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  • Writer's pictureDr Heather Dyson

Unravelling the Complexities: A comparison between PTSD and Complex-PTSD

When a traumatic event occurs, its impact can reverberate within the individual's psyche, leaving lasting scars on their mental and emotional well-being. While Post-Traumatic Stress Disorder (PTSD) is a well-known term, there exists a more intricate and multifaceted condition known as Complex Post-Traumatic Stress Disorder (C-PTSD). In this blog, we will explore some of the differences between PTSD and C-PTSD, unravelling their distinct characteristics of these two complex mental health disorders.

What is Post-Traumatic Stress Disorder (PTSD)? PTSD is a mental health condition that can develop in individuals who have experienced or witnessed a traumatic event. It is a complex and debilitating disorder that affects a person's emotional, psychological, and physiological well-being. PTSD can occur in people of all ages and backgrounds and is not limited to specific professions or experiences.

The defining feature of PTSD is the presence of symptoms that persist beyond the initial traumatic event. These symptoms can significantly impair the individual's daily functioning, disrupt relationships, and impact overall quality of life. The duration and intensity of these symptoms can vary from person to person.

Common symptoms of PTSD can be grouped into four main categories:

1. Intrusive Thoughts and Memories: Individuals with PTSD often experience intrusive and distressing thoughts, memories, or nightmares related to the traumatic event. These intrusive symptoms can reoccur involuntarily, causing intense emotional and physical distress.

2. Avoidance and Numbing: A hallmark feature of PTSD is the avoidance of stimuli associated with the traumatic event. This can include avoiding certain people, places, activities, or conversations that serve as reminders of the trauma. Individuals with PTSD may also exhibit emotional numbness, feeling detached from others and experiencing a reduced range of emotions.

3. Negative Changes in Mood and Cognition: PTSD can lead to significant changes in mood and cognitive processes. This may involve persistent negative beliefs or expectations about oneself or the world, distorted thoughts related to blame or guilt, difficulty concentrating or remembering, a diminished interest in previously enjoyed activities, and feelings of detachment from others.

4. Hyperarousal and Reactivity: Individuals with PTSD often experience heightened states of arousal, leading to increased irritability, hypervigilance, exaggerated startle responses, and difficulty sleeping. They may also be more prone to outbursts of anger or exhibit reckless and self-destructive behaviour.

The development of PTSD is influenced by various factors, including the severity of the trauma, personal vulnerability, available support systems, and previous experiences with trauma. It is important to note that not everyone exposed to a traumatic event will develop PTSD, as individual resilience and coping mechanisms play a role in determining the outcome.

What is Complex-PTSD?

CPTSD, also known as developmental trauma disorder, is a psychological condition that can develop in individuals who have experienced chronic, prolonged, or repeated traumatic events. Unlike PTSD, which typically arises from a single traumatic incident, C-PTSD stems from ongoing trauma, such as childhood abuse, neglect, domestic violence, long-term captivity, or repeated interpersonal trauma.

C-PTSD encompasses a broader range of symptoms and has a more profound impact on various aspects of an individual's life, including their sense of self, relationships, and overall functioning. It can result in enduring difficulties in emotional regulation, self-perception, interpersonal relationships, and coping strategies.

The distinguishing features of C-PTSD include:

1. Emotional Dysregulation: Individuals with C-PTSD often experience intense and fluctuating emotions. They may struggle to regulate their emotions, leading to frequent mood swings, emotional reactivity, and difficulty managing stress.

2. Distorted Self-Perception: C-PTSD can disrupt an individual's sense of self and identity. They may struggle with low self-esteem, a fragmented self-concept, feelings of worthlessness, or a persistent sense of shame and guilt related to the trauma they endured.

3. Problems with Relationships: C-PTSD can significantly impact an individual's ability to form and maintain healthy relationships. They may experience difficulties with trust, intimacy, and establishing secure attachments. Patterns of interpersonal problems, including conflict, avoidance, or co-dependency, may emerge as a result of the trauma.

4. Changes in Beliefs and Worldview: Individuals with C-PTSD may develop negative beliefs about themselves, others, and the world as a result of their traumatic experiences. They may view themselves as fundamentally flawed, perceive others as untrustworthy, or believe that the world is inherently dangerous.

5. Dissociation: Dissociation refers to a coping mechanism in which individuals detach or disconnect from their thoughts, emotions, sensations, or memories as a means of self-protection. It can manifest as feeling disconnected from one's body, experiencing memory gaps, or feeling as if one is observing their own life from a distance.

6. Somatisation: C-PTSD can also manifest in physical symptoms, including chronic pain, gastrointestinal issues, headaches, and other somatic complaints. These physical symptoms often have no clear medical explanation and may be linked to the psychological impact of the trauma.

