Therapist Pete Walker‘s 2013 book Complex PTSD: From Surviving to Thriving: A Guide and Map for Recovering from Childhood Trauma acknowledges that there’s PTSD—and then there’s Complex PTSD (C-PTSD). Although other clinicians have also worked on raising awareness of C-PTSD, Walker gets more personal than most—he’s both a provider of care and a survivor.

As Walker explains, repeated exposure to abuse and/or neglect is usually the distinguishing dynamic behind C-PTSD, whereas many cases of PTSD arise from single-incident trauma.

C-PTSD is not yet, however, considered as a separate diagnosis in the DSM-5.

An intro to the manifestations of Complex PTSD by Walker (from his website’s FAQ’s):

In my experience, many clients with Complex PTSD have been misdiagnosed with various anxiety and depressive disorders, as well as bipolar, narcissistic, codependent and borderline disorders. Further confusion arises in the case of ADHD (Attention Deficit Hyperactive Disorder), as well as obsessive/compulsive disorder, which is sometimes more accurately described  as an excessive, fixated flight response to trauma. This is also true of ADD (Attention Deficit Disorder) and some dissociative disorders which are similarly excessive, fixated freeze responses to trauma…

I believe that many substance and process addictions also begin as misguided, maladaptations to parental abuse and abandonment – early adaptations that are attempts to soothe and distract from the mental and emotional pain of complex PTSD.

According to Medical News Today, C-PTSD is a combination of the symptoms of PTSD and some or all of the following (and maybe more):

• A negative self-view
• Changes in beliefs and worldview
• Emotional regulation difficulties
• Relationship issues
• Detachment from the trauma
• Preoccupation with an abuser

Although Walker believes there are many paths to healing he provides on his site his own “top ten practices of [his] ongoing recovery.” Below is my shortened version with brief excerpts.

1. Milking Self-Kindness and Self-Protection out of Grieving: “Most of the silver linings that I discovered about my trauma appeared on the other side of grieving.”
2. Whittling Down the Critic: Self-hate is his “parents’ most poisonous legacy…Many tools eventually helped, especially grieving self-compassionate tears. But shrinking it was glacial until I shifted into angrily counter-attacking it whenever I caught it biting me.”
3. Flight-into-Light: “Like many survivors, my recovery process began unconsciously with a spiritual quest. I needed to find something profoundly good about life to counteract the soul crushing effects of my family.”
4. Bibliotherapy: As a child “[Books] ‘introduced’ me to compassionate adults who helped me with their wise and kind words. For decades I read my way into a better relationship with myself.”
5. Writing that Helped Me To Right Myself: “Journaling taught me to bear witness to myself – to validate that I was born innocent – unfairly deprived of a child’s birthright to be loved.”
6. Meditation: There’s No Boogeyman in My Inner Closet
7. Getting and Giving Individual & Group Therapy: As a client “(w)hat especially struck me was that all my helpful therapists reparented me to some degree.”
8. Self-Reparenting: Finding an Inner Mom and Dad: “[John] Bradshaw gave us many reparenting tools to meet the unmet needs of survivors of such abandonment.”
9. The Created Family: Healing the Loss of Tribe: “I experience my [self-created] current clan as concentric circles of intimacy.”
10. Gratitude: A Realistic Approach: “Gratitude is a thought-correction practice that gradually eroded the negative noticing of my toxic critic. Now, I refuse to let all-or-none thinking throw out the baby of daily niceties with the bathwater of normal disappointments.”