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May 9, 2024

What is Complex PTSD?

Delve into the nuances of PTSD and complex trauma, addressing myths about their differences and how treatment interventions can help survivors manage their symptoms of either effectively.

Sofia Noori, MD, MPH
What is Complex PTSD?

Traumatic experiences can leave profound marks on individuals, manifesting in various ways. Among these are Post Traumatic Stress Disorder (PTSD) and its emerging counterpart, Complex Trauma. The differentiation and treatment of these conditions have been a subject of discussion and debate in the psychological community—this article aims to dispel some common misconceptions.

PTSD vs. Complex Trauma: Are They Really That Different?

At its core, PTSD arises from experiencing a traumatic event, such as sexual violence, warfare, accidents, or abuse. Symptoms include flashbacks, avoidance of reminders, hyperarousal, and negative changes in thoughts and mood. Oftentimes people think about PTSD as arising from a single or discrete incident of trauma. However, many people with PTSD have suffered prolonged exposure to trauma and often at the hands of loved ones, such as child abuse or intimate partner violence. Such repeated trauma can dramatically alter a person’s personality, attachment style, and relationship with the world. 

It is important to note that complex trauma is still PTSD. In fact, the traumas that are most likely to cause PTSD are interpersonal traumas, such as intimate partner violence. The average person with PTSD generally suffers from three traumas and many also suffered child abuse — making complex trauma single incident PTSD. 

Because there is so much overlap between complex trauma and PTSD, they have not been separated in diagnostic manuals as distinct diagnoses. Rather, complex trauma is an informal category for a particular presentation of PTSD. 

Myth: Traditional Trauma Therapies Only Address Single-Incident PTSD

One misconception is that traditional trauma therapies cater solely to single-event traumas. The reality is more nuanced because traumas often occur in sequences or over extended periods. The majority of individuals grappling with PTSD have experienced multiple traumas, and therapies have evolved to address this complexity.

The Origin of Trauma Treatments and Their Application to C-PTSD

Original trauma therapies were developed with an understanding that trauma is most often cumulative in nature. While distinctions between PTSD and complex trauma weren't as clear in earlier years, many foundational treatments were designed for what we now recognize as C-PTSD. Much of the research included participants with complex trauma backgrounds, even though the term C-PTSD was not yet coined (recognized as a concept by WHO and diagnosis by ICD-11 coding, but not by the DSM-5).

Why the Misconception Exists

The evolution of understanding trauma has brought about more nuanced issues. With the introduction of C-PTSD as a term, a perceived rift between it and PTSD emerged. Some began to believe that treatments validated for PTSD were not suitable for  complex trauma. This belief is further compounded by a lack of distinction in earlier research, inadvertently leading to generalizations.

The Efficacy of Traditional Trauma Therapies on C-PTSD

Despite misconceptions, therapies like Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and EMDR have demonstrated effectiveness in treating complex trauma. For instance, a study shared by Sofia Noori showed that individuals with complex trauma presentations sustained recovery for ten years after undergoing CPT or PE, highlighting the long-term effectiveness of these approaches.

So, What Are the Most Effective Treatments for PTSD?

While there are various treatments for PTSD,  their effectiveness often depends on the individual's . CPT, PE, and EMDR, treatments like Dialectical Behavior Therapy and trauma-focused CBT have shown promise. It's imperative for individuals to work closely with professionals to find the most suitable approach for their needs.

In conclusion, It is shown that evidence-based treatments have proven to be effective for PSTD whether it is a single incident trauma or complex trauma.

If you're facing challenges with PTSD, rest assured that help is available. At Nema, our specialists are proficient in Cognitive Processing Therapy (CPT) which is tailored for effective treatment of PTSD and anxiety, aiming for lasting recovery. If you're interested in learning more, we invite you to reach out to our compassionate team. Click here to schedule a consultation.