PTSD vs. Complex PTSD – Thoughts for Survivors of Narcissistic Abuse

May 11, 2026
Narcissistic Abuse

When I was in grad school, I studied Post-Traumatic Stress Disorder (PTSD). One of my assignments was to look over the PTSD screening questionnaires available to clinicians. I remember being surprised that they talked about only one traumatic event.

I had experienced so many traumatic events in my life that it seemed odd to think of focusing on only one. Which one would I choose? That was my first step in understanding the difference between Complex PTSD and PTSD.

In addition, the questionnaires asked questions about the difference between the person’s life before and after the event. Many people with Complex PTSD don’t have a before and after to compare, as abuse and trauma started earlier than we can remember—in the womb for some of us. Another clue that PTSD didn’t quite fit.

PTSD Facts

PTSD is a mental health condition that can occur after a person is exposed to a single traumatic event, such as witnessing death, serious injury, accidents, natural disasters, or sexual violence. It can also occur from learning that someone close has experienced the traumatic event.

Someone with PTSD can experience things like intrusive or distressing memories, dreams/nightmares, flashbacks, emotional distress, and physical reactions to triggers from the event. They may also experience the following:

Avoiding people or places that remind them of the event
Unable to remember the event
Negative beliefs about themselves or the world
Blaming themselves for the event
Losing interest in things they used to enjoy
Feeling detached from other people
Irritable, angry, reckless or self-destructive behaviors
Exaggerated startle response or hypervigilance
Sleep and concentration problems
Dissociation

Complex PTSD

Complex PTSD happens when the trauma is prolonged, repeated and inescapable.
The following are some scenarios of people with CPTSD:

A war veteran who was not only in the war, but also held captive.
A child who is being abused, neglected, or trafficked, unable to care for themselves or escape the situation.
An adult who is being mentally, emotionally, and/or physically abused, who may have been manipulated into thinking the abuse was love, or that they deserved it. Sometimes victims are so exhausted, devalued, confused, and broken down that they cannot get themselves out of the situation.

Similarities between PTSD & CPTSD:

Both share core symptoms like flashbacks, nightmares, avoidance behaviors, hypervigilance, and a negative impact on mood, but CPTSD includes additional struggles that can include difficulties with emotional regulation, severe negative self-worth, and relationship difficulties. In both cases, trauma can wound our nervous system, thwart our ability to form a solid sense of self, and make relationships extremely difficult.

Instead of being mental health disorders that signal “deviance”, a somewhat detached, clinical perspective, Dr. Glenn Patrick Doyle refers to them as injuries that require care and compassion.

Complex PTSD After Narcissistic Abuse

Many adults who have experienced narcissistic abuse were also abused or neglected as children.

With constant triggering and unspeakable cruelty, narcissistic abuse unearths our wounds from the past, making unhealthy patterns seem “normal.” When red flags were the only thing we knew growing up, red flags seem normal.

How Complex PTSD Feels

We just can’t quite seem to “get it together” – After having been subjected to things that injured our nervous system, sense of self, and our ability to trust ourselves, others, the world and life in general, it’s no wonder we don’t always meet our goals for the day or rise to every challenge.
We don’t fit in anywhere – Many of us didn’t experience healthy attachment with our caretakers or receive the devotion that we needed from them to feel safe. We weren’t given the tools by our absent or dysfunctional caretakers to know how to belong.
We don’t have friends or close people in our lives, yet we yearn for closeness – We didn’t receive modeling of healthy relationship behaviors as children, so we often gravitate to the familiarity of toxic relationships. We’re unsure of how to be in relationship, and when we get hurt again, we may just decide it’s easier to avoid relationships altogether.
We do not ask for help – Some days our home might have felt safe (if we were lucky), and then things would fall apart again once more, leaving us on our own to figure out things far above what we were capable of at our age. When there was no one there to begin with, when we were navigating life on our own, even as young children, we learn fast to do things all on our own.
Life’s responsibilites are hard – Things like maintaining finances, jobs, or our physical, mental and emotional health can be difficult when we’re mostly focused on just trying to survive the day…or even the moment.
We are actors – We walk around pretending we’re fine when really, we are struggling to survive while dealing with indescribable pain, anxiety, depression, overwhelm, etc.
We believe we’re too much – We feel like, or may even have been told, that we’re just too much. This is false information was given by people who didn’t have the capacity to be present with us and to reflect the truth of who we are back to us. You’re NOT too much.
We feel lazy – In fact; we work incredibly hard every moment of the day to keep ourselves and our lives upright while battling old survival patterns that don’t work as adults, navigating the needs of our unhealed inner children, and trying to deal with the pain of our past wounds. Things that are easy for other people are difficult or can feel impossible to us. We’re exhausted, not lazy.
We’re different than others in our families – We may feel like we’re falling apart, when the rest of our family seems “fine.” In truth, each family member had different experiences with our caretakers, at different ages and stages, and dealt with them in their own way. In addition, their brains may be wired differently than yours. You may be a highly sensitive person who feels everything, whereas others can hide and stuff their emotions.