Complex PTSD and the Realm of Dissociation


Louise often feels like part of her is “acting.” At the same time, “there is another part ‘inside’ that is not connecting with the me that is talking to you,” she says. When the depersonalization is at its most intense, she feels like she just doesn’t exist. These experiences leave her confused about who she really is, and quite often, she feels like an “actress” or simply, “a fake.” ~ Daphne Simeon (Feeling Unreal: Depersonalization Disorder and the Loss of the Self)

The majority of the clients I treat have been exposed as I was, to repeated traumatic episodes and threats during childhood. Our heinous histories of emotional, psychological and sexual abuse at the hands of trusted caregivers, led to suffering from complex PTSD.

C-PTSD is more complicated than simple PTSD as it pertains to chronic assaults on one’s personal integrity and sense of safety, as opposed to a single acute traumatic episode.

This chronic tyranny of abuse results in a constellation of symptoms, which impact personality structure and development.

The symptom clusters for C-PTSD are:

~ Alterations in Regulation of Affect and Impulses

~ Changes in Relationship with others

~ Somatic Symptoms

~ Changes in Meaning

~ Changes in the perception of Self

~ Changes in Attention and Consciousness

When one is repeatedly traumatized in early childhood, the development of a cohesive and coherent personality structure is hindered. Fragmentation of the personality occurs because the capacity to integrate what is happening to the self is insufficient.

The survival mechanism of dissociation kicks in to protect the central organizing ego from breaking from reality and disintegrating into psychosis.



Rev. Sheri Heller, LCSW, RSW
The Break Down Wake Up Journal

Therapist, Coach & Author. Complex Trauma & Addiction. Dual citizen. Survivor, World traveler, love art and nature. I appreciate the absurd.