Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder: the Similarities and Differences

Posted On November 5, 2019

There is some confusion about the differences and similarities between PTSD and CPTSD.

Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) sound alike but although they have some similar symptoms, they are completely different disorders.

In this article, we shall examine together the differences and similarities of these two life-changing diagnoses.

What is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder develops when a person experiences or witnesses something which is frightening, shocking, dangerous, or scary. Most people recover from such experiences, but some people develop short-term or ongoing symptoms including re-experiencing the event(s) through flashbacks or nightmares, avoiding places, events or objects which remind them of what they experienced, or arousal symptoms like being easily startled.

Some people develop a latent form of post-traumatic stress disorder that does where the symptoms do not appear until years after the traumatic event occurred.

More symptoms of PTSD may include:

• spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic events
• recurrent distressing dreams in which the content or effect (i.e. feeling) of the dream is related to the events
• flashbacks or other dissociative reactions in which the individual feels or acts as if the traumatic events are recurring
• intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
• physiological reactions to reminders of the traumatic events
• persistent avoidance of distressing memories, thoughts, or feelings about or strongly associated with the traumatic events or of external reminders
• inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
• persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
• persistent, distorted blame of self or others about the cause or consequences of the traumatic events
• persistent fear, horror, anger, guilt, or shame
• markedly diminished interest or participation in significant activities
• feelings of detachment or estrangement from others
• persistent inability to experience positive emotions
• irritable or aggressive behavior
• reckless or self-destructive behavior
• hypervigilance
• exaggerated startle response
• problems with concentration
• difficulty falling or staying asleep or restless sleep
• clinically significant distress or impairment in social, occupational, or other critical areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition

As can be seen, the list is long and arduous with the effects of these symptoms is tragically severe.

What is Complex Post-Traumatic Stress Disorder?

Complex post-traumatic stress disorder (CPTSD) is a mental condition resulting from ongoing or repetitive exposure to traumatizing and highly stressful situations. The signs and symptoms of the disorder are varied and generally intense, similar to PTSD.

As was discussed above, PTSD is a trauma disorder that can occur after exposure to a single traumatic event like participating in a war battle, assault, natural disaster, or any event that threatens someone’s life or safety. It’s usually the result of one specific incident.

Complex PTSD, on the other hand, develops after repeated exposure to traumatizing or abusive conditions. In most cases, Complex PTSD is related to events that occurred and persisted through childhood, but it’s possible to develop the disorder as an adult.

Examples of situations that can cause Complex PTSD includes:

• Long-term childhood abuse
• Surviving imprisonment in a concentration or labor camp
• Being held captive
• Exposure to repeated domestic violence

In short, living in any type of oppressive situation where one feels powerless for an extended period of time can result in the development of Complex PTSD.

Other symptoms of CPTSD may include:

• Losing memories of trauma or reliving them
• Difficulty regulating emotions that often manifest as rage
• Depression
• Suicidal thoughts or actions
• Sudden mood swings
• Feeling detached from oneself
• Feeling different from others
• Feeling ashamed
• Feeling guilty
• Difficulty maintaining relationships
• Difficulty trusting others
• Seeking our or becoming a rescuer
• Feeling afraid for no obvious reason
• Having a feeling of always on the alert
• Becoming obsessed with revenge on the perpetrator
• Feeling a loss of spiritual attachment and either ignoring or depending upon religion for self-worth

In comparing the symptoms of PTSD to CPTSD one can see there are similarities but great differences as well. Read on for more information.

The Differences Between Post Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder

One of the primary differences between PTSD and CPTSD is that post-traumatic stress disorder results from a single event, where complex post-traumatic stress disorder forms in relation to a series of traumatic events.

Normally, PTSD involves experiencing a single traumatic event such as the following:

• Car Accident
• Tornado or Other Natural Disaster
• Mugging
• Rape

These events, while highly traumatizing, are quickly resolved with emotional support from either friends/family, short-term psychotherapy, or both.

However, CPTSD usually involves traumatic and long-term abuse: physical, emotional, or sexual in scope. The following are a few examples.

• Sexual Abuse
• Emotional Abuse
• Neglect
• Physical Abuse
• Mental Abuse
• Domestic Abuse
• Human Trafficking
• Living as a Prisoner of War
• Living in a War Zone
• Surviving a Concentration or Internment Camp

Clearly, complex traumatic-stress disorder results from a different kind of traumatization than PTSD, and healing may take decades or even an entire lifetime.

The Differences in the Treatments for CPTSD and PTSD

While there is a fundamental difference in the two diagnoses of CPTSD and PTSD, there are some striking similarities when it comes to treating them. Below we have broken down the recommended treatments of each one and highlighted at the end the similarities.

Recommended Treatments for PTSD

Trauma-focused psychotherapies are the most highly recommended type of treatment for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event or its meaning.

While some techniques help to process traumatic experiences much use visualizing, thinking about the traumatic memory, or talking about it to desensitize you from the trauma of the past.

These techniques for treatment may include:

Cognitive Processing Therapy (CPT)

CPT teaches trauma victims to reframe negative thoughts about what happened in the traumatic event. This form of therapy involves talking with a therapist about negative thoughts and doing short writing assignments to change the narrative.

Prolonged Exposure (PE)

PE teaches you how to gain control by talking about your trauma with a therapist and going ahead and doing the things you have avoided since your exposure to the traumatic event.

Recommended Treatments for CPTSD

The best therapist to have to treat complex post-traumatic stress disorder is one who is trauma-informed. However, if a trauma-informed therapist is not available most therapists will understand how to treat a trauma-related disorder such as CPTSD.

The first step in treating CPTSD is stabilization. This means the therapist helps you separate the trauma from the past from where you are today. Using grounding techniques, a therapist can teach you how to stay in the “now” where things are quiet and safe as opposed to living in the past where there is pain.

Other forms of therapy may include:

Cognitive Behavioral Therapy (CBT)

CBT is a talking therapy that helps people manage their problems by changing the way they think and behave.

A Common Treatment for Both CPTSD and PTSD

While there are many differences in the treatment of complex post-traumatic stress disorder and post-traumatic stress disorder, one is common to both. Eye movement desensitization and reprocessing therapy is useful for treating both disorders and many others.

EMDR helps people to heal from CPTSD by using certain eye movements and a procedure to deal with the emotions and flashbacks that may occur while in treatment.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps people living with PTSD to process and make sense of what happened during the traumatic event. It involves remembering the trauma while paying attention to a  back and forth movement or a sound. Somehow this combination of remembering and paying attention to a movement or sound desensitizes the brain to the traumatic event(s).

Can a Person Have PTSD and CPTSD at the Same Time?

The short answer to the question is yes. You can have both at the same time, but there are a few things to remember.

First, PTSD formed in childhood does not convert to CPTSD in adulthood, they are two different diagnoses with two different causes related to the number of times a traumatic event occurred and how the person felt during that trauma.

However, it is not beyond the realm of possibility that a person who formed CPTSD in childhood might have a traumatic event as an adult and form PTSD as well. This is also true in reverse.

This can happen because post-traumatic stress disorder and complex post-traumatic stress disorder are so different in how they manifest when the trauma is replayed in flashbacks and behaviors.

Second, while those who are reliving the past with PTSD know pretty well where their trauma occurred and why they are feeling emotionally distraught, many times those experiencing CPTSD are not aware of what transpired and baffled by the emotions when they surface.