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Writer's pictureJulie Lee

What’s the difference between PTSD and CPTSD?

what treatment is used for trauma?
What’s the difference between PTSD and CPTSD?

Trauma refers to an emotional response to a distressing or disturbing event that overwhelms an person’s ability to cope. These events can range from accidents, abuse, natural disasters, violence, or other significant threats to personal safety. Trauma affects people on emotional, psychological, and even physical levels, leading to feelings of helplessness, extreme fear, or a loss of control.

Trauma can be divided into different types:


  • Acute Trauma: Results from a single distressing event (e.g., an accident, assault).

  • Complex Trauma: Results from exposure to multiple pervasive traumatic events, often of an invasive, interpersonal nature (e.g., long-term abuse).


The Difference Between PTSD and Complex PTSD (CPTSD)


Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person experiences or witnesses a traumatic event. The symptoms of PTSD generally fall into four categories:


  1. Intrusive Thoughts: Flashbacks, nightmares, and distressing memories of the event.

  2. Avoidance: Efforts to avoid anything that reminds the person of the trauma, including people, places, and thoughts.

  3. Negative Changes in Thought and Mood: Feelings of detachment, guilt, shame, distorted beliefs about oneself or others.

  4. Changes in Arousal and Reactivity: Hypervigilance, being easily startled, irritability, trouble sleeping, and difficulty concentrating.


Complex Post-Traumatic Stress Disorder (CPTSD) typically arises from prolonged, repeated trauma, especially of an interpersonal nature (such as childhood abuse, domestic violence, or human trafficking). While it shares many symptoms with PTSD, there are additional symptoms that distinguish it:


  1. Emotional Dysregulation: People with CPTSD may have intense, unpredictable emotions and struggle to manage their feelings.

  2. Negative Self-Perception: There is often a deep-seated feeling of worthlessness or guilt, which can make it difficult to have healthy relationships.

  3. Dissociation and Detachment: In severe cases, individuals may feel disconnected from their bodies or surroundings.

  4. Difficulty in Relationships: Trust issues, fear of intimacy, or repeated patterns of unhealthy relationships are common.

  5. Persistent Feelings of Shame or Guilt: Unlike PTSD, where these feelings may be specific to the trauma, CPTSD can involve a pervasive sense of unworthiness.




 

What does being traumatised feel like?


Trauma can trigger a variety of responses, including:


  • Emotional Reactions: You may feel sad, anxious, fearful, helpless, or numb. Irritability, anger, or self-blame are also common.

  • Negative Thoughts: You might develop negative beliefs about yourself, others, or the world, and struggle with trust.

  • Memory Issues: Difficulty recalling key aspects of the traumatic event is common.

  • Hyperarousal: Feeling constantly on edge, easily startled, or unable to relax, which can lead to irritability, angry outbursts, and trouble sleeping.

  • Flashbacks: Reliving parts of the trauma, sometimes as vividly as watching a video, along with sensory experiences like sounds, smells, tastes, or physical sensations.

  • Withdrawal: You may feel disconnected from others, avoid social interaction, or feel abandoned.

  • Overthinking: Persistent, obsessive thoughts about the event or people involved.


Most reactions to trauma are normal and socially understandable. How you respond depends on various factors, such as past experiences, other stressors, and the level of support available to you.

If you're struggling after a traumatic experience, remember you are not alone and can seek help. Taking care of your basic needs—like eating, sleeping, and staying hydrated—can be a good starting point.


Management and Treatment of PTSD & CPTSD


Treatment:

The primary treatment for Complex PTSD (CPTSD) is psychotherapy, specifically Eye Movement Desensitisation and Reprocessing (EMDR). In EMDR, while thinking about traumatic memories, the individual focuses on external stimuli, such as specific sounds or movements introduced by the therapist. Over time, this process aims to reduce the emotional impact of the trauma.  EMDR is an 8 phased protocol which begins with learning grounding and stabilisation techniques and a solid history take, it is highly successful and treating trauma.


Another form of therapy can also be used to treat trauma; a specific form of cognitive behavioural therapy (CBT) known as trauma-focused CBT.


This therapy is conducted by a trained mental health professional, such as a psychologist or mental health worker. It provides support, education, and guidance to help individuals—and sometimes their loved ones—function more effectively and enhance overall well-being.


Trauma-focused CBT includes:

  • Understanding how your body responds to trauma and stress.

  • Learning strategies to manage symptoms.

  • Identifying and challenging problematic thinking patterns.

  • Gradual exposure to distressing situations (exposure therapy).


Healing from complex and developmental trauma, often involving a lifetime of structural dissociation, is a process of reconnecting with the body. This sounds positive—who wouldn’t want to be more present and aware? However, for trauma survivors, this reconnection often brings increased emotional sensitivity, which can lead to greater discomfort, especially anxiety. This heightened emotional awareness can be distressing, discouraging, and difficult to endure. 

During such times, it may feel like therapy and personal healing efforts aren’t working or worth it. It can seem like you’re making progress, only to feel like you’re sliding backward. Along with increased anxiety, feelings of fear, depression, and confusion may surface, fuelled by a sense of powerlessness and disappointment in the healing process. As a trauma therapist, I’ve come to recognise this pattern, and I’m sharing this to offer reassurance and encouragement.


There are often two factors contributing to this increase in emotional intensity. First, learning about trauma and understanding what’s happened, can bring painful realisations. Second, as dissociation decreases through healing, memories that were previously suppressed or denied can come into sharper focus. This often includes events that may not have been recognised as traumatic at the time. These newly clarified memories can bring distress and a new sense of loss, as a person views their past through a new lens. A bi-product of processing trauma is often loss and grief which can also be worked through in therapy.


While these experiences, in a more embodied state, may feel like a setback or worsening of mental health, they are actually a sign of increased awareness of boundaries, and reduced dissociation. The body is finally able to process the trauma it had blocked due to denial, shame, or lack of support. Recognising that these feelings are temporary and part of the healing process can help to manage them without turning to harmful coping mechanisms.


I can promise you that there is hope and you can move forward.


When enough embodiment and presence are sustained, the trauma can process through the nervous system, leading to a sense of psychological and neurological resolution. As this happens, the painful feelings will diminish, and you will experience a greater sense of peace and well-being. During this phase, it’s crucial to practice gentleness and self-compassion. While some therapists emphasise building “distress tolerance,” which suggests healing must involve pain, with EMDR Therapy healing should not be unnecessarily painful.  Reducing distress IS possible.


What is the efficacy rate of EMDR?

EMDR has proven to be highly effective in treating trauma, with success rates between 80-90%. But what contributes to such high effectiveness?


When a person experiences a traumatic event, the brain engages multiple regions to process it. These include the amygdala, which signals stress and danger; the hippocampus, responsible for learning about safety and risk; and the prefrontal cortex, which manages behaviour and emotions. If the brain has not fully processed the trauma, the person may continue to experience a fight, flight, or freeze response when reminded of the event.


The purpose of EMDR therapy is to help the brain resolve this fight, flight, or freeze reaction, allowing it to process the trauma in a healthier way. As a result, the debilitating emotional responses diminish. EMDR’s focus on the underlying neurological processes of trauma is what makes it so successful.




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