Viewer discretion is advised, as the descriptive language in italics may be emotionally charged for some. The fictional narrative presents a sincere portrayal of someone profoundly affected by past traumas and the ongoing impact on their life.
It draws inspiration from Complex Post-Traumatic Stress Disorder (Complex PTSD), marked by exposure to recurring, inescapable traumatic events. The disorder encompasses re-experiencing, avoidance, and an enduring sense of threat, alongside emotional regulation difficulties, negative self-perception, and challenges in forming close relationships (World Health Organization, 2022).
The story vividly conveys the weight of living with an internalised sense of threat and the profound exhaustion that accompanies unresolved trauma. It explores the haunting re-experiencing of traumatic memories, the narrator’s internalisation of a negative self-concept from external judgments, and how these judgments have become a part of their self-identity. The narrator’s addiction is depicted as a desperate attempt to escape the overwhelming affect dysregulation, and emotional turmoil. The narrative touches on their interpersonal struggles – the part of them yearning for connection, love, and relief from suffering yet fearing vulnerability and rejection. It delves into the narrator’s ongoing battle with avoidance as a coping mechanism for trauma and emotional pain. This narrative invites you to enter the world of complex trauma, experience the narrator’s emotions, and grapple with their inner turmoil.
Viewer discretion is advised, as the descriptive language in italics may be emotionally charged for some. The fictional narrative presents a sincere portrayal of someone profoundly affected by past traumas and the ongoing impact on their life.
It draws inspiration from Complex Post-Traumatic Stress Disorder (Complex PTSD), marked by exposure to recurring, inescapable traumatic events. The disorder encompasses re-experiencing, avoidance, and an enduring sense of threat, alongside emotional regulation difficulties, negative self-perception, and challenges in forming close relationships (World Health Organization, 2022).
The story vividly conveys the weight of living with an internalised sense of threat and the profound exhaustion that accompanies unresolved trauma. It explores the haunting re-experiencing of traumatic memories, the narrator’s internalisation of a negative self-concept from external judgments, and how these judgments have become a part of their self-identity. The narrator’s addiction is depicted as a desperate attempt to escape the overwhelming affect dysregulation, and emotional turmoil. The narrative touches on their interpersonal struggles – the part of them yearning for connection, love, and relief from suffering yet fearing vulnerability and rejection. It delves into the narrator’s ongoing battle with avoidance as a coping mechanism for trauma and emotional pain. This narrative invites you to enter the world of complex trauma, experience the narrator’s emotions, and grapple with their inner turmoil.
***
Every day, I choose to open my eyes to live another day. Someone’s already awake, and so I wake up. I can recognise their footsteps. My body feels heavy, and I don’t have the energy to go to school. I can’t stay in bed too long, though. We both know what would happen if I did. I’m tired; I’m so tired. It’s taking so much energy to live. When night falls, I’m awake for too long and in bed. I hear the front door unlock. I already recognise the slur in his voice and the resentment in hers. The door slams, and my heart jumps. Shouting fills the house; no matter how much I turn up the volume, it fills me with fear. What makes people afraid? Eventually, they both storm off. I can hear footsteps coming closer to my room. I’m aware of the danger but unable to escape it. I try to make myself invisible, but it doesn’t stop the fact that I get screamed at for being awake; every word spat at me shatters. Do we get this angry at someone we love? Every day ends the same.
***
I’ve grown older and stronger, but the weight of countless days like this one has moulded my sense of threat into something monstrous. I fear this lurking monster instinctually; as a result,
it has honed my senses. Every footstep, however faint, inches closer like the ominous approach of inevitable danger. The slamming of doors reverberates through my core, each resounding thud carrying with it a wave of anger, an anger so palpable it feels almost tangible, a furious presence within the walls. And when the shouting begins, I can’t help but believe that the monster has finally found me. Yet, when I calm my mind and realise there is no danger, I cannot shake the feeling that I’m haunted by a ghost. Why do people feel fear? How does it affect our innermost selves?
***
I can feel anger consume every part of me. But I can’t express it. How could you let them do that to you? Again, and again. You stay silent, although you want to scream. You’re a disappointment, a collection of problems and deficiencies. Good-for-nothing. You can see it in their face, their actions. Utter regret. I’m so angry and furious that rage has almost eclipsed this humiliation. You need to feel that startling slap of pain. You crave the relief. To let the anger out somewhere before it consumes you. Like it did to him. We both know what would happen. Drain away the poison, the rage inside. I feel so many things, and I need to feel nothing at all. Until I’m absolutely empty.
