Complex Posttraumatic Stress Disorder (C-PTSD) vs. Simple PTSD
While I, typically, discuss standard combat posttraumatic stress disorder (PTSD) as it is the most common, today I’d like to highlight a more rare form of PTSD caused by prolonged trauma – complex PTSD. Today I'll answer the question, “What is complex PTSD?”
Causes of Complex PTSD vs. Simple PTSD
PTSD is typically caused by one of more short incidences of trauma. In other words, a person experiences one or more time-limited situations in which he or she fears for his or her life (or the life of another) and this results in PTSD. When we think of combat PTSD, the PTSD is caused by exposure to combat trauma, although PTSD can be caused by many civilian experiences as well such as assault.
In complex PTSD, the sufferer has experienced prolonged trauma which leads to a particularly severe form of PTSD. This can be related to combat such as in the case where a warrior is a prisoner of war, or, more commonly, when a person suffers from prolonged trauma such as domestic violence, abuse, or exploitation.
Symptoms of Complex PTSD Compared to the Symptoms of Simple PTSD
- Symptoms related to re-experiencing of the trauma
- Avoidance of anything that reminds the person of the trauma
- Negative changes in beliefs and feelings
- Symptoms related to hyperarousal (feeling “keyed up”)
A person with complex PTSD will experience the above symptoms but he or she also typically experiences:
- Problems with emotional regulation – such as persistent sadness, suicidal thought, or extreme anger outbursts
- Issues with consciousness (being in the current moment) – this can involve very engrossing reliving of traumatic events, amnesia of the trauma, or dissociation (where one feels detached from one’s body and consciousness)
- Problems with self-perception – feeling different from all other human beings, feelings of helplessness, stigma, shame, or guilt
- Distorted perception of the perpetrator(s) – possibly attributing total power to the perpetrator, obsession over revenge or the relationship with the perpetrator
- Problems with interpersonal relationships – possibly involving mistrust, isolation, or repeated attempts to find a “rescuer”
- Problems with overall meaning – can include a loss of faith or a sense of despair or hopelessness
People with complex PTSD may also self-harm or use substances to try to deal with the pain caused by the prolonged trauma.
Misdiagnosing Complex PTSD
Combat PTSD is easier to diagnose because there is such a noticeable start date and because it manifests so predictably after exposure to combat trauma but because complex PTSD is, indeed, so complex, and has so many symptoms associated with it, it can be very hard to diagnose. In fact, it’s common for people who have suffered chronic trauma to receive other diagnoses such as borderline personality disorder. This is, in part, because of the symptomology but it may also be because the person refuses to disclose the prolonged traumatic event due to the pain it causes him or her.
For patients, then, this means that being honest about any prior traumas is critical and for healthcare providers this means absolute due diligence whenever complex PTSD is a possibility.
Treatment for Complex PTSD
The treatments for standard PTSD are commonly used to also treat complex PTSD but additional treatment is often needed to address the additional symptoms of complex PTSD. This additional treatment often takes the form of in-depth psychotherapy to help in alleviating the symptoms as well as processing of the original chronic trauma.
There are two important things to remember if you’re dealing with chronic trauma:
- Recovery from complex PTSD is possible with treatment.
- You can only recover once you reach out for help and get an accurate diagnosis.
So I encourage anyone with complex PTSD to reach out to a specialist in trauma-related healing because people do recover from complex PTSD but they may need specialized help to do it.
Please see this article by the U.S. Department of Veterans Affairs on complex PTSD for more information and references.
Croft, H. (2015, June 5). Complex Posttraumatic Stress Disorder (C-PTSD) vs. Simple PTSD, HealthyPlace. Retrieved on 2020, July 12 from https://www.healthyplace.com/blogs/understandingcombatptsd/2015/06/complex-posttraumatic-stress-disorder-ptsd-vs-simple-ptsd
Author: Harry Croft, M.D.
To go along with my last post PTSD should never be called Simple. Single Event would be a much better descriptor.
You are doing your readers a disservice by sending them to the US Dept of Veterns Affairs in fact you may be causing people harm. It is my experience that people you have CPTSD need relational therapy that can diminish the feeling of mistrust and shame. The Vets experience things very differently than a person who was sexually abused as a child. Anonomous
I’ve been diagnosed with general PTSD about 4 years ago after experiencing an emotionally threatening relationship, which the mental abuser continued to threaten me emotionally with slander and threats of suicide if I didn’t take him back. I almost never hear or read of PTSD (of any kind) including emotional/mental abuse with sexual tendencies as one of the causes, and sometimes it makes me angry because “sexual abuse” is so general and people often think physical only when they consider it. Is PTSD’s abuse causation symptom truly only relevant if the experience was physical? If so, that’s nonsense.
This article explains so much. Have been under treatment for 6 months with DBT group and individual therapy weekly. The doctor is attempting to reduce my anxiety medication. My therapist understands now, recently, that I was in a fairly long-term abusive/exploitive relationship. My flashbacks and extreme panic attacks happen multiple times daily, and it is so difficult to break out of them. It's like I'm stuck. My whole body shakes violently and I get violently ill. There are too many things that trigger me...places, smells, old songs. I avoid any shows that I haven't seen. When I tell my doctor how bad it is, she always compares me now with how I was after I attempted suicide last year. She says that I will always have symptoms, and need to learn to deal with them. I try...I use the "tools" that they teach me in therapy...but when I have a flashback, nothing works. I need someone, like my mom, to talk to me, hold me really tight, to get out of it. People don't understand why I'm not improving enough. I try to push myself to go out for short periods of time and do simple things. When I get home, it takes me a long time to "recover" from being out...more shaking and getting sick. The doctor says going out is an improvement. Well, yes and no. I WANT to do better, be better. I hate this.
I have found that Rapid Eye Movement Treatment, done by a Pychologist has helped over the years from being in car accidents. It helps takes you through the trauma and out the other side. I realize my fibromyalgia is trapped traumas in my body, and dealing with the traumas helps reduce my pain and hyper nervous system.
Practical simple stratergies, schools of thought on treatment overview to choose a therapy, further reading, to end with see a profression is unprofessional.
Yeah Ive had several episodes of trama and assault back to back which causes me not to trust people. Its like what do you want from me or what are you going to do to me. Panic attacks make the journey muxh mire difficult. Still I know I dont deserve to be treated this way eo I stay solo..much easier than being abused also safer from abusers.
The VA is useless when it comes to treating CPTSD &especially with us women Veterans.
Over the last weekend a brother to my house girl wrote a message that he wanted to kill himself. The reason being he was accused of having a relationship with somebody's wife where he works. I sent him fare to come to my place we see how we could help but he switched his phone off. Even right now he can't be located I hope he never committed suicide. All the same I did my part because it is far from where I stay.
I have read about the treatment of PTSD
How can you find a specialist who can help with forms of PTSD like this when it was said that nothing can be done except try to adapt to the fact that you live with AvPD, SAD, SHSMD as well as with PTSD? Can you post without using my name, please? Post anonymously? And advice would be appreciated. Thanks
I contacted you last week but I never got your response.
I’d like to introduce myself, My Name is Alec and I work at [moderated]
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