatched Tupperware and lids...with some unidentifiable, icky gunk in them.

A few months after talking with my bestie about this, I finally was able to see a therapist and get a diagnosis of cPTSD. This led me to begin EMDR treatment and other forms of trauma therapy. Looking back now after having “graduated” trauma therapy, there are a few things that make more sense.

A big one is that I did have some specific trauma events that I was well aware of, but dismissed because they didn’t make me “feel like” trauma. One in particular involved recurring nightmares even. The thing is, one of the other things trauma can do to memories is dissociate your feelings. Like a form of psychological triage, your brain amputates the feelings that went along with those memories. So, just because it doesn’t “feel traumatic” doesn’t mean it wasn’t and hasn’t left a wound upon you.

A bigger insight I’ve gained is from the ongoing conversations some of us trans folks are having in the mastodon/fediverse space about “gender trauma.” CJ Bellwhether’s thread sparked a lot of conversations earlier this year, Tattie has written a few pieces related to how gender trauma impacted their gender journey, and, of course, Doc Impossible has launched a whole series on cPTSD and gender trauma on Stained Glass Woman.

Complex trauma is the result of being trapped in a situation where you understand yourself to not be safe or where you perceive a grave threat as being ever present. Many pieces online will point to a POW or someone who is kidnapped as examples, to give you a sense of an extreme form.

But traumatic experiences don’t have to be anything so dramatic.

Childhood

During childhood, your survival literally depends on the adults around you. If those adults can’t be trusted or relied upon, you find yourself persistently trapped in a situation where your survival depends on people who could also be a threat. And for children, there’s no ability to calibrate this sense of threat, allowing a terrified imagination to run wild.

I suspect most of us trans folks live with some degree of cPTSD. We discover very young that there is something deep-rooted about us that adults and the wider culture we live in violently hates. In my case, I didn’t know I was a girl, but I knew I had these dreams and fantasies about becoming one – and that I had to hide this from the adults in my life to be safe.

In retrospect as an adult, I know now my mom would have been safe, but the way I was treated by other family members I relied upon after coming out as an adult confirmed these fears.

A common symptom of PTSD are “flashbacks.” These don’t have to be whole memories like in the movies, but might emerge as emotional states that are locked in a moment from your past.

The first time I went out as myself wearing a skirt and make-up, I became paralyzed by panic as I stepped outside my door. My fight/flight/freeze/fawn system was suddenly activated. It was a sunny day, with a few fluffy white clouds in the sky. No one was visible on the street. I was just a person wearing a skirt standing outside. But this act had run me headfirst into a wall of trauma.

I felt a child’s fear in that moment. It was without proportion or relative to the situation. I wasn’t afraid of someone harassing or assaulting me - I was afraid the sky was falling or a mob with pitchforks and torches was coming to do something worse than kill me somehow. It was a fear that coated the inside of the shell produced by my trauma and cracking through led to a geyser of deep fear and pain erupting.

While I recognized this feeling as being out of place and time, it wasn’t until I began to address my cPTSD that it clicked: most of my gender dysphoria was actually an emotional PTSD flashback.

Someone would misgender me and it felt like the whole facade of my personhood had collapsed through the floor. I would be looked at in a way that reminded me of how some people saw me and it felt like this oozing, inky black, knotted up ball in my chest was throbbing. These small things felt like life and death...and gave me feelings from another time and place.

I do suspect, with further study and research, that there may be things we describe as gender dysphoria that aren’t strictly a product of cPTSD, such as dissonance between body and subconscious sex as Julia Serano suggests. But realizing much of it is likely a trauma response leads to better options for supporting ourselves.

So what are these options for helping ourselves if a gender dysphoria experience is cPTSD related?

De-escalation

In the immediate situation, when experiencing a PTSD flashback, one of the best things to do is to help restore a sense of security and grounding in the present moment. For this reason, doing some basic grounding and mindfulness exercises can help deescalate that activation, such as the old 5-4-3-2-1 exercise.

Others can help by being a safe and supportive presence, like a friend’s calm voice on the phone to anchor yourself to. This has helped me before.

Another tool I’ve found helpful is a form of self-talk, repeating to myself, “Joscelyn, you are here and you are safe. I am here now and I will protect you.”

Another small trick people don’t realize can help: drink a cold glass of water. Drinking water activates a different part of the nervous system and can help deescalate that trauma stress response.

Basically, the goal is to deescalate a system that tells you that you are not safe by restoring a connection to a sense of safety and bringing yourself out of past emotions to the present moment.

In the long-term, we can engage in different forms of trauma therapy, such as EMDR, that can help reprocess and heal those pathways to our fight/flight/freeze/fawn system. I often describe this as being like if you break a bone and it doesn’t heal right – you have to break it again to reset it and allow it to heal properly. It will never be unbroken, but you can heal a lot of the pain and reduce the way it disrupts your life.

I’m guessing you have questions about EMDR, what it’s like, and what the results are. Seems kinda hard to believe, right? I’m hoping I can answer some of those questions in part two, “Holding the Girl,” as I describe my experience of undergoing and “graduating” from EMDR therapy.

What I’ve discussed above is a lot though, so please take time to reflect and feel your feelings on it. Maybe go for a walk, get some vitamin D, and touch some grass. Maybe cuddle a companion animal or a plushie. If you need to cry, let the tears out. As SOPHIE sings, it’s okay to cry.

Know that if you’re having a really rough moment as you reflect on this, there are people out there who will listen and support you.

In the US, you can call the Trans Lifeline at 877-565-8860 or go to their website. There is also the Trevor Project for younger folks, especially those under the age of 24, that you can call at 866-488-7386, text at 678-678, or chat with online.

Joscelyn Inton-Campbell (she/they) is an independent scholar writing about trans lives, media, and mental health on her blog, “Transpiring Considerations.” You can also follow her Mastodon account where she posts a weekly microblog about trans musical artists under #TransMusicMonday. She is also currently working to produce an online zine, “How to Gender Euphoria,” with practical advice on how people can find gender euphoria, which you can subscribe to on her Patreon.

Other articles in the Grinding Glass series:

Shattered, a new model for understanding gender dysphoria.
Growing Up Broken, an examination of how trans trauma forms.
Slivers, a discussion of how we reenact our trauma on ourselves.

Facets is a series on Stained Glass Women which invites trans writers other than Doc Impossible to contribute material as they see fit, with as minimal editorial interaction as possible. For transparency, I am cataloguing all changes I have made or requested to the originally-submitted text:

Formatted the text for consistency with other Stained Glass Woman articles.
Added sections.
Added a header image.
Added “fawn” to the fight/flight/freeze reflex, which appears several times in the article.
Links to a few sources were added, and links Joscelyn submitted herself were embedded.

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