***
As the years have unfolded, my sense of rage has unravelled. I’ve realised that the relentless frustration that once fuelled my anger resulted from suppressed emotions. Back then, any hint of emotional expression was met with harsh punishment. My inability to protect myself, to summon the strength to resist, only reinforced the growing belief in my own failure and worthlessness. Each instance of powerlessness added to the idea that I was to blame. It was a belief that integrated at my core, a relentless question mark that hung over my existence. Did anyone survive it?
***
I wake up sweating. It was a nightmare. Touch lingers on my skin, every inch of it crawling. I want to tear it out of my skin. My body is not my own. Disgusting. It feels so disgusting. I wish I could wash myself clean. Take apart every part of myself and thoroughly scrub it all down. I hope to rinse every tainted part of me, my whole self. I hate it, I hate my mind, I hate myself. I can’t sleep anymore. I can’t let it happen again. Don’t sleep, don’t let them get you. We both know what would happen. The sun will come up, but not soon enough. The intrusions crowd all my other thoughts. It takes real effort to keep myself from raging with despair and shame.
***
Growing up, adults often told me that I would outgrow my shyness. I mistakenly believed that these nightmarish spectres would also vanish with time. How desperately foolish I was. Yet, they persist, resurfacing when I least expect them. A reminder that I don’t deserve my sanity. And as I grapple with the inexplicable yearning for suffering, I’m left to wonder—what does my subconscious mind know about the trauma that my conscious self is yet to fully confront? What darkness resides in its depths? Why does it continue to torment my nights?
***
Substituting one addiction for another. It’s too much to cope with. I cannot escape this place. I don’t want to feel anything at all. I don’t want to be alone with these thoughts. Visions of slamming my head against the wall and cracking to stop my mind. It’s an overwhelming blur that never makes sense. So I breathe, hoping it pulls me further away from myself.
You will drown in the memories; you must do something. We both know what would happen. I do it when I am exhausted from trying when being awake and alive demands so much energy. I’ve always been exhausted. So the present I’m living, I work so hard to forget, seems to fade into a grey water colour wash.
***
Now that I’m older, I realise something about my addiction. It’s been an ardent struggle, a violent attempt to smother the searing pain that followed the abuse and death that scarred my soul. To survive, I separated myself from my emotions. The cruel isolation forged loneliness into my being. You don’t really have to do this. You could let go. It is the only way to avoid the bottom line of meaningless suffering. I’m alive, yet I lack the will to live. That’s the truth I did not want to confront. The paradox remains the struggle between life and its loss, the ebb and flow of the will to live. A reminder that human experience is as complex as it is profound.
***
Don’t go, I wanted to tell them. Stay here with me. I’m scared to be alone. But I would never say this. I want to love and feel loved, but I am too much. Relationships will always involve an exchange. When I am asked for my side of the deal, just swallow, but don’t cry. I can’t bear to have you see me as I really am. It may have all been really motivated by their pity for me. I fear what I know other people think about me. Is it better to trust or to be wary? Could you have a real friendship if some part of you always expects betrayal? The process of getting to know someone is always so challenging. Fear of everyone, hatred of myself. Fear of everyone, hatred of myself. Although I’d convinced myself that I felt nothing, I’m terrified.
***
After all these years and numerous potential connections, I constantly wonder why I am incapable of closeness? It’s always the same: I always feel distanced by a chasm. Within its depths lies a dark and forbidding secret that I guard jealously, for I fear that if another were to peer into the abyss, they would recede in abhorrent horror. If anyone dared to venture too close, they would be met with the truth that I am composed of decaying flesh. I am constructed from the remains of past missteps and regrets. The only response left for them would be pity, a condescending sympathy born not out of genuine understanding but from the shock and revulsion at the sight of my inner turmoil.
***
All my life has led up until this moment. I guess I’m a sacrifice for the greater good. The trauma has continued to haunt me as a reminder and motivation to change things for others. Today is a big day. I am proposing a diagnosis for Complex PTSD to the committee.
Over the past decade, enough information has been presented to formalise a working diagnosis. This pivotal step promises to be a turning point for those individuals who engage with the mental health care system, as they will finally be granted a well-defined care path based on this diagnosis (Balogh et al., 2015). It is an opportunity, not merely for survival, but for genuine living.
In a way, it may make up for all those times I should have been helped. All those chances I could’ve had at feeling alive. Complex PTSD involves six distinct clusters of symptoms that are not fully addressed by traditional PTSD diagnosis. Three of these clusters mirror those found in PTSD: the haunting re-experiencing of trauma, an instinctual avoidance of reminders, and a persisting sense of threat. Complex PTSD unfurls an additional triad of symptoms (Brewin et al., 2017). These include emotional dysregulation, where emotions exist in a perpetual state of turmoil. There’s also the haunting spectre of a negative self-concept, intricately shaped by traumatic experiences, leading to self-doubt and an erosion of self-worth. Lastly, relationship difficulties are marked by trust issues and the heart-wrenching isolation (Brewin et al., 2017).
