Why Complex PTSD Sufferers May Avoid Eye Contact


Above image licenced by Shutterstock


Steuwe et al. (2014) was conducted to cast light upon why many with individuals suffering from posttraumatic stress disorder (PTSD), including those suffering from complex-PTSD, often find it excruciatingly uncomfortable every time the rules of social etiquette compel them to make eye to eye contact with another human being (I, myself once attempted to circumvent this problem by deliberately buying a pair of glasses with lenses that were by far the wrong strength for me so that, whilst, to whomever it was I was required, as the law of social norms decrees, to make eye contact, I appeared to be doing so in the conventionally stipulated manner,  in fact, all that my eyes were actually meeting with was a comfortingly, non-threatening, benign blur).

Returning to Steuwe et al’s study et al.’s experiment :

The experiment consisted of two groups :

1) Survivors of chronic trauma

2) ‘Normal’ controls

What Did The Experiment Involve?

Participants from both of the above groups were subjected to brain scans whilst a making eye to eye contact with a video character in such a way as to mimic real-life, face to face contact.

What Were The Results Of The Experiment?

In the case of the ‘normal’ controls (i.e. those who had NOT suffered significant trauma), the simulated eye to eye contact with the video character caused the are of the brain known as the PREFRONTAL CORTEX to become ACTIVATED.


In the case of the chronic trauma survivors, the same simulated eye contact with the video character did NOT cause activation of the PREFRONTAL CORTEX. Instead, the scans revealed that, in response to the simulated eye contact, the part of the chronic trauma survivors’ brains that WAS ACTIVATED was a very primitive part (located deep inside the emotional brain) known as the PERIAQUEDUCTAL GRAY.


The prefrontal cortex helps us judge and assess a person when we make eye contact, so we can determine whether their intentions seem good or ill.

However, the periaqueductal grey region is associated with SELF-PROTECTIVE RESPONSES such as hypervigilance, submission and cowering.

Therefore, we can infer that those with PTSD / complex PTSD may find it hard to make eye contact because their brains have been adversely affected, as a result of their traumatic experiences, in such a way that, when they make eye contact with another person, the ‘appraisal’ stage of the interaction (normally carried out by the prefrontal cortex) is missed out and, instead, their brains, due to activation of the periaqueductal region, cause an intensely fearful response.

This constitutes yet another example of how severe and protracted childhood trauma can damage the physical development of the brain.


Whilst some studies have suggested that people who avoid eye contact are less sincere  (Izuka et al., 1992) and less conscientious (Izuka et al., 1992) than those who make appropriate eye contact (although recent research conducted at Edith Cowan University suggests that in order to be conversationally effective it is not necessary to look one’s interlocutor directly in the eyes because simply gazing somewhere around their face or head does just as well.

But what about too much eye contact? According to Robert Hare, making intense, protracted eye contact is interpreted by some as a feature of psychopathy.



Overcome Fear of Eye Contact | Self Hypnosis Downloads


Iizuka, Y. (1992). Evaluation of gaze pairs by female observers. Japanese Journal of Experimental Social Psychology, 31(3), 231–239. https://doi.org/10.2130/jjesp.31.231
Randy J.Larsen et al., Gaze Personality and social judgments of people who avoid direct face-to-face contact. Person et al. Personality and Individual Differences. Volume 21, Issue 6, December 1996, Pages 90
Steuwe, C (2014) Effect of direct eye contact in PTSD related to interpersonal trauma: an fMRI study of activation of an innate alarm system. Social Cognition Affect Neuroscience. 2014 Jan; 9(1): 88–97.7-917



David Hosier BSc Hons; MSc; PGDE(FAHE).