“But I'd begun, slowly, to understand that complex post-traumatic stress disorder, or cPTSD, was different. It was particularly difficult to treat, because - like a flat landscape - it didn't offer a significant landmark, an event, that you could focus on and work with. Complex post-traumatic stress, according to the psychiatrist Judith Lewis Herman, is the result of 'prolonged, repeated trauma,' rather than individual traumatic events. It's what happens when you're born into a world, shaped by a world, where there's no safety, ever. When the people who should take care of you are, instead, scary and unreliable, and when you live years and years without the belief that escape is possible.

When you come from a world like this, when all your muscles are trained to tension and suspicion, normal life feels unbearable. It doesn't make sense, getting up, going to class, eating lunch, returning home, sleeping. You don't trust it. It doesn't feel real. And unreality can hurt more than pain.”