How long does it take to recover from C-PTSD?

“It does not matter how slowly you go as long as you do not stop.” – Confucius

Starting on a journey to recovery from Complex Post-Traumatic Stress Disorder (C-PTSD) can, for so many of us, feel akin to setting off on a trek through Mordor versus a short, one-mile loop through your favorite park.

Big. Scary. Arduous. Seemingly never-ending. Filled with danger.

It’s a natural response, a question often stemming from desperation and so many years of pain, to wonder, “How long will it take to recover from C-PTSD? Is there an end to this journey, or will this go on forever?! How will I know when I’m done? Why isn’t this done yet?!”

I get it because I’ve asked all these questions, too.

Many times.

It’s perfectly normal and natural for you to want to know the timeline of your recovery and to be frustrated with how long it feels.

Who wants to start a hike without having some idea of when they’ll reach the summit or at least a rest point where they can sit down, have some water, and rest their weary legs?

Not me.

But just as every hike is unique—meaning as unique as the person and the capabilities of their body undertaking it, not to mention the topography and terrain traversed—so too is the path to recovery from C-PTSD unique and subjective.

That means that no one, really, not ever, can ethically tell you how long your own recovery from C-PTSD will last or when you’ll be done.

Not what you wanted to hear, I know, but bear with me because I have some more nuance despite the lack of my crystal ball about when your own journey will end…

While each person’s recovery from C-PTSD will be unique, what’s true for nearly all of us is that the complexity of C-PTSD makes it a ‘long-haul’ healing journey rather than a sprint with a definitive finish line.

It IS a long-distance trek and not a short one-mile loop through our favorite park.

This can seem overwhelming, but remember, this journey of C-PTSD recovery is not about reaching the end as quickly as possible but about making tangible progress, no matter how small it might seem at the time.

And on this seemingly endless proverbial hike, even though it feels like Mordor, there is a basic map, there are known ways we navigate the terrain, and there ARE markers of progress along the way.

And these trail markers, in particular, are vital reminders that you’re not standing still; you’re moving forward.

And knowing how and when to look out for these markers is really important so you can keep faith “on the hike.”

So, while the answer to “How long will it take to recover from C-PTSD?” is wholly subjective and nearly impossible to answer, in this essay, I want to share a proverbial kind of “map” of the journey that most trauma therapists will guide their clients through on their C-PTSD recovery “hike” and what “trail markers” of progress can be so you can decide for yourself if you’re making progress and what “being done” with the hike looks like for you.

What is Complex PTSD?

“Repeated trauma in childhood forms and deforms the personality. The child trapped in an abusive environment is faced with formidable tasks of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy, safety in a situation that is unsafe, control in a situation that is terrifyingly unpredictable, power in a situation of helplessness. Unable to care for or protect herself, she must compensate for the failures of adult care and protection with the only means at her disposal, an immature system of psychological defenses.” ― Judith Lewis Herman, MD

First, let’s break down and define what Complex Post-Traumatic Stress Disorder (C-PTSD) is so we can understand the complexity of the recovery journey.

Acknowledged by the World Health Organization’s International Classification of Diseases, 11th Revision – a globally used diagnostic tool for epidemiology, health management, and clinical purposes – C-PTSD condenses the tangled, jagged aftermath of complex trauma into clear (but goodness knows not simple!) diagnostic schema which center on three primary domains:

• Affective dysregulation (aka: an inability to emotionally regulate oneself) expressed through an extended presence of negative and distressed emotional states.
• Persistent alterations in consciousness, encompassing memory gaps, dissociation, and changes in self-perception.
• Somatic and somatopsychic (aka relating to the body and mind) symptoms that signify profound alterations in physical experiences (e.g., chronic pain, GI issues, body dysmorphic disorder, and more).

On top of these primary schema, individuals dealing with C-PTSD may also experience pervasive maladaptive thoughts about themselves and others, leading to dysfunctional relationship patterns and isolation.

They may also experience an overwhelming sense of being defeated or trapped, intensified by feelings of guilt and shame.

Moreover, they may also deal with emotional turmoil, which often results in reckless or self-destructive behavior, providing temporary relief but causing long-term harm.

They can also struggle with rapid and intense changes in emotional reactivity, and difficulty managing emotional and physical stress responses are also prevalent, further complicating the diagnosis.

Another critical component of C-PTSD includes disturbances in self-organization, which may manifest as instability in goals, aspirations, values, or career directions.

Finally, performance in areas such as work, self-care, and leisure can be severely compromised, causing additional distress and disruption in daily life.

Really, the complexity of C-PTSD cannot be understated.

Why am I emphasizing this?

Why am I listing out all of the many painful symptoms that go along with a C-PTSD diagnosis?

To showcase that it was never going to be an easy, one-mile loop around the lake in your favorite nearby park.