What are the key differences between PTSD and C-PTSD? a) Duration and Recurrence: PTSD typically arises as a result of a single traumatic event, and its symptoms can persist for months or years. On the other hand, C-PTSD develops due to chronic or repetitive trauma, extending over a prolonged period, which can lead to enduring and recurring symptoms.

b) Symptom Presentation: While PTSD and C-PTSD share common symptoms, C-PTSD encompasses additional symptoms not present in PTSD. These symptoms include emotional dysregulation, difficulties forming and maintaining relationships, feelings of emptiness, dissociation, distorted self-perception, chronic feelings of shame and guilt, and a pervasive sense of helplessness or powerlessness.

c) Impact on Identity and Relationships: C-PTSD tends to disrupt an individual's core identity and interpersonal relationships due to the severity and chronicity of the trauma experienced. It can lead to challenges with trust, attachment, and intimacy, as well as a distorted sense of self-worth and self-identity. In contrast, PTSD may primarily impact specific aspects of an individual's life but not necessarily the core aspects of their identity or relationships.

d) Developmental Impact: C-PTSD often emerges during childhood or adolescence when the brain is still developing, potentially interfering with the formation of key cognitive and emotional processes. This developmental impact can result in pervasive difficulties across various life domains, including academic achievement, social functioning, and emotional regulation. PTSD, however, can occur at any age, following a single traumatic event. How do the treatment approaches for PTSD and C-PTSD differ?

Whilst the treatment approaches for PTSD and C-PTSD share some similarities due to the complex nature of C-PTSD, there are some significant differences in how clinicians will work with individuals who identify with the symptoms associated with the diagnosis of C-PTSD.

Trauma Focus: Both PTSD and C-PTSD treatment approaches emphasise addressing the underlying trauma. However, in C-PTSD, therapy often delves deeper into the multiple and prolonged traumatic experiences that contribute to the condition. Therapists may explore the individual's history, attachment patterns, and early childhood experiences to gain a comprehensive understanding of the impact of trauma on their development and sense of self.

1. Duration and Intensity of Treatment: Due to the chronic and complex nature of C-PTSD, treatment duration is often longer compared to PTSD. C-PTSD treatment may involve a more extended and intensive therapeutic process to address the extensive impact of the trauma and work through the various symptoms and challenges that arise.

2. Emotion Regulation and Self-Regulation Skills: C-PTSD treatment frequently places a strong emphasis on developing emotion regulation and self-regulation skills. Individuals with C-PTSD often struggle with emotional dysregulation and may benefit from learning strategies to manage intense emotions, enhance distress tolerance, and improve self-soothing abilities. Therapies such as Dialectical Behaviour Therapy (DBT) or somatic-based approaches can be useful in this regard.

3. Addressing Interpersonal Difficulties: C-PTSD often results in significant challenges in developing and maintaining interpersonal relationships. Subsequently, treatment may focus more explicitly on addressing relational issues, attachment patterns, and fostering healthy connections. Therapists may incorporate interventions aimed at developing secure attachment, improving communication skills, and enhancing relational boundaries.

4. Somatic-Based Interventions: C-PTSD treatment may involve somatic-based interventions that emphasise the mind-body connection. These approaches recognise the impact of trauma on the body and aim to release stored trauma and tension through techniques such as body-based therapies, mindfulness, or yoga. These interventions can help individuals with C-PTSD develop a sense of safety and embodiment.

5. Additional Therapeutic Modalities: While both PTSD and C-PTSD can benefit from trauma-focused cognitive-behavioral therapies (CBT) and eye movement desensitisation and reprocessing (EMDR), the treatment of C-PTSD often incorporates additional therapeutic modalities. These may include psychodynamic therapy, internal family systems therapy (IFS), attachment-based therapies, or other approaches that address the complex interplay between trauma, self-identity, and relationships.

It's important to note that treatment approaches may vary based on individual needs, the psychologists expertise, and the specific symptoms and challenges faced by the person seeking treatment. Effective treatment for both PTSD and C-PTSD requires a comprehensive and individualised approach, focusing on the unique aspects of each person's experience. Consulting with a mental health professional experienced in trauma-related disorders is essential to determine the most appropriate treatment plan.

Understanding the differences between PTSD and C-PTSD is important for accurate diagnosis, effective treatment, and compassionate support. While both conditions originate from traumatic experiences, C-PTSD represents a more intricate and pervasive disorder resulting from prolonged exposure to trauma. It encompasses a wider range of symptoms, impacts core aspects of an individual's identity and relationships, and often manifests during critical periods of development. Seeking professional help from mental health experts is essential for individuals experiencing these disorders, as proper diagnosis and targeted treatment can significantly improve their quality of life, facilitate healing, and restore a sense of stability and well-being.

If you, or someone you know is struggling with symptoms associated with PTSD or CPTSD, please feel free to email me at

Photo by Ümit Bulut on Unsplash

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