Dating when you have Post-Traumatic Stress Disorder (PTSD) is already tricky, so dating with complex PTSD sounds even more challenging. Complex PTSD is, well, complex and most people haven’t even heard of the term before. It’s a newer term that has been acknowledged by the International Classification of Diseases 11^th Revision (ICD-11), but not yet by the Diagnostic and Statistical Manual of Mental Disorders 5^th Edition (DSM-V).

In this article, we discuss what complex PTSD is, how it affects relationships, and what to do if your partner has it.

What is Complex PTSD?

Complex PTSD is a mental health condition caused by recurring or chronic traumatic events. These events can include childhood abuse or neglect, domestic violence, sexual abuse, war, and human trafficking. This is contrary to PTSD, which is thought to occur after a singular traumatic event. Complex PTSD holds the same symptoms as PTSD but with additional symptoms as well.

Common PTSD symptoms are:

• Flashbacks or nightmares about the traumatic event.
• Hypervigilance or overly alert and startled.
• Avoiding people, places, or situations that remind them of the traumatic event.

Those with complex PTSD symptoms may also experience:

• Feelings of worthlessness, guilt, and/or shame.
• Trouble regulating emotions.
• Feeling disconnected from other people.

Complex PTSD is not just psychological, it’s physiological as well. Several brain imaging studies have shown that those with complex PTSD may have more severe neural impact than those with PTSD. Additionally, trauma can affect your hypothalamic-pituitary-adrenal (HPA) axis, which helps manage stress and your cortisol levels. Research suggests that the abnormal development of the HPA axis could lead to unstable cortisol levels and your autonomic nervous system which controls functions such as your heart rate, blood pressure, and breathing.

Complex PTSD is thought to typically occur during childhood, a crucial point of development for any person. But complex PTSD may also occur during adulthood, as repeated traumatic events can happen at any time of one’s life.

Dating with Complex PTSD

Complex PTSD usually results from being hurt by someone else, often someone close to those suffering from it. This deep sense of betrayal and loss of safety impacts not only one’s symptoms, but how one connects with others.

This can lead to many relationship problems for those with complex PTSD, such as:

• Distrust. Someone who has been abused by their caregiver or protector may not trust very easily as they were taught that those who are supposed to care for them will end up hurting them. Relationships need trust in order to be sustainable, so those with complex PTSD tend to have difficulties opening up to their partner.
• Emotional Disconnection. The emotions connected to trauma can be excruciating, so those with complex PTSD often avoid feeling any emotions at all. They never had a safe space to do so. It is common for them to shut down or dismiss vulnerable feelings, coming off as emotionally disconnected and distant.
• Unhealthy Relationship Cycle. A victim of domestic violence may associate love with abuse. A turbulent relationship may feel like home to those who grew up in unsafe environments. People naturally gravitate towards relationships that remind them of their first model of love, which typically comes from their parents. This includes not just how they treated each other but how they treated the individual as well. If one’s first lesson in love was that they should be treated poorly, they might subconsciously think that is what love is as they’ve never learned otherwise. It’s easy to find comfort in what’s familiar, even if what’s familiar is dangerous.
• Self-Isolation. Getting close to someone requires vulnerability and may threaten one’s sense of safety when they suffer from complex PTSD. Because of this, many will withdraw from or avoid relationships. This doesn’t mean they don’t want intimacy in their life; these reactions are a result of wanting to protect oneself.

It should be noted that how trauma manifests in each person depends on their trauma and may show up differently in each relationship. What may be true for one person may not be for others.

Complex PTSD Triggers in Relationships

Triggers are anything that bring a traumatized person back to how they felt when experiencing their trauma. They revolve around reminders of their lack of safety, as the body is constantly on alert to protect itself.

Some common triggers to look out for are:

• Fear and anxiety surrounding things related to their trauma.
• Panic attacks or emotional shutdowns during conflicts.
• Verbal and non-verbal communication styles.
• Tone and volume of voices.
• Certain phrases or words.
• Certain acts of intimacy or intimacy in general.
• Holidays or other distinct dates such as birthdays.
• Sensitivity to loud noises or other startling things.

It can be difficult to spot when your partner is feeling triggered without knowing the signs, and it can be confusing and frustrating to encounter when you are unaware. Learning about your partner’s specific triggers can give some clarity and guidance in what to do.

How to Deal with Trauma Triggers in a Relationship

Dating someone with complex PTSD can be difficult, but not impossible. Just like any relationship, it will take work and a willingness to understand them. Some suggestions on how you can deal with trauma triggers in a relationship together are:

• Don’t minimize. What seems like a small issue to you may be a big deal to them. When those with complex PTSD are triggered, they are typically not reacting to the present but rather their painful past. Validate their feelings and let them know that they are safe.
• Be patient. Trauma is nuanced and is difficult to navigate. Even when actively working through trauma, some may never completely overcome their symptoms. However, a fulfilling relationship and life are still possible even with symptoms of complex PTSD. Learning how to manage symptoms and unpack trauma is a process that requires sensitivity and patience.
• Be consistent. By being consistent in your actions and words, your partner may slowly be able to build trust with you. Inconsistency can cause anxiety in anyone. Show your partner that they can rely on you to stay a safe space.
• See it from the bigger picture. It can be hard not to take things personally, especially when the behaviors and reactions of your partner affect you. Take the time to understand your partner’s experiences and triggers, so that way the next time their symptoms flare up you can be compassionate rather than defensive.
• Take care of yourself too. Managing complex PTSD can be emotionally taxing, not only on your partner but on you too. Check in with yourself regularly and make sure your needs aren’t thrown to the wayside. You can’t effectively support someone if you’re struggling too.

Other Ways to Support a Partner with Complex PTSD

Another way to help support your partner is to help them get treatment for their complex PTSD. There are a few evidence-based, trauma-focused therapies that have been highly effective for treating PTSD. Eye movement desensitization & reprocessing therapy can help process trauma and reduce the intensity of your partner’s reactions to triggers. Cognitive processing therapy can help reduce and challenge the negative thoughts that often come with complex PTSD.

If you’d like to be more involved, you can also consider couple’s therapy. Cognitive-behavioral conjoint therapy is specially designed for couples where one partner has PTSD. This type of therapy aims to help decrease symptoms and improve overall relationship function.

If you or your loved one is experiencing complex PTSD or PTSD, the Los Angeles Outpatient Center can help you. Our programs are individualized, multi-disciplined, and evidence-based to ensure each individual can sustain long-term healing. Contact our admissions team today to learn more.