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The Difficult Road to Intimacy: Living with Complex Post-Traumatic Stress Disorder

Those of us living with dissociative identity disorder most certainly live under the thumb of complex post-traumatic disorder. This piece is about learning to have a relationship despite having a traumatic past.

Living with complex post-traumatic stress disorder (CPTSD) is very challenging. If affects every aspect of the lives those who suffer under its symptoms. In this article, we are going to examine together with a brief synopsis of CPTSD and how this disorder creates difficulty in forming and maintaining intimate relationships.

An Overview of Complex Post-Traumatic Stress Disorder


CPTSD isn’t yet in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the Bible used by psychiatrists and psychologists to diagnose mental health issues. Instead, it is part of a category called Trauma and Stress-Related Disorders under post-traumatic stress disorder (PTSD).

The problem is that while PTSD generally involves a single traumatic event, complex post-traumatic stress disorder involves exposure to repeated traumatic events. One argument is the reason for the exclusion of CPTSD from the DSM-5 is that while PTSD affects 7-8% of adults, CPTSD occurs in .05% of adults.

The symptoms of complex post-traumatic stress disorder are broader than those of PTSD. In the following sections, we’ll examine these deeper problems and how they affect a survivor’s ability to form and maintain healthy intimate relationships.

Trust Issues


One of the most profound and perhaps the beginning of all the other issues I’ll mention below involves problems trusting others.

Since many who live with complex traumatic-stress disorder in their lives formed the condition as the result of enduring ongoing trauma while young, it isn’t hard to see why trust issues are a problem.

The trauma normally involved some type of abuse and betrayal by the very people who were supposed to care for and nurture survivors when they were children. This repeated behavior by caregivers trains the brains of children to cope with the inevitability of more trauma making these kids as adults hardwired to be fearful of intimacy and not to trust.


Flashbacks are not simply remembering a traumatic event a survivor finds themselves thrust back in time and is reliving it as though it were occurring today.

There are three types of flashbacks, visual, somatic, and emotional and while all three are harmful to the formation of relationships emotional flashbacks are more so.

When survivors experience emotional flashbacks, they are irrational and will often strike out at the innocent people in their current lives. Normally, people who have these flashbacks do not understand where the emotional outburst comes from and it takes a long time to make amends to those they harm.

Painful Loneliness


Survivors who live with CPTSD feel disconnected from humanity and themselves. In fact, survivors often describe how they feel they are here on earth by mistake and that they do not belong anywhere. Survivors remain in an intense state of loneliness even when standing in a crowded room because of the disconnection and lack of trust they feel to and from other people.

The lack of trust survivors feel causes them to either consciously or subconsciously push anyone who wants to get close away and is compounding by internal beliefs of survivors that they are damaged goods, broken and unlovable.


Survivors of complex trauma have a deep subconscious need to watch for any clues that someone is going to harm them. This results in survivors constantly scanning their environment for signs and sounds tell their brains to prepare to flee.

The signs might include non-verbal movements, body language, and tone of voice of another person or sounds in the room or even outside that remind them of a previous traumatic event.

Hypervigilance is exhausting and makes a survivor choose to be alone rather than to be in a group where they can socialize and form relationships.

Body Image Difficulties


Due to the trauma perpetrated by caregivers in childhood, many people living with complex traumatic-stress disorder have deep-seated body image problems.

Too often, people who have CPTSD see their bodies as ugly, fat, and undesirable. These difficulties with self-image can lead to not only the formation of eating disorders but also making the survivor fearful of allowing others to see them unclothed.

It is easy to see how this internal terror can lead to the survivor choosing not to get involved in an intimate partner relationship.

Searching for a Rescuer

Survivors often have one of two different reactions when it comes to relationships. They will either search incessantly for someone to rescue them, or they will avoid relationships altogether.

Those who search for someone to rescue them feel helpless and believe they need someone to save them from the pain of their past. They believe if they get involved with the right person they can feel complete and rely on them for comfort and support.

Sadly, this thought process often leads to survivors choosing the wrong partner because humans tend to look for romantic relationships that mimic our childhoods. These unfortunate people ignore behaviors that others would see as clear warning signs. Instead, they look past any flaws because they feel deep desperation to experience love and validation.

This lack of discernment of others can lead to the perpetration of exploitation and intimate violence.

Choosing Not to Form Any Intimate Relationships


Survivors living with complex post-traumatic stress disorder have the same desires and needs for intimacy, sex, and attachment as anyone else. The difference is that they may choose to avoid forming intimate partner relationships.

It is vital to understand that in childhood these adults experienced betrayal of trust but often the sexual violation of their bodies.

Due to the betrayal of their trust in childhood, often when these survivors do find themselves in a romantic relationship they confound their partners by allowing them to draw close but then quickly withdrawing.

Then, due to the sexual violation in childhood, sex is a huge issue for some forcing survivors to act like they are enjoying sex with their partner. This pretense can result in them feeling dirty, used, and full of revulsion.

It is easy to see that in either scenario there will be big problems with anyone who attempts to form a loving and long-term relationship with survivors leading to broken hearts and break-ups.

Because of the pain survivors inflict on others and themselves, many choose to live in terror of forming intimate relationships and avoiding them totally.

The Problem of Shame in the Forming of Intimate Relationships


Shame is a fundamental emotion that shapes our lives from the time we are born until our death. When used in a positive manner, shame can help children learn to control their emotions and treat others with respect and dignity.

However, shame used as a weapon to control and harm children the effects of that treatment are lifelong and cause great difficulties later in life in the formation of healthy intimate relationships.

A paper published in 2010 in the Journal of Traumatic Stress1 titled The Impact of Dissociation, Shame, and Guilt on Interpersonal Relationships in Chronically Traumatized Individuals: A Pilot Study offers some insights into how shame shapes our relationship formation later in life.

The researchers found that the accumulation of shame throughout a person’s lifetime is a predictor of intimate relationship difficulties. Not only this but when coupled with severe dissociative symptoms, survivors can feel an intense sense of disconnectedness to other people.

With such internal conflicts happening inside the minds of survivors of complex trauma, it is almost impossible to form and maintain intimate relationships.

Do Not Lose Hope


Reading this article might have caused some readers to feel there is no hope of them forming lasting, loving, and fulfilling relationships due to having lived through complex trauma.

That is not the purpose of this piece. It’s the purpose of this article and those that follow are to help survivors be less of an enigma to themselves by explaining some of the most troubling problems with complex trauma and relationships.

In the articles that follow, we will examine together the effects complex trauma has on the brains of survivors and ways to help yourself conquer over your symptoms.

Whatever you do, do not lose hope.


1 Dorahy, M. J. (2010). The impact of dissociation, shame, and guilt on interpersonal relationships in chronically traumatized individuals: A pilot study. Journal of Traumatic Stress, 23(5), 653-656.

Survival can be summed up in three words – never give up. That’s the heart of it really. Just keep trying. ~ Bear Grylls























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