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PTSD vs. Complex PTSD

Trauma is “any situation in which the intensity of some experience was greater than our felt compacity to bare it” (Ron Siegel). This can include acute situations, such as car accidents, natural disasters, miscarriage, infidelity, and more chronic situations, such as physical/emotional/sexual abuse, neglect, and/or chronic illness. Surveys of the general population suggest that at least half of all adults in the United States have experienced at least one major traumatic stressor (Elliott, 1997; Kessler, Sonnega, Bromet, Huges, & Nelson, 1995).

Honestly, after the last year of experiencing Covid, we can all say we’ve experienced a form of trauma. Symptoms from trauma can include:

Intrusive thoughts Sleep disturbances Flashbacks

Poor memory Increased Distress Self-blame

Dissociation Mistrust Irritability

Difficulty concentrating Shame Anger

Complex Trauma

While complex PTSD is similar to PTSD in that they both suffer from nightmares, avoidance, and flashbacks, complex PTSD specifically relates to traumas that were reoccurring or prolonged overtime. A common example of this would be military trauma, EMT’s and firefighters. While PTSD can develop regardless of age, more times than not, complex PTSD is a result of childhood trauma. The psychological and developmental impact of complex trauma at such a young age extends deeper and has more emotional sting, creating a wide array of symptoms and manifestations. Symptoms of complex trauma can include:

Inability to control emotions Negative self-perception

Difficulty in relationships Loss of meaning in religion/beliefs

Loss of identity Distorted perception of your abuser


Behavioral Manifestations

Trauma, whether complex in nature or not, can result in change in behavior and coping skills to minimize emotional intensity of symptoms . These behavioral manifestations of trauma can look like:

Cutting Drinking /Drugs Compulsive picking OCD

Eating Disorders Rumination

Increased spending Codependency

Isolation Avoidance

Agitation Anger

Treatment for PTSD and C-PTSD

Since the current version of the DSM does not list Complex PTSD has a diagnosis, one will more likely be diagnosed with Post-traumatic Stress Disorder. Psychiatrist, psychologist, psychotherapists and primary care physicians are capable of diagnosing PTSD after doing a thorough assessment that can include a verbal interview, as well as completing questionnaires. Once diagnosed, a client with the help of their clinician can collaboratively make decisions around appropriate treatment options that include but are not limited to, psychotherapy, medication, and Neurofeedback.

Evidenced based therapies for treating PTSD include Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavioral Therapy, Trauma Focused Cognitive Behavioral Therapy, Somatic Experiencing, and Cognitive Processing Therapy.

Your therapist can describe the various approaches and their unique approach to healing so can you choose the modality that best fits for you.

I encourage you to be kind and graceful with yourself as you enter into the healing journey. Healing takes time and I often tell my clients to expect at least 6 months of dedicated therapy, but one’s level of involvement can be a strong indicator of the speed of progress. And like cancer, you wouldn’t stop treatment because you got most of the cancer out. For that reason, it’s best to continue treatment until you feel symptoms that once interfered have been eliminated and the emotional sting of the memory is alleviated. This helps ensure memories, behaviors, and emotional responses will not be recycled in future scenarios.

PTSD does not have to be a life sentence. There is hope, healing, and you are capable of transforming into the person you want to be.

Chelsea McDonald, MA, LPC


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