What Is Complex PTSD (CPTSD)?
If you’re reading this, there’s a good chance that you or someone you love is suffering from complex PTSD (CPTSD). Or maybe you’re a mental health worker who’s doing their best to learn more about CPTSD. Regardless of who you are or why you’re here, I hope this article helps you understand CPTSD and gives you hope that healing is possible.
What’s the Difference Between Complex and Acute Trauma?
Before discussing CPTSD, it’s important to understand complex trauma. Complex trauma refers to repeatedly experiencing multiple types of trauma over a prolonged period of time. Typically, these traumas occur at the hands of a caregiver when someone is a child, meaning they’re often interpersonal in nature.
Examples of complex trauma can include repeated physical abuse, sexual abuse, neglect, and abandonment. Witnessing trauma repeatedly, such as seeing one parent harm another, is also a form of complex trauma.
In contrast, acute trauma describes a single incident. This event may or may not have been caused by another person. Examples include a car accident, natural disasters, or being assaulted.
Check out the graphic below to help understand the difference between complex and acute trauma.
How Is CPTSD Different From PTSD?
Now that you understand complex trauma, we can start talking about CPTSD.
As you may have guessed, complex trauma can lead to CPTSD, while acute trauma can cause PTSD. While CPTSD and PTSD are both serious mental health conditions, there are several meaningful differences between them.
When diagnosing PTSD, there are several groups of symptoms therapists look for. These symptoms include:
Re-experiencing
Reliving the traumatic event via nightmares, flashbacks, unwanted memories, or emotional/physical distress
Avoidance
Avoiding internal and external reminders of the trauma
Negative alterations to cognition or mood
Distressing thoughts or emotions related to the trauma
Arousal and reactivity
Feeling on edge, irritable, or hypervigilant
These symptoms must begin after someone has experienced a traumatic event and occur for at least one month.
CPTSD includes all the symptoms of PTSD, plus a few additional symptom clusters. These other symptoms include:
Affect dysregulation
Significant difficulties regulating emotions, such as having anger outbursts or feeling easily overwhelmed by normal life stressors
Negative self-concept
Chronic feelings of guilt or shame
Relationship difficulties
Problems feeling connected to others or consistent relationship ruptures
Check out the graphic below to help understand the difference between PTSD and CPTSD.
Is CPTSD Worse Than PTSD?
It’s common for people to ask if CPTSD is “worse” than PTSD. Because both disorders can be severe, I don’t think it’s helpful to categorize one as worse than the other.
However, research does suggest that complex trauma is linked to many negative health outcomes, such as diabetes, heart disease, and substance abuse.
In fact, research has found that experiencing just one traumatic event can increase the likelihood of being diagnosed with a physical health condition like the ones mentioned above.
Repeated trauma can also increase the risk of experiencing negative mental health symptoms such as depression and anxiety.
Why is trauma linked to negative health outcomes? One researcher coined the term “allostatic load” to describe the impact of trauma on a person’s health. This term suggests that the bodies of individuals exposed to trauma will begin to “wear out” after trying to manage the emotional and physical tolls of trauma.
Essentially, our bodies can only take so much before they begin to deteriorate, leading to disease.
This relationship between trauma and negative health outcomes suggests that people with CPTSD may experience more health complications than someone with PTSD.
Is CPTSD a Real Diagnosis?
CPTSD is a controversial topic in the mental health world. While most trauma therapists and researchers recognize CPTSD as a legitimate diagnosis, the American Psychiatric Association (APA) does not. According to the U.S. Department of Veterans Affairs, the APA made this decision because “there was too little empirical evidence supporting…that [CPTSD] was a separate diagnosis.”
In my opinion, the APA’s decision is lacking much evidence of its own. A quick search for CPTSD on Google Scholar, a website for finding empirical research, shows a plethora of articles about CPTSD.
Additionally, the World Health Organization (WHO) does recognize CPTSD as a real diagnosis in the International Classification of Diseases 11th Revision (ICD-11), lending further evidence to its credibility as a legitimate diagnosis.
How Is CPTSD Treated?
I wrote about how CPTSD is treated in another article that you can access by clicking here.
In case you don’t feel like reading an entire article on the topic, I’ll give a brief summary. Dr. Judith Herman was one of the first mental health providers to provide a framework for trauma therapy.
She organized trauma therapy into three phases: Safety and Stabilization, Reprocessing and Mourning, and Reconnection. As survivors move through these phases, they learn techniques to manage their distress, talk about their trauma, and begin to form healthy relationships.
Whether you’re struggling with PTSD or CPTSD, help is available. You can reach out to Trailhead Counseling Services to get started on your recovery journey!
