Impact of Complex Post-Traumatic Stress Disorder on Romantic Relationships: Symptoms, Causes, and Precautions
Complex post-traumatic stress disorder (CPTSD) can present significant challenges in romantic relationships. This condition, officially recognised in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR) and the Internation Classification of Diseases, 11th Revision (ICD-11) by the World Health Organization (WHO), affects individuals who have experienced prolonged, repeated, or severe trauma[1][2].
CPTSD can lead to a variety of symptoms that impact relationships, such as emotional withdrawal, hypervigilance, mood swings, emotional numbness, and fear of vulnerability[3][5]. These symptoms can create barriers to closeness, leading to misunderstandings or feelings of rejection in partners.
Key areas where CPTSD may impact relationships include trust issues, emotional walls, emotional dysregulation, avoidance and detachment, and flashbacks and anxiety[4]. Trauma survivors often struggle to trust partners due to past betrayal or harm, leading to suspicion or insecurity even without cause[5]. To protect themselves, survivors may build emotional barriers, which can feel like distance or detachment to their partners[5]. Intense mood swings, anger, anxiety, or numbness disrupt connection and complicate communication[1][4]. Survivors may avoid emotional closeness to reduce perceived danger, resulting in withdrawal or disconnect in intimacy[3]. Intrusive memories or triggers can cause sudden distress during interactions, making stable relationship dynamics difficult[1][5].
Managing these challenges involves a combination of strategies that promote healing, safety, and connection. Trauma-informed therapy, such as trauma-focused cognitive behavioral therapy (TF-CBT) or EMDR, can help process trauma and improve emotional regulation and trust[4]. Building trust gradually by creating a transparent, consistent, and supportive relationship environment fosters safety and reduces suspicion over time[5]. Partners can help survivors dismantle emotional walls through nonjudgmental support and encouragement to express feelings safely[5]. Education and empathy about CPTSD help normalise symptoms and reduce misinterpretation of behaviours[3]. Developing emotional skills through therapy and practice can enhance emotional recognition, regulation, and communication to improve intimacy and reduce conflict[4]. Shared compassion and courage can deepen connection despite challenges, as both partners accept that intimacy may look different and evolve through recovery[3].
Individuals with CPTSD may have a higher risk of developing the condition if they experienced trauma at a young age, harm by someone they were close to or trusted, or a lack of opportunity to escape the trauma[6]. Scheduling time to relax and enjoy others is a helpful behaviour in relationships for individuals with CPTSD. The time of day, season, or holiday can also potentially serve as triggers for individuals with CPTSD, so learning about triggers is an important part of self-care[7]. Self-care tips for individuals with CPTSD include eating a healthy and balanced diet, getting regular exercise, spending time outdoors, and avoiding the use of illegal drugs and excessive alcohol intake[8].
Relational trauma, such as child abuse or neglect, domestic violence, sex trafficking, torture, slavery, and war, can be a major cause of CPTSD[9]. Some research suggests that people with CPTSD may experience symptoms typically associated with borderline personality disorder (BPD), including difficulties with regulating emotions around others, sharing emotional and physical intimacy, feeling close to others, and trusting others[10]. The anniversary of the traumatic event can be a potential trigger for individuals with CPTSD, as can obvious or subtle triggers, such as sights, sounds, smells, locations, temperatures, feelings, and specific instances[11].
In conclusion, CPTSD complicates romantic relationships primarily via trust difficulties, emotional withdrawal, and trauma triggers, but targeted therapy and relationship efforts can foster healing and stronger emotional bonds over time[1][3][4][5]. By understanding the impact of CPTSD on relationships and implementing strategies to manage challenges, individuals with CPTSD can build and maintain healthy, supportive relationships.
References: 1. Bryant, R. A., & Yule, W. (2011). The Psychology of Trauma: Theory, Research, Practice, and Policy. Guilford Press. 2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Text Revision. Arlington, VA: American Psychiatric Publishing. 3. Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror. Basic Books. 4. Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking. 5. Courtois, C. A., & Ford, J. D. (2015). Treating Complex Trauma: A Sequenced, Relationship-Based Approach. Guilford Press. 6. National Institute of Mental Health. (2021). Complex Post-Traumatic Stress Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/complex-post-traumatic-stress-disorder-ptsd/index.shtml 7. National Center for PTSD. (2021). Self-Care for PTSD. Retrieved from https://www.ptsd.va.gov/professional/pages/self-care-for-ptsd.asp 8. National Alliance on Mental Illness. (2021). Complex PTSD. Retrieved from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Complex-PTSD 9. National Child Traumatic Stress Network. (2021). Complex Trauma. Retrieved from https://www.nctsn.org/trauma-types/complex-trauma 10. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder: A dialectical approach. Guilford Press. 11. National Center for PTSD. (2021). Triggers. Retrieved from https://www.ptsd.va.gov/professional/pages/triggers.asp
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