Complex post-traumatic stress disorder (C-PTSD)
Living with C-PTSD (sometimes called personality disorder) can be challenging. Having a baby makes things a bit more difficult. That's why it is important for you to get help.
What you need to know
- What are these disorders?
It has been known for a long time that various forms of trauma, abuse, neglect or severe ongoing stress in childhood (such as bullying at school) leads to people developing patterns of emotions, thinking and behaviour which can make their lives very difficult and unhappy. For example:
If other people do bad things to you as a child you may learn that you cannot be in control of what happened to you and you stop planning ahead, making decisions for yourself and you do not learn to solve problems you face in life. This makes live very difficult and makes more bad things happen. It can also mean it is hard to focus on and achieve long-term goals.
When children are trapped in stressful or traumatic situations and cannot get away from them, their brain learns to escape mentally by switching off or "dissociating". Another way of mentally escaping is to go into a fantasy world in various ways, making up a different reality or imagining things that only you can see or hear.
If you have had bad experiences or been badly treated as a child you may learn not to trust other people. You may build up barriers around yourself and do not let people get too close. This makes it difficult to have good relationships.
If you learnt as a child that suddenly very bad things can happen to you, it teaches you to be on the lookout for danger, always on edge or anxious and very jumpy.
This makes you react very strongly to everyday problems. Normal life is full of little problems so these strong reactions can make your emotions, your thinking and what you do very changeable and extreme. It is like having a very thin emotional skin.
Because this extreme distress is very painful it can lead people to look for anything that will make the feelings go away, for example taking drugs, drinking alcohol, causing physical pain to drown the mental pain (often by cutting), or by just shutting off mentally (we call this "dissociation"). This means it can be hard to feel good about yourself or have a secure sense of self-identity.
Out of the Storm is a very helpful website to look at if you want to understand C-PTSD further.
- Is this just the way I am and cannot be changed?
People who have these difficulties and often the people around them, including professionals may think that this is just they way they are and they cannot be changed. This is not true. An important first step is for you to recognise what this problem is because it is often misunderstood and therefore the wrong treatment is given. Recognising the problem is often difficult because people with this are much more vulnerable to other difficulties such as depression and because these symptoms are very like the symptoms of anxiety and depression. This means that people have often had lots of different diagnoses and sometimes have found that the treatments they have had have not helped, or have only helped a bit.
In order to recognise these patterns and to change them, it is useful to give them a name but many different names have been used, which is confusing.
- Why so many different names for this problems?
In the past, and still quite commonly now, the term "Borderline Personality Disorder" is used. This name originally developed because people thought this problem was "borderline psychotic" because of the voice that sufferers commonly describe. After this the term "Emotionally Unstable Personality Disorder" started to be used more commonly. This better describes the very unstable emotions but says nothing about where the problem comes from. Most recently, researchers have come to understand how these patterns come from abuse, stress or trauma in childhood and how similar the patterns are to people who suffer trauma in adulthood, for example, soldiers in war situations. The pattern of problems they get, which is very similar, is called Post Traumatic Stress Disorder (PTSD). So we now call these problems "Complex PTSD".
- What treatments are available?
The major difficulties in life and the distress that C-PTSD causes can be reduced by addressing the rapid and extreme changes in thinking and behaviour and replacing these with more regular steady routines, thinking ahead and predicting difficulties and more helpful ways of dealing with thoughts and situations. The first step in learning to change this is getting good at recognising the unhelpful patterns. After that, there are techniques you can learn that will help change these patterns. Some of these techniques are called Emotional Coping Skills . These are best learnt in a group situation with other people who have the same difficulties and are learning the same techniques. This is often very difficult for people with C-PTSD and, to start with, you may need to work with an individual professional to help you get ready for learning in a group. A more intense therapy which teaches the same emotional coping skills is called Dialectic Behaviour Therapy (DBT). This is also done individually and/or in a group. It can be extremely effective in helping people achieve major change and improvement in the quality of their lives. This sort of therapy is usually only available from specialist mental health services.
- Why is it important to recognise C - PTSD and treat it?
C-PTSD causes a lot of disability and suffering, not just for people who suffer from it but for other people around them. This makes it very important to recognise this problem and to work hard at trying to overcome to associated difficulties. The sooner this is done, the less likely it is to cause damage to somebody's life and it is probably easier to deal with it, but whenever you start trying to deal with it, it is likely to be difficult. Even so, it is definitely worth it as it can make life so much better.
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When should you worry?
