Complex PTSD
You cannot see the future without seeing the past.
– Dune 2
The past is never behind us, it’s within us.
– Michael Meade
According to the US Centers for Disease Control and Prevention, over 49,000 people died by suicide in 2024 in the United States.[1] That’s one death every 11 minutes. And the rate of suicide by men is four times that of suicide by women. That means that of those 49,000 suicide deaths, 39,200 were men. One man took his own life every 13 minutes. Men make up 49% of the US population but nearly 80% of suicides. To put that number in perspective, the seating capacity of Madison Square Garden in New York City is just under 21,000. And, if that weren’t horrifying enough, 13.2 million people seriously thought about suicide, 3.8 million made a plan to kill themselves, and 1.6 million attempted it. This epidemic of male suicide is not unique to the United States. In Australia, 75% of all suicides are men. In the UK, it’s 74%, in Italy, 78%, France 75%, Brazil 80%...the numbers are remarkably consistent around the world.
So, are four times as many men as women depressed? The answer is not that simple.
Psychologists and therapists have only in the last twenty-five or so years begun to understand that the things I have described, especially repeated and compounded over a period of years, are repetitive traumas – not Trauma with a capital “T,” like sexual abuse, or witnessing a horrific event, but traumas, nevertheless. And those traumas, especially starting in early childhood, create the same lasting damage, the same neuro-physiological effects as more obvious capital “T” trauma. This kind of chronic trauma, such as prolonged child abuse or domestic violence, is called Complex post-traumatic stress disorder, or C-PTSD.[2]
Why has it taken so long to figure out? As Terry Real says in “I Don’t Want to Talk about It,”
“Understanding that innumerable small acts of passive trauma are driven by images of masculinity requires of us an act of conscious deliberation. Like fish trying to get a good look at the water they swim in, we find it hard to keep in focus the passive injuries we inflict on boys, because they are both so subtle and so common.”
Psychologists tend to evaluate and treat trauma (with a capital “T”), but often don’t recognize or treat the many wounds inflicted on us as children. While perhaps individually small, repeated and accumulated over time, they are indeed traumas (with a small “t”) and are equally as damaging as larger, more obvious traumatic experiences. Let me tell you that, despite all the work I've done to understand and heal from my childhood trauma, I am very much still a work in progress, though I’m miles advanced from where I was just a few short years ago.
A 1995-97 study conducted jointly by the US Centers for Disease Control and Prevention and Kaiser Permanente[3] found that childhood abuse and household dysfunction were highly correlated to health problems and death in adulthood. They developed a tool for measuring categories of Adverse Childhood Experiences (ACEs) and found a direct correlation to later physical and psychological health problems. Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt, a 2- to 4-fold increase in smoking, poor self-rated health, greater than 50 sexual intercourse partners and sexually transmitted disease, and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity.
A few years ago, I listened to the audiobook version of Fierce Intimacy, another of Terry Real’s works, and in the very first session, he talked about his relationship with his father. The similarities between his experience and mine floored me. And he said, “I came from a family of violence.” I never would have thought of my own experience as having come from a family of violence, and it shook me.
Everyone’s childhood experience is different, but like most victims of early childhood trauma, I took on, I believed in my core, that the abuse I suffered from my father was my fault. If only I could have learned how to be less selfish, stronger, more obedient and a better son, he wouldn’t rage at me and beat and berate me the way that he did. And so, I buried my anger, my pain, and my sadness deep, deep down inside me, and I learned that, no matter how hard I tried, it didn't matter. I didn’t matter. I buried it so deeply that as an adult, I had no idea it even existed, until a confluence of experiences caused it to explode into my conscious awareness.
After years of intense and painful personal work and therapy, going through a trauma recovery coaching program, and reading Terry’s books and many others about trauma voraciously, I finally came to understand the true nature of my suffering. I have begun to excavate all the anger, pain, and sadness, and come to realize that when I raged, I was reenacting what my father modeled for me as the way a man acts, and in no small way, defending myself in a very forceful manner that I was not able to as a child. Because of all the personal work I’ve done sitting in groups with other men, in therapy, and reading, I have learned how to understand my anger without projecting it onto others, and I can now talk about and process all the anger and pain that I had to bury as a kid. The most positive outcome of all the work I’ve done is that I’ve learned how to intercept that anger before it explodes, damaging me and the people around me.
I heard an interview with the actor Hugh Laurie (who played House on the series of the same name), and he said something which has stuck with me: “Most men are trying to play the role of their father until they find out, if they ever do, who they really are.”
I wish I could tell you that understanding the reasons why you act out is enough to give you everything you need to stop doing it, but it's not that easy. Understanding and healing is just not as simple as flipping a switch. Healing from C-PTSD is a process of recognizing the many small wounds repeatedly inflicted on us in childhood, and recasting them from an emotionally mature adult place. It doesn’t mean denying that they happened. It doesn’t mean ignoring them or pretending that they didn’t impact us, and that those impacts have followed us into adulthood, and in significant ways shaped who we are as adults. Rather, it means seeing them through a lens of emotional maturity, and releasing myself from the messages I took on as a child.
[1] https://www.cdc.gov/suicide/facts/data.html#cdc_data_surveillance_section_3-suicide-deaths-plans-and-attempts-in-the-united-states
[2] https://my.clevelandclinic.org/health/diseases/24881-cptsd-complex-ptsd