In today’s world, there is often confusion and blurring between the terms PTSD and CPTSD. Since Complex PTSD (CPTSD) has gained more recognition, it has, at times, become almost synonymous with PTSD. However, while these conditions share similarities, they are profoundly different. Understanding these differences is not just important…it is essential. It allows us to honor our own wounds with the care they deserve and to better understand the depths of the wounds of others.
Misusing or oversimplifying these terms does a disservice to the very purpose they serve – to help us comprehend the intricate workings of our psyche and the path of our healing. These terms were crafted with care to guide us through the complexity of trauma and recovery, but when misused, they lose their power and their meaning. By respecting their true definitions, we can create a space for healing that is compassionate, nuanced, and deeply rooted in understanding. This is not just about language—it’s about the respect and care we owe to ourselves and each other on this shared journey of recovery.
- Post-traumatic stress disorder (PTSD) is a mental and behavioral condition that can be triggered by experiencing a traumatic event, such as sexual assault, warfare, car accidents, child abuse, domestic violence, or other threats to a person’s life or well-being. It can also result from witnessing violence. These traumatic experiences, whether one or multiple but singular in nature, can deeply impact an individual, leaving emotional scars that may last long after the event.
- Complex PTSD, however, is the result of repeated and ongoing traumatic experiences that often begin in childhood and extend into adolescence or adulthood. These prolonged periods of trauma – sometimes lasting months or years – have a profound impact, shaping a person’s thoughts, emotions, behaviors and even their sense of self. Over time, these experiences can alter their relationships with themselves and others.
Complex PTSD can develop following exposure to a series of deeply threatening or horrific events – often those that are prolonged and difficult or impossible to escape. This might include torture, slavery, genocide, prolonged violence or repeated childhood abuse, whether physical or sexual. Complex PTSD meets all the diagnostic criteria for PTSD, but its impact extends further.
In 1988, Dr. Judith Herman (author of Trauma & Recovery) suggested that a new diagnosis, complex PTSD, was needed to describe the symptoms of long-term trauma to help better those who had been subjected to what most would consider unthinkable pain over and over again. Pain is pain, that is true, and we should honor our pain and that of others, but one doesn’t treat for example, the wound of someone who fell off a bicycle in the same way one would need to treat let’s say someone who was tortured – both experienced pain, but the severity is not the same- the same logic applies to the psyche.
Symptoms include, according to her formulation:
Behavioral difficulties (e.g. impulsivity, aggressiveness, sexual acting out, alcohol/drug misuse and self-destructive behavior)
Emotional difficulties (e.g. affect lability, rage, depression and panic)
Cognitive difficulties (e.g. dissociation and pathological changes in personal identity)
Interpersonal difficulties (e.g. chaotic personal relationships)
Somatization (resulting in many visits to medical practitioners)
In addition, Complex PTSD is characterized by severe and persistent:
-Problems in affect regulation
-Beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event; and
-Difficulties in sustaining relationships and in feeling close to others.
These symptoms cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.
Thoughts/Beliefs About Self & The Future:
Altered self-perception, including feelings of helplessness, shame, guilt, stigma, and being different from others, along with a loss of faith, hopelessness, and despair. I am a bad person, not good enough, broken, weak, and there is something wrong with me. I like control, answers, and certainty.
Feelings/Emotions:
Persistent sadness, suicidal thoughts, explosive or inhibited anger. I feel sad, angry, irritable, ashamed, scared, helpless, hopeless, insecure, lost, and apathetic.
Impacts On Relationships:
Isolation, distrust, or searching for a rescuer. I can’t trust anyone, trust the wrong people, want to be alone, can’t make or keep friends, and find relationships hard or not worth the effort. People eventually die or leave me.
Body/Soma Effects:
The body remains on guard, tense, nervous, and anticipating danger, with emotional symptoms becoming somatic. My shoulders are tense, I feel jumpy, disconnected from my body, experience stomach and head aches, body aches, fidget, am exhausted no matter how much I sleep, don’t like eye contact, touch, or being close to others emotionally and physically.
