by Charlotte Goff
CN: complex PTSD, suicidal thoughts, misdiagnosis, hypervigilance,
paranoia, abuse (emotional and physical), violence
I didn’t know that complex PTSD existed until I came across it in Judith Herman’s Trauma and Recovery and realised that I had it.
I had been searching for a diagnosis that fit my symptoms, and alongside my clinical psychologist had discounted depression. I had had depression at university, and this was different. The suicidal thoughts and self-loathing were the same, but the physical symptoms were missing: there was no dramatic weight loss or gain, I could sleep, and I could get out of bed in the morning. So despite one psychiatrist announcing, after a single appointment, that I ‘quite clearly’ had major depression, I kept looking for a diagnosis that fit.
I was looking for a diagnosis which would explain the suicidal thoughts, but would also account for other symptoms not typical of depression. One of these was hypervigilance.
Home alone, the smallest noises would send me into panic. I had a constant sense that I needed to be alert, and this hypervigilance started to morph into paranoia. I believed that I was being stalked, and that someone was trying to kill me.
Towards the end of university I started sleeping with a chair pressed against my locked door; a year later, and living in Tokyo, I refused to have my name on the post-box outside our flat, as is normal in Japan. I became obsessed with the idea that an old friend would come to Japan, learn the Japanese alphabet, and wander around neighbourhoods until he found a sign with my name on it, at which point he would break in and murder me. I thought often about how ‘easy’ this would be. I thought that nowhere in the world was safe.
“I believed that I was being stalked, and that someone was trying to kill me”
It got harder when I lived alone for a while. Living alone was something that I had wanted to do, to prove to myself that I could be independent. After having grown up with abusive stepfathers, I wanted to prove that I would never be trapped again. But it terrified me, and doing anything in the house took twice the time it should; every few seconds I would need to look over my shoulder, in case someone had crept in to slit my throat.
I kept the slats of the bathroom window shut because I imagined someone in the shadows, holding a gun, and though I had an electric toothbrush I used it as a manual, convinced that the buzzing of the brush would drown out the sound of someone breaking in. In Japan it is normal to have a ‘genkan’, or small space by the door to keep your shoes. Sometimes, when the fear took over, I would sit in the genkan, eyes trained on the door. It was easier for me to feel safe in this small space than in a room where there were windows and cupboards and other places that I needed to keep watching.
“Doing anything in the house took twice the time it should; every few seconds I would need to look over my shoulder”
Night time was the hardest. I slept in the loft, and each night I would pull the heavy ladder up after me like a drawbridge so that I could fall asleep. And each night, I would beat myself up for needing to do this. I tried to work out whether someone could jump the distance into the loft, and started thinking about bringing the kitchen knife up to sleep next to.
My psychologist suggested, once, that I was scared of the dark. For a while I was relieved- a fear of the dark seemed like something manageable, that we could work with. But these thoughts, though they intensified at night, did not belong to it. I remember going for coffee with a friend and having to divide my concentration three ways, between keeping up the conversation, and looking at her bag, which I thought she might have put a gun in, and then to looking at the window, in case she had asked someone else to shoot me through the glass.
If anything, I think the increased intensity of this paranoia at night time had simply to do with a lack of energy. I was depleted, and had less energy to fight off the thoughts that I could bat away more easily most mornings.
“The only person who I admitted it to was my boyfriend, and when he looked concerned not about my imminent assassination, but about the state of my mind, I felt disappointed: he just didn’t understand”
I knew, even at the time, that these thoughts sounded ‘crazy’, and so didn’t talk to people about them. The only person who I admitted it to was my boyfriend, and when he looked concerned not about my imminent assassination, but about the state of my mind, I felt disappointed: he just didn’t understand. Because to me, for a long time, it didn’t seem to be related to my mental health at all. The way I saw it then, being stalked and hunted was just my situation, and nothing to do with my mind. But as time went on and the number of people who I thought wanted to kill me rose, I started to think that it was at least worth mentioning to my therapist.
Hypervigilance makes a lot of sense when you think about it in the context of trauma. I wasn’t in any danger, but there was a time when I had been. There was a long time – over a decade – where I did have to be constantly alert and on guard.
There was a stepfather who punched me, who punched my mother and sister, and then we left him and after that there was a stepfather who never punched me, but who attacked me far more thoroughly: who routinely called me pathetic, deluded, and worthless, and told me that I would never amount to anything; a stepfather who would blow up over a teaspoon left in the sink or a car door closed at the wrong volume, who would contort his face in impressions of me and say ‘sense of humour failure’ when I couldn’t laugh about it.
In the ten years I lived with this man, which took me from child to undergraduate, I taught myself to be alert, and to minimise his attacks as much as I could. I learned to be smaller, and even to breathe more shallowly, which I didn’t know then is a common response to prolonged childhood trauma. In other words, I went through a long process of learning to be hypervigilant as a natural response to an unsafe environment.
“If I had known then what I know now – that hypervigilance is a normal reaction to prolonged trauma – I could have been kinder to myself”
When, suddenly, I was in a safe environment, it took a long time for that environment to feel safe. So for a long time I carried on responding as though to threat, even though the threat had been removed. I felt on edge, and in danger, and it made sense for me to attribute that feeling to an external source: to assume that someone really was trying to kill me.
If I had known then what I know now – that hypervigilance is a normal reaction to prolonged trauma – I could have been kinder to myself. I could have stopped thinking of myself as mad, and thought of myself instead as someone who had been taught, during their formative decade, that I needed to be constantly vigilant to stay safe. Instead of thinking of myself as weird, or broken, I could have thought of myself as someone who was resourceful, who had learned without even meaning to, to look out for the smallest signs of displeasure in other people’s faces, and to associate these with danger.
There was a time when the things that scared me were spiders, dogs, and the wicked witch from The Wizard of Oz.
There was a time, my later childhood and adolescence, when everything scared me: going downstairs, being too noisy, being too quiet, studying, not studying, and so on.
There was a time again, in Tokyo, away from the abusive house, where everything scared me.
How did I know when I was ‘cured’? People often equate being cured with being happy, but that’s not how it was for me. I went through an intensive course of Eye Movement Desensitization and Reprocessing (EMDR) therapy, and at the end of it, I did feel a lot happier. But I couldn’t be sure that happier meant cured – for all I knew, happier was a temporary feeling born of seeing my family and friends in the UK for a while, and having twice-weekly therapy.
I knew that I was cured, or at least that it felt more accurate to say I ‘had’ complex PTSD in the past tense, a few months after I returned to Tokyo. I was home alone, and cooking whilst singing along to a CD. It didn’t strike me until afterwards, but that is something I would never have been able to do before the treatment: to cook for pleasure, without looking back over my shoulder, to listen to music and even to sing, filling the house with sounds that before I would have worried would conceal an attack. I have even started using my electric toothbrush. That, for me, is ‘better’.
People hear PTSD and think of veterans experiencing flashbacks. That is part of the story. But there is more to trauma than war, and more to PTSD than flashbacks. To help survivors of trauma, we need a broader understanding of the causes and symptoms of PTSD, including its variants.
Header image by Roman Drits