How Can Complex PTSD Manifest in the Workplace?

The odds are pretty high that you work with someone (or multiple people) with Complex PTSD (C-PTSD). These coworkers may or may not be aware that they have this condition. If they do, they may not choose to share that with you. They may not trust that stigma and stereotypes won't appear if they were to share this information. They may fear that a lack of boundaries will lead you to ask "what happened". They may feel shame, vulnerability or embarrassment. They may not trust that, if they confide in you, you will protect their "story" with the utmost confidentiality - it's not your story to tell.?

For these, and many other reasons, it's important that workplace leaders demonstrate curiosity, trustworthiness and be non-judgmental. If someone at work who has traditionally met performance expectations has a significant change in performance, ask them if they are ok and listen - even if there is a period of silence while they consider whether they can trust you. If they say no, don't ask them what's going on - they may not want to share their story with you which is reasonable. Instead, ask what you can do to help. If you have employee assistance plan (EAP) benefits, give them the phone number to call for support. If your business doesn't have this, offer them privacy to call 988 for mental health support. Ask if they need to take some time off (and don't count it as an unplanned absence) and make sure they know that they may be eligible for a job-protected leave of absence. Be open to any requests for workplace accommodations that may help them to better manage their triggers and meet performance expectations. If they say they are ok, even if you don't think they are, don't push further. Be compassionate and kind.

When triggered, C-PTSD can have significant impacts on individuals in the workplace. Some common ways it may appear include:

• Difficulty with Relationships: C-PTSD can make it challenging to establish and maintain healthy working relationships with colleagues and supervisors due to trust issues, hypervigilance, and difficulty in regulating emotions. It can also swing the opposite way, if they have established trust with a supervisor, they may struggle with organizational changes and feel abandoned as a result of the leadership change.
• Flashbacks and Triggers: Individuals with C-PTSD may experience flashbacks or be triggered by workplace situations or interactions, making it hard to focus on tasks and causing emotional distress. They may not even be aware of their triggers to be able to identify what ignited this experience.
• Emotional Dysregulation: Emotional dysregulation is common in C-PTSD, leading to mood swings, intense emotions, and difficulty managing stress, which can affect job performance and teamwork. When stress is long term, like it was during the pandemic, it accumulates and can overwhelm C-PTSD survivors.
• Hypervigilance: Constantly being on guard can make it difficult to concentrate on tasks, leading to decreased productivity and making it harder to feel comfortable in the workplace. This is often referred to as being in survival mode. In people with C-PTSD, this can last for years and lead to a collapse from exhaustion.
• Absenteeism: Some individuals with C-PTSD may need to take more sick days or mental health days due to the impact of their symptoms on their ability to work. In these situations, having the job protection of the Family Medical Leave Act (FMLA) may be necessary and should be discussed with their healthcare provider. This can offer job protection for up to 12 weeks (continuous or intermittent absences).
• Impaired Decision-Making: C-PTSD can affect an individual's ability to make clear and rational decisions, potentially impacting their job performance and decision-making in the workplace. When struggling to make decisions, they may experience dissociation in the form of a fight (argumentative), flight (avoidance), freeze (stripped of emotion) or fawn (people-please) response.
• Difficulty with Authority: Trust issues and a history of trauma may result in difficulties with authority figures, leading to conflict in the workplace. Trust is elusive for C-PTSD survivors. When the situation is compounded with a combination of difficulty with relationships, hypervigilance, self-doubt and perfectionism, building these relationships can be very challenging.?
• Perfectionism: Some people with C-PTSD may struggle with perfectionism, leading to overwork and burnout as they constantly strive to meet unrealistically high standards. This is often associated with the fawn response and can lead to stress and burn-out. If prolonged, it can lead to collapse from exhaustion. They may miss deadlines because they feel their work isn't yet perfect.
• Self-Doubt: A lack of self-esteem and self-worth can undermine confidence at work, preventing individuals from seeking promotions or taking on new challenges. This may be intertwined with perfectionism. These individuals may not have confidence in their work unless they feel that it is perfect and aligned with their standards, which may be unrealistic. They may ask for the validation of others and appear to struggle with confidence (in themselves or their knowledge).
• Isolation: People with C-PTSD may isolate themselves from colleagues, leading to feelings of loneliness and reducing opportunities for collaboration and networking. This is a common protective measure, frequently used to avoid conflicts with others (due to any of the above reasons). It can become a vicious cycle of alternating between needing the support of others and having trust, connection and conflict that has proven to be challenging in forging and maintaining relationships.

It's important for employers to create a supportive and understanding workplace environment for everyone, not just those with C-PTSD. Encouraging open communication, providing access to mental health resources, and implementing trauma-informed policies can help individuals with C-PTSD manage their symptoms and thrive in their jobs. Additionally, seeking therapy and support outside of work can be crucial for individuals dealing with C-PTSD to improve their overall well-being and functioning in the workplace.