It’s important to underscore that Complex PTSD identifies a distinct group that has often experienced multiple and sustained traumas and displays more pronounced functional impairment compared to those with PTSD (Brewin et al., 2017). Accurate diagnosis and classification of Complex PTSD not only provides hope but also drives ongoing research and deepen our understanding of this condition. With time, this understanding can give rise to more effective treatments and interventions, as has already been demonstrated by pilot studies showing significant improvement after treatment (Dorrepaal et al., 2010). The
urgency of this approval cannot be overstated; it is an opportunity to rewrite the narratives of countless lives, offering the hope of healing where it is desperately needed.
The room fell silent as the last echo of my words hung in the air; a fragile hope intertwined with heavy anticipation. I cannot stress the need for a diagnosis more. But I cannot make the committee feel my suffering and that of everyone who suffers from Complex PTSD. The time between the proposal and the final decision feels like an eternity. Finally, the committee expressed their decision. The weight of rejection feels insurmountable, and the need for approval is painfully evident. It was a sinking feeling, a deep well of hopelessness that seemed to engulf me, leaving me adrift in a sea of despair. We both knew this would happen. My life led to nothing. Meaningless suffering.
References
-
Bertó, C., Ferrin, M., Barberá, M., Livianos, L., Rojo, L., & García-Blanco, A. (2017). Abnormal emotional processing in maltreated children diagnosed of complex posttraumatic stress disorder. Child Abuse & Neglect, 73, 42–50. https://doi.org/10.1016/j.chiabu.2017.09.020
-
Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., Humayun, A., Jones, L. M., Kagee, A., Rousseau, C., Somasundaram, D., Suzuki, Y., Wessely, S., van Ommeren, M., & Reed, G. M. (2017). A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and Complex PTSD. Clinical Psychology Review, 58, 1–15. https://doi.org/10.1016/j.cpr.2017.09.001
-
Choi, H., Kim, N., & Lee, A. (2020). ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among organized violence survivors in modern South Korean history of political oppression. Anxiety, Stress, & Coping, 34(2), 203–214. https://doi.org/10.1080/10615806.2020.1839889
-
Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Improving Diagnosis in Health Care. Washington (DC): National Academies Press (US); 2015 Dec 29. 2, The Diagnostic Process. Available from: https://www.ncbi.nlm.nih.gov/books/NBK338593/
-
Dorrepaal, E., Thomaes, K., Smit, J. H., van Balkom, A. J. L. M., van Dyck, R., Veltman, D. J., & Draijer, N. (2010). Stabilizing group treatment for complex posttraumatic stress disorder related to childhood abuse based on psycho-education and cognitive behavioral therapy: A pilot study. Child Abuse & Neglect, 34(4), 284–288. https://doi.org/10.1016/j.chiabu.2009.07.003
-
Knefel, M., & Lueger-Schuster, B. (2013). An evaluation of ICD-11 PTSD and Complex PTSD criteria in a sample of adult survivors of childhood institutional abuse. European Journal of Psychotraumatology, 4(1). https://doi.org/10.3402/ejpt.v4i0.22608
-
World Health Organization. (2022). ICD-11: International classification of diseases (11th revision). https://icd.who.int/
***
Every day, I choose to open my eyes to live another day. Someone’s already awake, and so I wake up. I can recognise their footsteps. My body feels heavy, and I don’t have the energy to go to school. I can’t stay in bed too long, though. We both know what would happen if I did. I’m tired; I’m so tired. It’s taking so much energy to live. When night falls, I’m awake for too long and in bed. I hear the front door unlock. I already recognise the slur in his voice and the resentment in hers. The door slams, and my heart jumps. Shouting fills the house; no matter how much I turn up the volume, it fills me with fear. What makes people afraid? Eventually, they both storm off. I can hear footsteps coming closer to my room. I’m aware of the danger but unable to escape it. I try to make myself invisible, but it doesn’t stop the fact that I get screamed at for being awake; every word spat at me shatters. Do we get this angry at someone we love? Every day ends the same.
