What is the Difference Between PTSD and C-PTSD?

Imagine: You’re moving through your workday, like usual, handling the day’s joys and stresses like the boss you are. When, all of a sudden, it feels like the world around you has changed. For the worse.

Your heart drops into your stomach, your body feels vulnerable and exposed, and then you begin to feel confused about where you are or what you were doing.

Mentally, emotionally, and perhaps even physically, you feel like you were just dropped back into the worst day of your life. You’re immobilized. Bracing. Waiting for it to happen all over again.

That is what a flashback feels like, for people experiencing PTSD. But what does a flashback feel like for individuals experiencing C-PTSD?

Post Traumatic Stress Disorder (PTSD) can set in after experiencing a single, horrific event. Think of things that happen in a flash, like being in a car accident, grieving the death of a loved one, or experiencing assault.

Complex Post Traumatic Stress Disorder (C-PTSD) can set in after experiencing repeated trauma. Instead of going through a key event once, it’s caused by living through a lengthy and highly stressful period of time. This includes chronic or repeated experiences.

PTSD follows the worst day of your life, while C-PTSD follows the worst time in your life, ranging from an entire relationship, employment stay, or developmental period. 

Unlike those diagnosed with PTSD, who experienced a single, existentially-threatening event, those diagnosed with C-PTSD may have experienced an entire childhood of abuse, ongoing domestic abuse with a partner, being a prisoner of war, or experiencing abuse or harassment in a long-term workplace. This complex stress can arise from a series of major events or from prolonged micro-aggressions. Complex Post Traumatic Stress Disorder (C-PTSD) can set in after experiencing repeated trauma. Instead of going through a key event once, it’s caused by living through a lengthy and highly stressful period of time. 

trauma isn’t defined by the scale of the event, but rather by the person’s ability to cope with the event(s).

This means that a lifetime of experiencing micro-abuses, neglect, aggression, etc., can produce the unique web of hypervigilant pain and wounding that we clinically refer to as C-PTSD. Post Traumatic Stress Disorder (PTSD) can set in after experiencing a single horrific event. Think of things that happen in a flash, like being in a car accident, grieving the death of a loved one, or experiencing sexual assault.

SYMPTOMS OF PTSD AND C-PTSD

Both PTSD and C-PTSD share a lifetime of symptoms, such as:

· Hypervigilance or constantly feeling on edge.

· Being emotionally disconnected from those around you.

· Juggling multiple negative emotions at once.

· Re-living the trauma through intrusive thoughts or horrific flashbacks.

· Tendency to avoid people, places, or thoughts that remind you of the event.

However, symptoms that are more likely to show in those with C-PTSD include:

· Chronic pain in the form of headaches, chest pain, or stomach aches.

· Intense feelings of worthlessness, shame, or guilt.

· Poor emotional regulation and management.

· Difficulties maintaining long-term relationships.

· Thoughts of suicide.

SHARED TREATMENTS FOR TRAUMA

Many forms of therapy have proven successful for both PTSD and for C-PTSD clients. Two popular approaches include Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT), though many other therapeutic models have proven effective with trauma-related symptoms. So, what are EMDR and CBT, exactly?

EMDR (EYE MOVEMENT DESENSITIZATION AND REPROCESSING)

EMDR is a great option for people who struggle to talk about the intimate details of their trauma (quite understandable). While you will need to share a bit with your therapist to build trust and the most appropriate treatment plan, the treatment itself uses minimal dialogue. This factor alone makes EMDR very useful for situations where you’re just not ready to verbalize every detail of your experience. If it all feels like too much to talk about, EMDR might be a good approach for you!

So, how does it work? It’s quite simple, actually!

While holding the traumatic memory in the forefront of your mind, your therapist will lead you through a series of eye movements. (This is known as bilateral stimulation and can also be auditory or tactical.) Movements like this help trigger the brain into re-processing and re-organizing the memory into a healthier, less emotionally charged space. Experiencing EMDR for the first time can almost feel magical—it is truly incredible what our brains can do, and how quickly they can reprogram and heal! But rest assured, EMDR therapy is grounding in years of neurological research and is on the cutting edge of trauma-informed therapy interventions.

CBT (COGNITIVE BEHAVIORAL THERAPY)

CBT is a kind of talk therapy that focuses on separating and observing a person’s thoughts, behaviors, and emotions. Seeing yourself in this way can help highlight your most repetitive negative thoughts and their most common triggers. Trauma experiences cause a hypervigilance that can make it hard to remain aware of your thoughts, feelings, self, and others. CBT helps you learn to pay attention to the things that trigger you, and eventually, you can learn different responses to these triggers so you can better manage your emotional reactions to them.

MEDICATION

Antidepressants and anti-anxiety medications are pretty common in PTSD/C-PTSD treatment plans. The most common include sertraline (Zoloft), paroxetine (Paxil), and clonazepam (Klonopin). While therapists can’t prescribe medication, they can help connect you to a medical provider who can assess and prescribe medication for the satellite effects that can orbit your daily life. Things like anxiety and depression can often accompany recovery from trauma.

C-PTSD-SPECIFIC TREATMENT

Skill-building is especially important in C-PTSD treatment. Learning how to manage overwhelming emotions, build supportive relationships, and directly address negative feelings about the self can help make life with C-PTSD manageable, meaningful, and fulfilling! 

It is important to recognize that a person is more likely to develop C-PTSD than PTSD if the event occurred in childhood, when their brain was still developing. That is just one reason why skill-building is so important—the person likely never learned what trust and safety actually looked and felt like. 

Not only must they build new skills, but they must also break down the counterproductive (often life-long) habits they developed to feel safe—like hypervigilance and self-isolation. The work is complicated and brings a magnifying glass to the deepest parts of their self and sense of safety. This one reason why C-PTSD treatment plans tend to be long-term and highly tailored to the specific client’s needs.

How to Treat Trauma With Therapy

It would be impossible to cover the variety of therapeutic treatments for trauma. Essentially, we believe that it takes a combination of a therapeutic relationship and a proven framework - or a mix of art and science - to successfully integrate after trauma. The first step is seeking a consultation for therapy to learn about your options.

Trauma and its affects can often feel like a lifetime sentence, but it doesn’t have to be an end. It can actually be a new beginning. The wounds inflicted can be healed. Life can be brighter and fuller than it ever was before. Don’t delay living the life you want!

Trauma Therapy in Long Beach

Prospect Therapy is a queer + trans affirming therapy practice based in Long Beach, CA, with a focus on mental health for first-generation, immigrant, and bicultural communities. We continue to provide online therapy for a variety of mental wellness and relationship concerns to clients throughout the state of California. Learn more about how we bring lived experience to our work with people of all ages in our communities by requesting a consultation below.