People with complex PTSD can experience difficulties with emotional regulation, which can cause problems forming relationships. Potential triggers in relationships can include certain sights, sounds, or smells.

Complex post-traumatic stress disorder (CPTSD) can occur when an individual has experienced prolonged or reoccurring trauma. It involves many symptoms of enhanced PTSD, such as flashbacks, numbness or blunt emotions, responses to environmental triggers, and detachment.

However, CPTSD also involves additional symptoms, such as emotional dysregulation, disrupted self beliefs, and difficulties forming and maintaining meaningful relationships.

This article explains why and how CPTSD may affect relationships. It also discusses ways to manage relationship issues that may occur with CPTSD and how to help a loved one with the condition.

Trigger warning

This feature mentions experiences of trauma and sexual abuse. Please read at your own discretion.

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CPTSD is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR).

However, the World Health Organization (WHO) recently included it as a new diagnosis in the Internation Classification of Diseases, 11th Revision (ICD-11).

Effects

According to research, CPTSD can affect a person’s life in many ways. It can lead a person to experience:

In some cases, these and other symptoms a person may experience, such as flashbacks and feelings of shame, can lead to social withdrawal.

Relational trauma

Relational trauma can be a major cause of CPTSD. Examples of long-term trauma that can lead to CPTSD include:

An individual may have a higher risk of developing CPTSD if they experienced:

  • trauma at a young age
  • harm by someone they were close to or trusted
  • a lack of opportunity to escape the trauma

Potential relationship challenges

Some research suggests people with CPTSD may experience symptoms typically associated with borderline personality disorder (BPD).

Examples include difficulties with:

  • regulating emotions around other people
  • sharing emotional and physical intimacy with others
  • feeling close to other people
  • trusting others

All of these can potentially cause difficulties in relationships. For instance, a person with CPTSD may find it hard to trust their partner because of an underlying belief that people are generally untrustworthy. Offhand remarks may also activate a strong emotional response in an individual with CPTSD.

Any of these experiences may make forming or maintaining relationships more challenging for someone with CPTSD. In some cases, they may lead a person to withdraw from a partner or others they are close to, such as family members.

A trigger is anything that sets off a memory of a person’s trauma.

Some things that can activate CPTSD might be obvious. However, others may be more subtle and take a person off guard.

Triggers are different for everyone and may include:

  • sights
  • sounds
  • smells
  • locations
  • temperatures
  • feelings

Triggers may also be associated with specific instances, such as:

  • an anniversary of the event
  • the time of day
  • the season
  • a holiday

Knowing what activates their CPTSD may help a person avoid triggers if necessary or learn ways to manage their symptoms in the presence of a trigger.

Maintaining relationships can be challenging for anyone. However, despite additional challenges they may experience, people living with CPTSD can still nurture and maintain positive relationships.

Behaviors that may help in any relationship include:

  • sharing feelings openly and honestly with respect and compassion
  • building problem-solving skills and ways to connect with others
  • building a personal support network
  • scheduling time to relax and enjoy others

Self-care is also an important part of living with CPTSD and nurturing relationships. Self-care tips an individual can try include:

  • learning about triggers
  • confiding in a trusted person, where possible
  • understanding that everyone responds to trauma differently and heals at their own pace
  • looking after physical health in the following ways:
    • eating a healthy and balanced diet
    • getting regular exercise
    • spending time outdoors
    • avoiding the use of illegal drugs and excessive alcohol intake

Ways to help and support a loved one with CPTSD include:

  • learning about their triggers
  • listening to them and allowing them time to talk at their own pace without assumptions or judgment
  • planning for times that may be difficult, such as by working together on a crisis plan and learning effective ways to deal with triggers
  • respecting their personal space and trying not to startle them
  • looking for signs of changes in mood and behavior and ensuring they know they can open up if they want to
  • helping them find additional support if needed
  • remembering to take time for self-care

Treatment for CPTSD often involves psychotherapy. However, not everyone responds to treatment in the same way. Different types of psychotherapy may be more effective for some than others.

Types of psychotherapy mental health professionals commonly use to treat CPTSD include:

If an individual believes they are experiencing CPTSD, it is best for them to contact a mental health professional.

The following are answers to some questions people commonly ask about complex PTSD and relationships.

How does PTSD affect romantic relationships?

The symptoms people with PTSD may experience can lead to issues with trust, closeness, problem-solving, and communication. These can all affect how an individual feels and behaves around others.

Can someone with complex PTSD have a healthy relationship?

With support, understanding, and effective treatment, if needed, a person with CPTSD can enjoy healthy relationships.

Complex PTSD can occur after a person experiences prolonged trauma. This can include childhood abuse or neglect, sexual abuse, and domestic violence.

A person with CPTSD typically experiences symptoms of PTSD, such as flashbacks and responses to environmental triggers, as well as symptoms similar to those of BPD, such as emotional dysregulation and disrupted beliefs about themselves.

These symptoms can create challenges in forming and maintaining meaningful relationships. They can lead a person to find it difficult to trust others and potentially withdraw from those around them.

With support, the use of self-care techniques, and treatment such as psychotherapy if needed, an individual with CPTSD can maintain healthy relationships.