It was always going to feel more like Mordor than an easy stroll…

The complexity and intensity of the symptoms that co-occur as part of this C-PTSD diagnosis mean that we’ve already graduated into trek and long-haul hike territory if we choose to begin a healing journey from our C-PTSD symptoms.

It’s so important to acknowledge this — that our journey will be long-haul versus short — given the very nature of what we’re trying to recover from.

But it IS a hike where there can be a proverbial kind of “end”, despite how long it can be and despite the lack of exact knowing about the timeline.

Let me explain.

Is it possible to fully recover from C-PTSD?

“Trauma destroys the social systems of care, protection, and meaning that support human life. The recovery process requires the reconstruction of these systems… The essential features of psychological trauma are disempowerment and disconnection from others. The recovery process therefore is based upon empowerment of the survivor and restoration of relationships.” – Judith Lewis Herman, MD

Okay, so now that we’ve established we’re very much in a long-haul trek kind of situation versus an easy walking path kinda deal, the question comes up: is it possible to fully recover from C-PTSD?

In other words, does the long “hike” even end?

The answer to that question is likewise also highly subjective.

Recovering from C-PTSD takes time, as we’ve established.

But, even with extensive treatment over time, some individuals may continue to face lifelong challenges due to the complex nature of the diagnosis, necessitating ongoing symptom management.

Conversely, for others on C-PTSD healing journeys, studies indicate that long-term trauma-focused therapies can significantly reduce symptoms.

So, is it possible to ever fully recover from C-PTSD?

Whether or not this will be the case for you, I can’t answer.

Again, I don’t have a crystal ball and no one can ethically answer that for you without intimate knowledge of you clinically.

And then, compounded with the lack of a crystal ball, there’s also the highly subjective piece about what “done” and “the end” will look like for you.

What do I mean by this?

Some of us may feel like the “proverbial hike” is accomplished when we’re able to live functional, responsible, full adult lives without the symptoms ruling us (but still living with occasional triggers from time to time).

Still others may feel like the journey has “ended” when a decade of memories are reclaimed and there’s an ability to get out of bed each day despite the lack of leading as full of a life as we would like.

What and how we define “fully recovered” (aka the proverbial end of the hike) will be different for all of us.

So is it possible to ever fully recover from C-PTSD?

It depends on how you define recovery for yourself and what’s possible within the scope of your symptoms and work to alleviate them.

But now let’s talk more about how we can alleviate those symptoms and what the C-PTSD recovery journey (aka, the map of that hike through Mordor) may look like.

How do we heal C-PTSD?

“It’s about becoming safe to feel what you feel. When you’re traumatized you’re afraid of what you’re feeling, because your feeling is always terror, or fear or helplessness. I think these body-based techniques help you to feel what’s happening in your body, and to breathe into it and not run away from it. So you learn to befriend your experience.” — Bessel Van Der Kolk

So now the million-dollar question: how do we heal from C-PTSD?

What does the healing map look like?

Professionally, I’ve found that the complexity of the disorder naturally leads to a need for a comprehensive treatment approach, and as a trauma therapist, I hinge my work with clients on the three-phase framework of traumatology (pioneered by psychologist Pierre Janet) followed by an integrative treatment plan.

Big fancy words to explain that the work happens in stages, and it happens with a wide range of tools.

What are the stages?

The three stages of C-PTSD recovery according to the three-phase framework of traumatology are:

• Stabilization: At the outset, in my clinical work the therapeutic focus is on establishing safety and coping mechanisms. Clients learn to ground themselves in the present, utilizing grounding techniques such as mindfulness practices and sensory exercises to manage the overwhelming emotions that threaten their equilibrium.
• Processing Trauma Memories: This stage (which can take a while for us to get to) entails confronting and integrating the fragmented aspects of the self that trauma has shattered. Various therapeutic modalities, such as EMDR (Eye Movement Desensitization and Reprocessing — the power tool in my own clinical toolbox) are employed to process these memories. In this stage, we can create a coherent narrative of clients’ experiences, fostering resilience and paving the way for adaptive responses to future stressors.
• Rehabilitation and Integration: The final phase concentrates on rebuilding one’s life holistically. It involves not only addressing the psychological wounds but also developing healthy relationships, establishing vocational or educational goals, and solidifying the sense of self that has emerged from the crucible of trauma. This phase is about rediscovering joy, purpose, and a renewed sense of identity.

Across these phases (which, let me be clear, are not always fully linear), trauma therapists like me will often rely on an integrative treatment plan that includes:

• Psychotherapy: Considered the foundation of trauma intervention, psychotherapy crucially assists in customizing evidence-supported therapeutic strategies to address the unique needs and experiences of each individual and their respective C-PTSD symptoms.
• Medication: Though not always the central mode of intervention, medication is often dovetailed with psychotherapy to manage symptoms like anxiety and insomnia that might hinder the therapeutic progress. Many therapists like to collaborate with psychiatrists and prescribers to assess whether or not this is necessary for their patients living with C-PTSD.
• Lifestyle Adjustments: Adopting healthy lifestyle practices such as regular exercise, nutritional balance, reducing stress, making necessary structural life changes, and nurturing meaningful social ties play a crucial role in enhancing resilience and supporting the longevity of recovery efforts.