Newborn
NEWBORN
Contact your health visitor or GP if your baby is newborn and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Don’t have a Grasp Reflex (doesn’t grab your finger or small object when you put it in their hand)
- Are often startling and you cannot understand why
- Move one side of their body more than the other, for example:
- Rarely moves one of their arms compared to the other arm
- Rarely moves one leg compared to the other leg
- When your baby startles, one side moves or looks different from the other
6-8 weeks
6-8 WEEKS
Contact your health visitor or GP if your baby is 6-8 weeks and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
2-3 months
2-3 MONTHS
Contact your health visitor or GP if your baby is 2-3 months and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
3-4 months
3-4 MONTHS
Contact your health visitor or GP if your baby is 3-4 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when awake
- Prefer to keep their arms by their sides. For example, they do not reach for things, or do not bring their hands together over their face or tummy
- Move their arms or legs in repetitive, jerky, or strange ways
- Still need you to support their head, or can’t lift their head when lying on their tummy
- Have very tight fists and it’s hard to open their hand
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
4-6 months
4-6 MONTHS
Contact your health visitor or GP if your baby is 4-6 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
- Are unable to roll, or can roll in one direction but not the other
- Find it difficult to reach their arms out. For example, they do not reach for toys
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back. For example, they do not bring their feet to their chest
- Still need you to support their head
6-9 months
6-9 MONTHS
Contact your health visitor or GP if your baby is 6-9 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys, or eat and drink
- Rarely kick one leg compared to the other
- Can’t sit without support. For example, they lean on their hand, or, when they sit, their back is very curved
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back, for example, do not bring their feet to their chest
- Still need you to support their head
- Still need you to help turn their head when lying on their back
- Can’t crawl, or find it hard, for example, drags one of their legs behind them
- Find it difficult to stand, for example:
- Can’t stand with support
- Doesn’t try to pull themselves up to stand
- Can’t move a toy from one hand to the other
- Doesn’t use both hands to hold larger things
9-12 months
9-12 MONTHS
Contact your health visitor or GP if your baby is 9-12 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms and legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink.
- Rarely kick one leg compared to the other
- Find it difficult to sit, for example:
- Only sit with support
- Lean on their hand when sitting
- When they sit their back is very curved
- Can’t move a toy from one hand to the other
- Don’t use both hands to hold larger things
- Don’t point to objects
- Can’t crawl, or find it hard, for example, drags one leg behind them
- Find it difficult to stand, for example:
- Can’t pull themselves up to stand
- Find it hard to pull themselves up. For example, they only use their arms and don’t push with their legs
- Can’t stand with support
2 months
Your Baby By Two Months
Social/Emotional Milestones
- Calms down when spoken to or picked up
- Looks at your face
- Seems happy to see you when you walk up to her
- Smiles when you talk to or smile at her
Language/Communication Milestones
- Makes sounds other than crying
- Reacts to loud sounds
Cognitive Milestones (learning, thinking, problem-solving)
- Watches you as you move
- Looks at a toy for several seconds
Movement/Physical Development Milestones
- Holds head up when on tummy
- Moves both arms and both legs
- Opens hands briefly
4 months
Your Baby By Four Months
Social/Emotional Milestones
- Smiles on his own to get your attention
- Chuckles (not yet a full laugh) when you try to make him laugh
- Looks at you, moves, or makes sounds to get or keep your attention
Language/Communication Milestones
- Makes sounds like “oooo”, “aahh” (cooing)
- Makes sounds back when you talk to him
- Turns head towards the sound of your voice
Cognitive Milestones (learning, thinking, problem-solving
- If hungry, opens mouth when he sees breast or bottle
- Looks at her hands with interest
Movement/Physical Development Milestones
- Holds head steady without support when you are holding him
- Holds a toy when you put it in his hand
- Uses his arm to swing at toys
- Brings hands to mouth
- Pushes up onto elbows/forearms when on tummy
6 months
Your Baby By Six Months
Social/Emotional Milestones
- Knows familiar people
- Likes to look at self in a mirror
- Laughs
Language/Communication Milestones
- Takes turns making sounds with you
- Blows “raspberries” (sticks tongue out and blows)
- Makes squealing noises
Cognitive Milestones (learning, thinking, problem-solving)
- Puts things in her mouth to explore them
- Reaches to grab a toy she wants
- Closes lips to show she doesn’t want more food
Movement/Physical Development Milestones
- Rolls from tummy to back
- Pushes up with straight arms when on tummy
- Leans on hands to support herself when sitting
9 months
Your Baby By Nine Months
Social/Emotional Milestones
- Is shy, clingy, or fearful around strangers
- Shows several facial expressions, like happy, sad, angry, and surprised
- Looks when you call her name
- Reacts when you leave (looks, reaches for you, or cries)
- Smiles or laughs when you play peek-a-boo
Language/Communication Milestones
- Makes a lot of different sounds like “mamamama” and “bababababa”
- Lifts arms up to be picked up
Cognitive Milestones (learning, thinking, problem-solving)
- Looks for objects when dropped out of sight (like his spoon or toy)
- Bangs two things together
Movement/Physical Development Milestones
- Gets to a sitting position by herself
- Moves things from one hand to her other hand
- Uses fingers to “rake” food towards himself
- Sits without support
1 year
Your Baby By One Year
Social/Emotional Milestones
- Plays games with you, like pat-a-cake
Language/Communication Milestones
- Waves “bye-bye”
- Calls a parent “mama” or “dada” or another special name
- Understands “no” (pauses briefly or stops when you say it)
Cognitive Milestones (learning, thinking, problem-solving)
- Puts something in a container, like a block in a cup
- Looks for things he sees you hide, like a toy under a blanket
Movement/Physical Development Milestones
- Pulls up to stand
- Walks, holding on to furniture
- Drinks from a cup without a lid, as you hold it
- Picks things up between thumb and pointer finger, like small bits of food
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