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It was just like every other summer day in Suburbia. My brother and sisters had gathered a few neighborhood kids on the front lawn for an impromptu baseball game, while our moms stood on the sidelines, sipping their afternoon cocktails and commiserating with one another about the high price of eggs.
I, the baby of the family at four years old, had just awoken from a nap and wandered out, sleepy-eyed, to find my Mommy. Aha! There she is! Letting the screen door slam behind me, I made a beeline for those familiar arms.
I don't recall if I even noticed that my sister was winding up for the grand-slam homer of a lifetime until the Louisville Slugger made contact with the side of my head but, to this day, I can hear the crack of the bat when it made contact with my skull - and the crack of my skull when the bat made contact with it. And, just like that - though the physical injury to my grey matter wouldn’t be visible on MRI for several more decades - I became one of approximately 2.5 million Americans who suffer a traumatic brain injury each year.
According to the National Institute of Neurological Disorders and Stroke, I suffered a non-penetrating TBI (also known as closed head injury or blunt TBI) which is caused by an external force strong enough to move the brain within the skull. This impact can cause bleeding between the brain and skull, and bruises can form. In other words, when the bat hit my head, my brain bounced off the walls of my skull and I got a really big boo-boo that no one else can see.
Often, when people refer to TBI, they are talking about the symptoms that follow the injury, but a TBI is actually the injury or event itself. The symptoms that result from a TBI are referred to as TBI-related or post-concussive symptoms, which are physical in nature:
Most TBIs are mild concussions, treated in emergency departments and urgent care centers, while tens of thousands more result in hospitalization, severe disability, or death each year, making TBI a significant public health concern.
“We’re going to try something different today, Jen.” My therapist closed the door, turned on the white noise machine and plopped down on the sofa next to me. “It’s Boxing Day, so we’re going to change roles. You get to play the therapist and I’ll be the client.”
She explained the forms that I, the therapist, was required to fill out. First, the insurance forms which required me to assign a primary diagnostic code to the client’s complaint, if I wanted to get paid for the session.
“I’ll be playing a client who's a bit...difficult...to work with because I stubbornly refuse to accept that I am experiencing trauma responses, not moral failings. It’s been particularly challenging to assign a treatment team to my case because I’m kind of all over the place, clinically, ” she said. (She was describing me, perfectly, and it stung.) “So, for this scenario, your job as head of the treatment team is to assign a primary diagnostic code to my case, and validate it with clinical evidence that I have accepted the diagnosis and voluntarily agreed to a treatment plan. Ready to play?”
She handed me a clipboard.
For the next fifty minutes, following the standard clinical procedures and protocols I learned in some college or another along the way, I conducted a client intake interview, filled in clinical evaluation forms, and completed a narrative timeline of the client’s traumatic life experiences, while my therapist responded to my queries with my own words, read back to me from the record.
“So, what’s the diagnosis?” she asked, when the session was over.
“You’re a pain in the ass,” I responded.
“Good diagnosis,” she quipped back, “but not billable. C’mon, Jen, time’s up.”
I reviewed my notes, double-checked the scores, and re-checked all the boxes. And there it was: The elephant in the room. The monster under my bed. The committee that lives in my head.
“Post-Traumatic Stress Disorder,” was all I said. It’s all I could say.
We looked at each other in silence for a heartbeat or two, then she asked, “So, I’ll see you next week?” as she rose from the sofa to tuck my file back into its alphabetical place among the other broken souls in the drawer. “Now that we have a diagnosis, we can talk about the treatment plan.” She sounded hopeful, like she actually expected this to work. Oh well, at least one of us was thinking clearly enough to come up with a plan.
"Sure," I called over my shoulder as I raced toward the exit, "I'll see you next week..."
PTSD can develop after experiencing or witnessing a traumatic event, such as violence, a serious accident, disaster, or assault. Symptoms persist beyond normal stress reactions and interfere with daily life.
There are four categories of PTSD symptoms:
Intrusion (Re-experiencing)
Avoidance
Negative Changes in Mood or Thinking
Arousal and Reactivity
PTSD is diagnosed when:
Who says a woman shouldn’t reveal her age? I’m sixty years old and proud to say it. It means I’ve survived for 60 years. It means I learned a thing or two on my walk around the block. It means I have earned the right to heal.
It also means I’ve lived long enough to remember rotary phones, shag carpet, and a time when we were told to “just get over it.” Spoiler alert: trauma does not respond to pep talks. If it did, I’d have been cured by 1987 with a fashion doll and motivational poster featuring a kitten hanging from a branch.
I’m a survivor of childhood sexual abuse. There, I said it. And I’m recovering—finally, recovering—from Complex Post-Traumatic Stress Disorder (C-PTSD). For years, I thought I had “regular” PTSD, because that’s the only label available to many of us. It’s the diagnosis I received that day in the therapist’s office, because it checked all the boxes.
PTSD usually grows out of a single terrifying event—an accident, an assault, a disaster, or a meeting with a Louisville Slugger. The brain’s alarm system goes off and gets stuck. Flashbacks, nightmares, avoidance, hyper-vigilance: the smoke detector won’t stop shrieking, long after the fire is out. When my brain finally noticed that my sister was winding up for a grand slam, it sounded the alarm. Now, I can’t silence it.
C-PTSD, though, comes from a different kind of ballgame and a different kind of head injury. It develops when trauma is chronic, inescapable, and often interpersonal—especially in childhood. Instead of one fire, it’s years of living in a house filled with smoke. The danger isn’t just something that happened; it’s something that keeps happening. It’s something you, somehow, adapted to. And, when the person harming you is someone you depend on – or someone in authority – your nervous system learns lessons that go far beyond fear. It learns shame. It learns silence. It learns that love and danger and pain can wear the same face.
This is where PTSD and C-PTSD both overlap and diverge. Both involve re-experiencing, avoidance, and a nervous system stuck in survival mode, but C-PTSD adds what clinicians call "disturbances in self-organization": difficulty regulating emotions, a harsh inner critic that never stops heckling, and relationships that feel either terrifying or exhausting—or both. It’s not that we survivors are “too sensitive.” It’s that our brains adapted to years of threat by becoming exquisitely alert to any possibility of harm.
C-PTSD is also frequently misunderstood and misdiagnosed, sometimes as a personality disorder. This is a well-documented pattern in clinical practice and mental health research, and has less to do with biology and more to do with gender bias, trauma type, and diagnostic frameworks. All too often, clinicians default to personality disorder labels – particularly Borderline Personality Disorder (BPD) – especially when the trauma history is minimized or overlooked.
The good news—yes, there is some—is that recovery is possible at any age. Trauma-informed therapies like EMDR, CBT, and exposure therapy, paired with skills to calm the nervous system, can help the brain learn something new: the danger is over. Healing doesn’t erase the past, but it does loosen its grip.
At sixty, I’m still learning. I still jump at loud noises. I still need reminders that I’m safe, here and now. But I also laugh more, rest more, and apologize less for taking up space and wasting oxygen. If you’re reading this and recognizing yourself, please know this: You matter. What happened to you matters. What doesn't matter is how long ago it was. What’s happening now can get better. The smoke alarm can be reset.
And no, you don’t have to “just get over it.”
People with C-PTSD experience symptoms of traditional PTSD, which include:
Additionally, people with C-PTSD also experience symptoms that affect their self-perception, relationships, and ability to regulate emotions in many ways .