Impacts On Consciousness:
Forgetting or reliving traumatic events, or dissociating under stress. I dissociate when stressed, during fights with my partner, or feel detached from my body. I feel like I’m floating through life, disconnected from my body, unable to recall early memories, relive traumatic events, or have nightmares. I’m constantly on edge, hypervigilant, and anticipate the worst.
If you live with someone with complex PTSD, here are some tools to help you be supportive in their journey without enabling and taking care of yourself…
10 Things To Say To Someone With CPTSD…
I hear you, I’m listening.
It’s not your fault.
Your feelings matter, you are important to me.
What would help right now – making a list, brainstorming, slowing down, taking a break?
Can I just sit next to you?
Would you like to tell me more? No pressure.
I’m here for you, you’re not alone.
Your reactions make sense given your past.
You’re not crazy, nothing is wrong with you.
You’ve been through a lot, I’m sorry.
The Goal:
Validate their feelings, actively listen, foster connection, be authentic and present.
10 Things Not To Say To Someone With CPTSD
It wasn’t that bad.
Why are you still upset?
Calm down.
You’re overreacting, get over it.
You’re too much.
What’s wrong with you?
I don’t believe you.
You’re crazy or dramatic.
Stop crying.
Others have it worse.
The Goal:
Don’t minimize, invalidate, compare, blame, or shame their experiences.
Additional Ways To Support Someone With CPTSD…
Be curious, not judgmental.
Validate their feelings and emphasize strengths.
Provide consistency and structure.
Anticipate distress and problem-solve.
Use direct communication.
Let them know perfection isn’t expected, mistakes are part of life.
Remember that you have to take care of your health or you won’t be of help to anyone. It is beautiful to try to help those we love, but this should not come at the expense of your own mental and physical health…
Taking Care of Yourself While Supporting Someone With CPTSD
Take care of your own health – rest, eat well, exercise, take breaks.
Set boundaries and communicate them clearly.
Acknowledge that you can’t fix everything.
Understand your own triggers, seek professional help if needed – understand what is yours to own and what isn’t.
Reflect on your relationship dynamics, personal boundaries, and triggers: What attracted me to this person in the first place?
What do I appreciate and value about this person?
What makes it hard (barriers) or challenging to be with this person?
What are their triggers?
What are my triggers?
What in my past might be replicating itself right now in this relationship?
What are their boundaries? Do they have healthy boundaries? Where and who did they learn boundaries from? How do they say no? Is it easy or hard? How do they accept others’ boundaries? Do they?
What are my boundaries? Do I have healthy boundaries? Where and who did I learn boundaries from? How do I say no? Is it easy or hard? How do I accept others’ boundaries? Do I?
How to Select a Therapist for CPTSD:
The most important factor is feeling comfortable and able to trust the therapist. Trust your instincts. A good trauma therapist should have knowledge of trauma, be trained in multiple trauma modalities, maintain strong boundaries, prioritize self-care, hold hope for healing, focus on strengths, and adapt treatment to your needs.
Schedule a consultation to gauge your comfort and connection. Assess if you feel you can open up, like the person, and if they are trained in trauma, PTSD, and specific areas like complex trauma, relational trauma, childhood trauma, attachment theory, neuroscience, dissociation, relational therapy, and interpersonal neurobiology.
Understanding the root of our pain and the intricate workings of our own psyche is the most profound journey we can undertake. Only by uncovering the hidden recesses of our inner world can we begin to reclaim the fragments of ourselves that have long been buried. This process is not merely a path of healing but a delicate unraveling, a dance with our most vulnerable truths. Through this intimate confrontation with the self, we find the power to transcend, to emerge whole again…like a flower blooming from the soil of its deepest wounds. As one of my favorite poets, who was no stranger to CPTSD, said, “We do not see things as they are; we see them as we are.” – Anais Nin
It is in this revelation, this tender awareness, that we truly begin to reclaim our lives.
Eiros 