Understanding Complex PTSD (CPTSD)

Hello!  

Today, let’s explore a topic that’s important yet often misunderstood: Complex Post Traumatic Stress Disorder (CPTSD). If you’re curious about what CPTSD is, how it differs from PTSD, and what it means for those affected, you’re in the right place.

What is Complex PTSD (CPTSD)?

 Complex PTSD is a type of post-traumatic stress disorder (PTSD) that arises from prolonged or repeated exposure to trauma, particularly when it occurs in situations where the individual feels trapped or unable to escape. Unlike PTSD, which can result from a single traumatic event, CPTSD typically results from sustained trauma over an extended period.

Diagnosis of Complex PTSD (CPTSD)

It is important to be clear here that CPTSD is a diagnosis, meaning that there are a set of symptoms and a person can either meet the criteria or not. At present CPTSD is not included in the Diagnostic and Statistical Manual (DSM), however it is included in the International Classification of Diseases (ICD). CPTSD is also recognised by the World Health Organisation (WHO). There is debate among professionals about the inclusion of CPTSD in the DSM.

CPTSD is a set of symptoms and forms a diagnostic criteria. A diagnosis can help with things like accessing funding for treatment, however it does not tell the whole story of a person’s experience. Often a person with a diagnosis of CPTSD will have experienced complex trauma, however a person with a complex trauma history will not necessarily have a diagnosis of CPTSD. I will be writing a blog about complex trauma soon.

What is the DSM?

 The issue of diagnosis for people with complex trauma experiences is challenging. Many people who have experiences of complex trauma are given many diagnoses. This is because our medical system works with diagnosis – which is a set of symptoms or a criteria for a disorder or illness. If a person has a certain number of symptoms then they can meet the criteria for a particular disorder. In Australia, health professionals use the Diagnostic and Statistical Manual (DSM). This is a handbook of mental illness or disorder that outlines the symptoms and is used for diagnosis of mental disorders.

Can CPTSD present as other disorders?

It is also important to remember that because the DSM is looking at symptoms of CPTSD for a diagnosis, the features of CPTSD can overlap and often be present in other disorders. For example, Attention Deficit Hyperactive Disorder (ADHD) have some similar features to CPTSD. These could be inattentiveness, impulsivity and executive functioning difficulties; however this will be different for each individual. CPTSD is a relatively new diagnosis and concept. Due to the overlap with other conditions and the relative recency of the diagnosis itself, it may not be common to receive a CPTSD diagnosis.

Key Characteristics of CPTSD

 1. Repeated Exposure to Trauma: CPTSD often stems from long-term or repeated trauma, such as chronic abuse, neglect, or ongoing exposure to harmful situations. This could be from childhood abuse, domestic violence, or living in a war zone.

2. Persistent Emotional Dysregulation: People with CPTSD may struggle with intense emotions that are difficult to manage or feel overwhelming.

3. Difficulty with Relationships: Individuals with CPTSD often find it challenging to form or maintain healthy relationships. They may struggle with trust, intimacy, or feeling disconnected from others.

4. Negative Self-Perception: CPTSD can lead to a pervasive sense of worthlessness or deep-seated shame. People may view themselves as damaged or fundamentally flawed due to their experiences.

5. Dissociation: This can involve feeling detached from oneself or one's surroundings. People may experience dissociative symptoms such as feeling like they’re outside their body or having gaps in memory related to the trauma. This is a nervous system response which can help a person survive at experience in the moment, however if this happens repeatedly, the system can become stuck.

6. Altered Sense of Perception: There can be a distorted view of the world, where the person feels unsafe, or there’s a sense that the world is a dangerous place.

7. Chronic Feelings of Hopelessness: A sense of hopelessness or persistent feelings of despair about the future is common in CPTSD. Individuals may struggle with seeing any positive prospects for themselves. 

How CPTSD Differs from PTSD

 While both CPTSD and PTSD involve trauma and share some symptoms, there are key differences:

 - Duration and Nature of Trauma: PTSD can result from a single event (e.g., a car accident, a natural disaster). CPTSD typically results from prolonged or repeated trauma, often occurring in interpersonal contexts (e.g., ongoing abuse, captivity).

- Symptoms: CPTSD includes symptoms that are not always present in PTSD, such as difficulties with emotional regulation, chronic feelings of shame or guilt, and pervasive negative self-view.

Causes of CPTSD

CPTSD is generally caused by long-term exposure to trauma, which can include:

- Childhood Abuse or Neglect: Repeated abuse or neglect during childhood can lead to CPTSD. This includes physical, emotional, or sexual abuse.

- Domestic Violence: Ongoing exposure to violence or emotional abuse within a relationship can contribute to CPTSD.

- War or Conflict: Living in a war zone or being exposed to ongoing violence can lead to CPTSD.

- Long-Term Institutional Abuse: Experiencing prolonged abuse in institutions such as orphanages, schools, or prisons can also cause CPTSD.

Treatment and Support for CPTSD

 

1. Therapy: Accessing a therapist who is trauma informed, understands CPTSD or complex trauma and specialises in trauma processing can be useful. With them you can both figure out what intervention or approach might be best for you.

2. Medication: While medication alone isn’t a cure, it can help manage symptoms of CPTSD, such as depression or anxiety. Consult with a healthcare provider for appropriate options.

3. Support Groups: Building connections with others who have similar experiences can be helpful for some people.

4. Self-Care: Being compassionate to yourself is so important. Engaging in self-care practices such as mindfulness, exercise, and building a supportive network can aid in recovery and overall well-being.

Final Thoughts

Complex PTSD is a diagnosis. It can result in challenging symptoms for the person. It is due to prolonged exposure to trauma or complex trauma. Understanding its characteristics and differences from PTSD is crucial for effective support and treatment. If you or someone you know is struggling with CPTSD, seeking professional help and exploring appropriate therapies can make a significant difference.

I hope this guide has helped clarify what CPTSD is and how it can be addressed. If you have any more questions or need further information, feel free to ask! 

Take care and stay compassionate.