Complex PTSD: How a New Diagnosis Differs From Standard PTSD

It's often referred to as “disorders of extreme stress not otherwise specified.”

By Reina Gattuso

Your palms sweat. Your heart races. You don’t remember where you are — are you here, now, or back in another, scarier time?

This is a flashback. And for many people living with PTSD, it’s a common experience. Faced with a reminder of a traumatic event, someone with PTSD can be jerked back into the mental, emotional and even physical experience of trauma.

But what happens when that trauma is ongoing, or a prolonged series of events? This is where a Complex PTSD diagnosis bridges an important behavioral health gap.

Basic Differences between PTSD and Complex PTSD

For many people with PTSD, this traumatic event was a singular occurrence: A natural disaster, or a single violent assault. But for survivors of ongoing trauma, flashbacks and other symptoms can be particularly intense. These survivors may suffer from a different form of PTSD, called “Complex PTSD” (C-PTSD) — also referred to as “disorders of extreme stress not otherwise specified.”

While the label Complex PTSD is still fairly new, many therapists and researchers believe that C-PTSD should have its own diagnosis, separate from simple PTSD. Recently, in fact, Complex PTSD even received its own mention in the Diagnostic and Statistical Manual (DSM).

Wherever individual therapists stand on Complex PTSD’s difference from PTSD, one thing is certain: If you’ve experienced trauma and are suffering, you deserve care. And you can heal. Here’s how.

What is Complex PTSD?

We know that PTSD is the result of a traumatic event. Some scientists describe it as as the body’s evolutionary defense mechanism to intense stress, with the symptoms of PTSD actually serving to keep you aware of future threat. Of course, what might have worked for ancient humans doesn’t necessarily work for residents of the modern world, and PTSD can seriously interrupt the daily lives of people who suffer from it.

For people who have been victimized by many traumatic events over a period of time, the struggle to survive and grow after trauma can be a long one. Complex PTSD is different from PTSD because it often occurs in people who’ve experienced extreme violence and stress over an extended period of time. These stressful events make the person feel trapped and thus hopeless — they may be physically or psychologically unable to escape.

Who is at risk for Complex PTSD?

People who have experienced ongoing domestic violence, severe child abuse, sexual abuse, war, police violence, or forced (non-consensual) sex work are all at risk of developing Complex PTSD. That doesn’t mean if you’ve experienced any of these things, you’re guaranteed to develop C-PTSD. But if you do struggle with Complex PTSD, remember that you’re not broken or alone — you’re having a very common and understandable reaction to a really difficult experience.

People with Complex PTSD will generally experience common PTSD symptoms like flashbacks, nightmares, and physical reminders of the event like nervousness or increased heart rate. They may also try to avoid or block out memories of the traumatic event, emotionally numbing themselves so that, eventually, they may not feel anything at all.

Because people who suffer Complex PTSD experienced long-term and particularly violent trauma, they may exhibit additional symptoms. These include feeling shame and guilt, including a false idea that you are responsible for what happened to you (of course, you’re not at all!). People with Complex PTSD may also experience periods of dissociation, meaning they will lose attention, concentration, and connection to their immediate surroundings as a defense mechanism against overwhelming stress. These symptoms can understandably make it hard for people with C-PTSD to navigate relationships and daily life.

How is Complex PTSD Treated?

While the symptoms of Complex PTSD are definitely serious, you can heal. The most important step to getting better? Reaching out for help. A therapist trained to work with trauma survivors can lead you down the path to healing.

The first goal of treatment for Complex PTSD is stabilization, meaning that the therapist will help you separate the traumatic past from the present. The therapist can teach you techniques, called “grounding techniques,” to stay in the here and now, where you are safe, rather than feeling threat and panic from the past.

You can think of grounding techniques as helping you keep your feet on the ground, in the present — sometimes literally. Therapists suggest walking barefoot and feeling the ground beneath your toes as one strategy to keep yourself in the here and now. Other grounding techniques can include paying attention to the sounds, sights, smells and textures in the present, or going somewhere safe and cozy and paying attention to those comforting feelings.

Your therapist may also use specific trauma-focused therapeutic techniques, like Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing therapy (EMDR).

You Can Heal

With so much trauma in this world, PTSD and Complex PTSD are unfortunately common.Surviving something emotionally, physically, or mentally traumatic will definitely have effects, as your body and mind struggle to adapt and heal. Having Complex PTSD doesn’t mean you’re wrong, broken, or hopeless — it means you’re having a totally understandable reaction to intense trauma, and you deserve care.

The road won’t necessarily be easy, but Complex PTSD can be treated, and you can lead a normal, healthy, and happy life defined by what you want to make of it — not by past trauma.

Originally published at

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