Patterns of repeated behavior to avoid feelings (promiscuity, internet use, sleeping, etc.)
Chaos in life (problems with relationships, employment, financial, etc.)
Self-harmful behavior (often “alluded to” but not obvious) such as scratching and cutting, burning self, hair-pulling, etc.
Intense self-blame and feelings of unworthiness or belief they are "ruined:"
Belief that they were responsible for original trauma
Irrational/illogical beliefs about responsibility for events in the present
Belief that they are bad, a failure, unlovable, a loser, damaged, insignificant, worthless
May induce others to treat them badly
Staying stuck in the victim, perpetrator, or rescuer roles:
Seek out relationships with abusive people
Induce abuse from others rather than waiting for it to happen
Perceive abuse which confirms the belief that they are unworthy and unlovable
Hurt others (different than appropriate self-protection)
Act aggressively toward others who are weak and vulnerable
Compulsively driven to help others, often to their own detriment
Acts of generosity not in accord with the relationship
Disorganized attachment patterns:
Inability to tolerate their ambivalence toward the perpetrator even after the trauma ceases
Inability to tolerate their ambivalence toward other trusted figures, such as failed rescuers or those who denied the trauma
Inability to tolerate their ambivalence toward significant persons currently in their lives
Difficulty maintaining healthy relationships:
Avoid relationships altogether
Avoid close relationships because of inherent risk
Avoid situations that might lead to closeness
Protect themselves, e.g., unfriendly to others before others are unfriendly to them
Have intense but brief relationships
Remain attached even when the relationship is unhealthy
Perceive the relationship in a distorted manner
Black and white thinking and other cognitive distortions:
Child-like, concrete, and magical thinking
What they think is normal and real does not coincide with "real life"
Derive "life rules" and “automatic thoughts” from childhood distortions
Cling to the distortions despite challenge or contrary evidence
Provoke a non-existent reality into being in order to verify a distortion
Collect evidence to support the distortion while ignoring evidence to the contrary
Patterns of distorted thinking (such as generalizations, all or nothing, discounting, jumping to conclusions, assuming, labeling, and emotional reasoning)
Intrusive thoughts, images, feelings, memories, and nightmares, pathological dissociation:
Loss of (long) spaces of time (can’t remember what they said or did)
Appear to "switch" personalities, or be different people, even in speech and behavior
Trances or sleepwalking
Childhood companions, "voices," "too much noise in my head"
Inability to recall important information, usually of a stressful or traumatic nature
Confusion about personal identity or assumption of a new identity
Extensive comorbidity/multiple diagnoses which may include addictions, mood disorders, and personality disorders