***
I’ve grown older and stronger, but the weight of countless days like this one has moulded my sense of threat into something monstrous. I fear this lurking monster instinctually; as a result,
it has honed my senses. Every footstep, however faint, inches closer like the ominous approach of inevitable danger. The slamming of doors reverberates through my core, each resounding thud carrying with it a wave of anger, an anger so palpable it feels almost tangible, a furious presence within the walls. And when the shouting begins, I can’t help but believe that the monster has finally found me. Yet, when I calm my mind and realise there is no danger, I cannot shake the feeling that I’m haunted by a ghost. Why do people feel fear? How does it affect our innermost selves?
***
I can feel anger consume every part of me. But I can’t express it. How could you let them do that to you? Again, and again. You stay silent, although you want to scream. You’re a disappointment, a collection of problems and deficiencies. Good-for-nothing. You can see it in their face, their actions. Utter regret. I’m so angry and furious that rage has almost eclipsed this humiliation. You need to feel that startling slap of pain. You crave the relief. To let the anger out somewhere before it consumes you. Like it did to him. We both know what would happen. Drain away the poison, the rage inside. I feel so many things, and I need to feel nothing at all. Until I’m absolutely empty.
***
As the years have unfolded, my sense of rage has unravelled. I’ve realised that the relentless frustration that once fuelled my anger resulted from suppressed emotions. Back then, any hint of emotional expression was met with harsh punishment. My inability to protect myself, to summon the strength to resist, only reinforced the growing belief in my own failure and worthlessness. Each instance of powerlessness added to the idea that I was to blame. It was a belief that integrated at my core, a relentless question mark that hung over my existence. Did anyone survive it?
***
I wake up sweating. It was a nightmare. Touch lingers on my skin, every inch of it crawling. I want to tear it out of my skin. My body is not my own. Disgusting. It feels so disgusting. I wish I could wash myself clean. Take apart every part of myself and thoroughly scrub it all down. I hope to rinse every tainted part of me, my whole self. I hate it, I hate my mind, I hate myself. I can’t sleep anymore. I can’t let it happen again. Don’t sleep, don’t let them get you. We both know what would happen. The sun will come up, but not soon enough. The intrusions crowd all my other thoughts. It takes real effort to keep myself from raging with despair and shame.
***
Growing up, adults often told me that I would outgrow my shyness. I mistakenly believed that these nightmarish spectres would also vanish with time. How desperately foolish I was. Yet, they persist, resurfacing when I least expect them. A reminder that I don’t deserve my sanity. And as I grapple with the inexplicable yearning for suffering, I’m left to wonder—what does my subconscious mind know about the trauma that my conscious self is yet to fully confront? What darkness resides in its depths? Why does it continue to torment my nights?
***
Substituting one addiction for another. It’s too much to cope with. I cannot escape this place. I don’t want to feel anything at all. I don’t want to be alone with these thoughts. Visions of slamming my head against the wall and cracking to stop my mind. It’s an overwhelming blur that never makes sense. So I breathe, hoping it pulls me further away from myself.
You will drown in the memories; you must do something. We both know what would happen. I do it when I am exhausted from trying when being awake and alive demands so much energy. I’ve always been exhausted. So the present I’m living, I work so hard to forget, seems to fade into a grey water colour wash.
***
Now that I’m older, I realise something about my addiction. It’s been an ardent struggle, a violent attempt to smother the searing pain that followed the abuse and death that scarred my soul. To survive, I separated myself from my emotions. The cruel isolation forged loneliness into my being. You don’t really have to do this. You could let go. It is the only way to avoid the bottom line of meaningless suffering. I’m alive, yet I lack the will to live. That’s the truth I did not want to confront. The paradox remains the struggle between life and its loss, the ebb and flow of the will to live. A reminder that human experience is as complex as it is profound.
***
Don’t go, I wanted to tell them. Stay here with me. I’m scared to be alone. But I would never say this. I want to love and feel loved, but I am too much. Relationships will always involve an exchange. When I am asked for my side of the deal, just swallow, but don’t cry. I can’t bear to have you see me as I really am. It may have all been really motivated by their pity for me. I fear what I know other people think about me. Is it better to trust or to be wary? Could you have a real friendship if some part of you always expects betrayal? The process of getting to know someone is always so challenging. Fear of everyone, hatred of myself. Fear of everyone, hatred of myself. Although I’d convinced myself that I felt nothing, I’m terrified.
***
After all these years and numerous potential connections, I constantly wonder why I am incapable of closeness? It’s always the same: I always feel distanced by a chasm. Within its depths lies a dark and forbidding secret that I guard jealously, for I fear that if another were to peer into the abyss, they would recede in abhorrent horror. If anyone dared to venture too close, they would be met with the truth that I am composed of decaying flesh. I am constructed from the remains of past missteps and regrets. The only response left for them would be pity, a condescending sympathy born not out of genuine understanding but from the shock and revulsion at the sight of my inner turmoil.