And how do we track progress even as we put this staged, multi-modal plan into place to support C-PTSD recovery?

How do we know when we’re making progress on that proverbial hike through Mordor?

How do I know if I’m making progress in recovering from C-PTSD?

Trauma therapists, like me, often adopt the biopsychosocial model of symptom reduction, taking into account a patient’s biological, psychological, and social factors both as indicators of the maladaptive symptoms currently at play and also as progress signs.

Think of progress signs in C-PTSD recovery as being like those paint blotches on trees or those stone piles that tell you that you’re still on the path, that you’re not going in circles, and that, indeed, you’ve made progress.

Some of those varied progress signs might include:

Emotional and Mental Transformations:

• Development of Coping Strategies and Resilience: Individuals can cultivate a big toolbox of tools to effectively navigate the complexities of their inner world and the intensity of their feelings.
• Reduction in Symptom Severity: As individuals progress, the intensity and frequency of emotional struggles and unhelpful behaviors decrease both in frequency and intensity.
• Self-Esteem Restoration: Through therapy, individuals with C-PTSD often regain a sense of self-worth that trauma had taken from them. A sense of self and esteem begins to bud.

Physical and Behavioral Changes:

• Improvement in Physical Health: Many trauma survivors face ongoing health challenges due to the complex physical effects of trauma. Recovery can bring a renewed focus on physical well-being, often resulting in decreased physical symptoms.
• Modification of Behavioral Patterns: Avoidance behaviors like isolation, self-sabotage, and substance abuse typically diminish during recovery. Instead, individuals adopt healthier practices that encourage personal growth and connection with others and the world.

And that’s just a handful of progress markers. There are so many more I could list.

Whatever and however your own biopsychosocial progress markers will look like, it’s important that you and your trauma therapist take the time to define what progress markers will look like for you on your proverbial hike so that you can both feel less overwhelmed by the seemingly unending nature of the recovery journey and also see concrete evidence of your progress and how far you’ve come.

Wrapping this up.

“It’s like in the great stories, Mr. Frodo. The ones that really mattered. Full of darkness and danger they were. And sometimes you didn’t want to know the end. Because how could the end be happy? How could the world go back to the way it was when so much bad had happened? But in the end, it’s only a passing thing, this shadow. Even darkness must pass. A new day will come. And when the sun shines it will shine out the clearer.” – Samwise Gamgee to Frodo, JRR Tolkien

So how long does it take to recover from C-PTSD?

Hopefully after reading this essay you realize how complex and completely subjective the answer to this question is.

And I hope, too, that you see the agency and self-determination you have to work with your therapist to define what “the end of the hike” will look like for you and what progress markers you need and want to see on the way to ensure that you’re making progress.

If I can be of support to you personally, I’d be honored. Just contact me here and we can get started together on a proverbial trek to support your recovery from C-PTSD.

And now I’d love to hear from you in the comments below:

When you’ve started to lose faith on your own C-PTSD recovery journey, what trail markers and signs have progressed have you looked for and found that indicate progress? What words of wisdom, support and encouragement would you say to someone else maybe a bit further behind in the journey than you?

If you feel so inclined, please leave a message so our community of 30,000 blog readers can benefit from your share and wisdom.

Finally, as you contemplate beginning trauma therapy to recover from your own C-PTSD symptoms, as you contemplate crossing your own proverbial Mordor, I would strongly encourage you to work with a licensed mental health professional who is also trained in an evidence-based trauma modality (like EMDR).

The proverbial hike may feel less arduous if you take it with a guide who has a rough map and a good sense of the “trail markers” you’ll be looking out for on the way.

If you’re in California or Florida and ready to begin high-quality, trauma-informed therapy, my team and I at Evergreen Counseling can help. Book a complimentary consultation with our clinical intake director, and she’ll match you to the therapist who’s the best fit for you personally, clinically, and logistically. (It may even be me!)

Wherever you live, join the waitlist for my upcoming course, “Fixing the Foundations.” It’s designed to transform entrenched survival patterns into authentic inner steadiness through a multi-phase, neuroscience-backed approach.

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Thank you for being here. Until next time, please take such good care of yourself. You’re so worth it.

Warmly,

Annie

 

References Section

1. “Classification of Diseases.” World Health Organization. Accessed March 25, 2024. Link.
2. “Continual Developmental Neurosimulation Using Embodied Computational Agents.” National Center for Biotechnology Information. Accessed March 25, 2024.Link.