Beyond PTSD: Trauma Creates a ‘Vicious Circle’ of Health Problems
Have you ever felt so stressed that your stomach was in knots, or a period of anxiety led to persistent back pain?
This familiar ‘mind-body‘ connection becomes a relentless, damaging cycle for people living with Complex Post-Traumatic Stress Disorder (cPTSD) and chronic physical health issues.
A new qualitative study delved into the experiences of individuals grappling with both cPTSD and chronic physical ailments to understand what factors feed this dangerous relationship.
Researchers used a reflexive thematic analysis of interviews with twelve participants to construct a narrative based on their subjective experiences.
The core insight is that one condition consistently triggers or worsens the other, creating a bidirectional – – or “vicious circle”—relationship.
Key Takeaways
- Complex PTSD (cPTSD) and chronic physical illness are linked in a “vicious circle,” where one condition consistently worsens the other.
- The study is the first of its kind to highlight that Disturbances in Self-Organization (DSO) symptoms, such as negative self-concept and difficulties in relationships, are key factors maintaining both conditions.
- Physical pain or seizures were reported to directly trigger mental health symptoms like flashbacks, which can be reminiscent of past trauma.
- Negative health behaviours like avoidance, substance misuse, and poor self-care are often attempts to cope with one condition but end up harming the other.
- Integrated, holistic treatment targeting both mental and physical health symptoms, as well as DSO symptoms, is vital for breaking the cycle.
When Physical Pain Replays the Trauma
For participants, the physical body was not a sanctuary but a reminder of past harm.
Pain, seizures, or physical distress could act like a direct echo of the traumatic experience.
In some cases, a new physical health diagnosis, such as Type 1 Diabetes, was even described as “another trauma”.
As a result, a physical symptom like neck pain could instantly trigger a flashback of being “held, pinned down”.
This highlights a direct, visceral link where the body’s current state replays the emotional content of past trauma.
The Shadow of Self-Worth and Social Isolation
The study found that the specific symptoms of cPTSD, known as Disturbances in Self-Organization (DSO), played a crucial and previously overlooked role.
These symptoms include a negative self-concept, emotion dysregulation, and difficulties in relationships.
Participants commonly felt “like a broken biscuit that no one wants”.
This negative self-concept directly interfered with seeking help.
Shame, self-blame, and feeling unworthy often led participants to hide their conditions or delay treatment.
Furthermore, physical symptoms exacerbated feelings of vulnerability, reinforcing negative self-beliefs.
Difficulties with relationships, another DSO symptom, meant they lacked the social support that could be a protective factor against PTSD.
Coping Strategies Become New Threats
The effort to manage the overwhelming symptoms of both conditions often led to behaviours that made things worse.
These Negative Health Behaviours were a desperate attempt to cope with distress.
Substance use, including alcohol or illicit drugs, was often employed to “escape” flashbacks or manage pain.
Similarly, participants would sometimes use more physical health medication than prescribed to induce sleep and avoid memories.
These coping mechanisms inevitably worsened physical health symptoms like diabetes or asthma.
An overarching theme was a belief of having a low locus of control.
Participants often felt their health “controls you,” not the other way around.
This feeling of helplessness, combined with a high danger appraisal (the world is dangerous) , fueled avoidance behaviors, such as withdrawing from social life and avoiding healthcare entirely.
The Cognitive Overload of Chronic Illness
Beyond emotional and behavioural factors, the sheer cognitive demands of living with cPTSD and chronic illness were debilitating.
Participants often described struggling to manage one hot stone, let alone two.
The constant mental load of adjusting insulin doses, managing pain, and dealing with trauma symptoms resulted in cognitive difficulties, affecting memory and attention.
This cognitive drain interfered directly with treatment adherence and fed into the negative self-concept, with some reporting they felt “stupid”.
Poor sleep, triggered by both pain and cPTSD symptoms, acted as a significant “double whammy” perpetuating the cycle.
Why It Matters: A Call for Integrated Care
The study strongly supports the need to move away from treating the mind and body as separate entities.
For individuals with cPTSD and chronic physical conditions, a mental health problem is not merely an “add-on” to a physical one; they are two sides of the same coin, each sustaining the other.
The findings advocate for new, holistic, multi-disciplinary treatment programs.
Clinicians should explicitly target DSO symptoms, cognitive appraisals of danger and control, and negative health behaviours within the context of trauma-focused therapy.
For everyday readers and their loved ones, the key takeaway is recognizing the complexity of this link.
It means understanding that unmanaged anxiety or emotional distress is not just a feeling; it is actively damaging physical health and vice versa.
Support systems must acknowledge the cognitive demands of the condition, perhaps by offering reminders and simplified information.
By validating the reciprocal “mind-body link” , this research paves the way for a more compassionate and effective approach to healing from the total impact of complex trauma.
Reference
Blackett, L., Radcliffe, P., Rexhepi-Johansson, T., & Reynolds, N. (2025). “When my mind hurts, my body hurts”: Complex PTSD and chronic physical health conditions—A qualitative study exploring the factors contributing to their relationship. British Journal of Clinical Psychology, 64, 1020–1042. https://doi.org/10.1111/bjc.12551