***
All my life has led up until this moment. I guess I’m a sacrifice for the greater good. The trauma has continued to haunt me as a reminder and motivation to change things for others. Today is a big day. I am proposing a diagnosis for Complex PTSD to the committee.
Over the past decade, enough information has been presented to formalise a working diagnosis. This pivotal step promises to be a turning point for those individuals who engage with the mental health care system, as they will finally be granted a well-defined care path based on this diagnosis (Balogh et al., 2015). It is an opportunity, not merely for survival, but for genuine living.
In a way, it may make up for all those times I should have been helped. All those chances I could’ve had at feeling alive. Complex PTSD involves six distinct clusters of symptoms that are not fully addressed by traditional PTSD diagnosis. Three of these clusters mirror those found in PTSD: the haunting re-experiencing of trauma, an instinctual avoidance of reminders, and a persisting sense of threat. Complex PTSD unfurls an additional triad of symptoms (Brewin et al., 2017). These include emotional dysregulation, where emotions exist in a perpetual state of turmoil. There’s also the haunting spectre of a negative self-concept, intricately shaped by traumatic experiences, leading to self-doubt and an erosion of self-worth. Lastly, relationship difficulties are marked by trust issues and the heart-wrenching isolation (Brewin et al., 2017).
It’s important to underscore that Complex PTSD identifies a distinct group that has often experienced multiple and sustained traumas and displays more pronounced functional impairment compared to those with PTSD (Brewin et al., 2017). Accurate diagnosis and classification of Complex PTSD not only provides hope but also drives ongoing research and deepen our understanding of this condition. With time, this understanding can give rise to more effective treatments and interventions, as has already been demonstrated by pilot studies showing significant improvement after treatment (Dorrepaal et al., 2010). The
urgency of this approval cannot be overstated; it is an opportunity to rewrite the narratives of countless lives, offering the hope of healing where it is desperately needed.
The room fell silent as the last echo of my words hung in the air; a fragile hope intertwined with heavy anticipation. I cannot stress the need for a diagnosis more. But I cannot make the committee feel my suffering and that of everyone who suffers from Complex PTSD. The time between the proposal and the final decision feels like an eternity. Finally, the committee expressed their decision. The weight of rejection feels insurmountable, and the need for approval is painfully evident. It was a sinking feeling, a deep well of hopelessness that seemed to engulf me, leaving me adrift in a sea of despair. We both knew this would happen. My life led to nothing. Meaningless suffering.
References
-
Bertó, C., Ferrin, M., Barberá, M., Livianos, L., Rojo, L., & García-Blanco, A. (2017). Abnormal emotional processing in maltreated children diagnosed of complex posttraumatic stress disorder. Child Abuse & Neglect, 73, 42–50. https://doi.org/10.1016/j.chiabu.2017.09.020
-
Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., Humayun, A., Jones, L. M., Kagee, A., Rousseau, C., Somasundaram, D., Suzuki, Y., Wessely, S., van Ommeren, M., & Reed, G. M. (2017). A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and Complex PTSD. Clinical Psychology Review, 58, 1–15. https://doi.org/10.1016/j.cpr.2017.09.001
-
Choi, H., Kim, N., & Lee, A. (2020). ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among organized violence survivors in modern South Korean history of political oppression. Anxiety, Stress, & Coping, 34(2), 203–214. https://doi.org/10.1080/10615806.2020.1839889
-
Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Improving Diagnosis in Health Care. Washington (DC): National Academies Press (US); 2015 Dec 29. 2, The Diagnostic Process. Available from: https://www.ncbi.nlm.nih.gov/books/NBK338593/
-
Dorrepaal, E., Thomaes, K., Smit, J. H., van Balkom, A. J. L. M., van Dyck, R., Veltman, D. J., & Draijer, N. (2010). Stabilizing group treatment for complex posttraumatic stress disorder related to childhood abuse based on psycho-education and cognitive behavioral therapy: A pilot study. Child Abuse & Neglect, 34(4), 284–288. https://doi.org/10.1016/j.chiabu.2009.07.003
-
Knefel, M., & Lueger-Schuster, B. (2013). An evaluation of ICD-11 PTSD and Complex PTSD criteria in a sample of adult survivors of childhood institutional abuse. European Journal of Psychotraumatology, 4(1). https://doi.org/10.3402/ejpt.v4i0.22608
-
World Health Organization. (2022). ICD-11: International classification of diseases (11th revision). https://icd.who.int/
