The researchers Ford and Courtois (2017) have identified eleven characteristics of the very serious condition complex PTSD which can develop as a result of severe, protracted, interpersonal childhood trauma that builds on earlier work by Ford that identified ‘the five ‘I’s’ of complex PTSD by adding six others. These are as follows:

Intentional:

Complex PTSD is particularly likely to occur as a result of INTENTIONAL ACTS such as a parent being deliberately psychologically abusive over a long period in order to exert control.

Interpersonal:

Complex PTSD is particularly likely to develop if the person who betrays and traumatizes us is a parent or primary carer upon whom we depend emotionally and physically

Inescapable:

Complex PTSD is more likely to occur if the traumatizing environment is inescapable (e.g. other than ‘running away’ which is unsustainable and potentially extremely dangerous a young child is not able to escape an abusive home unless social services intervene) which, amongst many other problems, can lead to ‘learned helplessness.‘).

Injury-causing:

This can include psychological wounds, emotional wounds, physical wounds (as in the case of physical abuse), and physical damage to the developing brain as a result of prolonged exposure to toxic stress.

Irreparable (potentially):

Injuries such as those referred to above can be irreparable or only partially repairable.

Intimate, Intrusive, and Invasive:

Acts of abuse and, maltreatment leading to complex PTSD are intrinsically intimate as they trample on an individual’s personal boundaries. Such acts that cross personal boundaries are also, by definition, intrusive and invasive. Additionally, complex PTSD often involves intrusive thoughts and intrusive memories.

Imminent Threat:

Complex PTSD is also particularly likely to occur if, as children, we lived in an environment in which we were constantly on the alert for danger (e.g. because one of our parents was an unpredictable, violent, abusive alcoholic). Living under such conditions can lead to us, as adults, feeling constantly hypervigilant (perhaps in part due to the adverse effects of living in a constantly fearful; state on the development of the brain region known as the amygdala) even years or decades after such abuse has ceased thus condemning us, in the absence of effective therapy, to live our whole lives as if we are in imminent danger even when, objectively speaking, we are relatively safe.

Identity deformation:

Complex PTSD can involve feelings of a weakened sense of identity and of ‘not really knowing who we are.’

Integration of Identity difficulties:

Complex PTSD may make us feel fragmented and as if our ‘self’ is separated into independent parts rather than a cohesive, whole, well-integrated entity.

Integrity maintenance problems:

The violation of personal boundaries which frequently precedes complex PTSD can lead us to develop an intense feeling that damage has been done to our sense of spiritual, emotional, and/or physical integrity.

Interpersonal relationship damage:

Not only does complex PTSD usually develop as a result of abuse and maltreatment within interpersonal relationships, but can lead to the victim experiencing lifelong problems with interpersonal relationships in general (e.g. due to an inability to trust others).

intimacy:

The intimate nature of the abuse or maltreatment that can give rise to complex PTSD makes it particularly emotionally, psychologically, and spiritually damaging.

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