PTSD And Complex PTSD-Dealing With Psychological Trauma

Mar Newhall

Victims of events such as natural disasters, war, rape, domestic violence, emotional neglect, and car accidents experience trauma that lasts for a short time. However, some people experience chronic trauma that lasts for months or years. Individuals who experienced prolonged trauma may have post-traumatic stress disorder (PTSD) or complex PTSD. Statistics from the National Center for PTSD indicate that every year, approximately 8 million people are at risk of developing the disorders, and the risk for women is twice that of men.

The difference between the symptoms of PTSD and Complex PTSD.

People who have common PTSD show four types of symptoms, while those with complex PSTD have additional symptoms. Complex PTSD is caused by prolonged trauma, such as sexual abuse in childhood and long-term domestic violence. Continue reading to know the difference between the symptoms of PTSD and complex PTSD.

1. Reliving the trauma.

PTSD: People who have PTSD relieve and re-experience the traumatic event through memories, disturbing thoughts, reoccurring nightmares, vivid flashbacks, and physical reactivity. Individuals with the disorder may also relive the ordeal when they encounter triggers in their daily lives that remind them of the traumatic events. For example, a victim of sexual abuse may relive his/her traumatic experience when he/she hears a voice that reminds him/her of the assailant.

Complex PTSD: Individuals who have complex PTSD relieve the traumatic event just like those with PTSD. However, they may also show an additional symptom such as emotional flashbacks whereby they re-experience the emotional state that they underwent during the traumatic event. Professionals in mental health have noted that people with complex PTSD respond through the fight, flight, fawn (seek to please) or freeze when they experience emotional flashbacks. The responses are defense mechanisms, but they may end up causing further harm to the individual.

2. Avoiding situations that remind the victim of the traumatic event.

PTSD: People with PTSD will try as much as possible to avoid any situation that may remind them of the ordeal or feelings associated with the traumatic experience. For example, victims of abusive relationships may isolate themselves from others or avoid dating for fear of being harmed. A rape victim may avoid events that may lead to physical contact, for example, showing affection to a romantic partner.

Complex PTSD: Those who have complex PTSD take extreme measures to avoid situations that remind them of the traumatic event. For instance, they may undertake extreme measures to avoid abandonment or please people. Consequently, people with complex PTSD may have trouble setting boundaries or being assertive when their rights are violated. Also, people with complex PTSD may be hypersensitive to disapproval or signs of abandonment.

3. Distorted belief systems and negative perceptions such as toxic shame and self-blame.

PTSD: The traumatic event people with PTSD undergo often causes a shift in their self-perception and belief system. For instance, they may suffer from low self-esteem, excessive ruminations, depression, memory loss, negative self-talk, self-blame, and loss of interest in activities they used to enjoy.

Complex PTSD: Apart from the above symptoms, individuals with complex PTSD may experience a strong sense of guilt, toxic shame, and the feeling that they are defective or remarkably different from others. People with complex PTSD may be harsh on themselves because of the verbal, physical, sexual or emotional abuse they underwent. The strong self-criticism people with complex PTSD experience may prevent them from taking risks or pursuing their dreams. This can lead to learned helplessness and can manifest in the form of the voice of the abuser, especially if the parents were the abuser.

4. Hyperarousal and Hypervigilance.

PTSD: People with PTSD are always on the lookout for impending dangers in their surroundings. They may experience a prolonged startle reaction, aggression, and irritability. They may also engage in risky behavior, and experience difficulties sleeping or concentrating.

Complex PTSD: Apart from hyperarousal and hypervigilance, people who have complex PTSD may experience suicide ideation and self-isolation. Furthermore, they may harm themselves, abuse drugs, and experience difficulty in trusting their intuition. People with complex PTSD may end in abusive relationships, and experts have called this habit “a repeat search for a rescuer.”

Treating PTSD and Complex PTSD

People with PTSD and Complex PTSD need therapy from highly skilled mental health professionals who have the competence and knowledge to help a patient identify the trigger. Studies have shown that some of the most effective treatment for PTSD includes trauma-focused psychotherapy, for example, prolonged exposure therapy. In this therapy, the client is meant to face the negative feeling that he/she has been avoiding. 

The second treatment for PTSD is cognitive processing therapy. This therapy teaches the patient to change their thoughts about the trauma.

The third therapy for PTSD is the EMDR (Eye-Movement Desensitization and Processing). This therapy entails processing the traumatic event by keeping track of the back and forth movement of sound and light.

However, when treating complex PTSD extra measures have to be taken because people with the disorder do not trust easily. Experts recommend that the treatment of people with complex PTSD should progress slowly. For example, they can start by doing regular activities such as getting a job, finding friends, taking hobbies, and regular exercises.

It is crucial for therapists to try to cultivate a feeling of trust when treating people with complex PTSD. The treatment of complex PTSD may progress in three stages.

The first stage is stabilization. This involves discussing with the therapist to learn how to control the feelings of distrust and isolation. One of the techniques used to overcome the sense of distrust is the grounding technique. It helps in separating the trauma suffered in the past from present events. Stabilization aims to make the past traumatic events less frightening and lower the number of flashbacks the patient experiences.

The second stage of treatment for the patient with complex PTSD is subjecting them to trauma-focused therapy like the ones used to treat common PTSD. Some of the therapies include psychotherapy, cognitive behavioral therapy, and eye movement desensitization and processing.

The last stage in treating complex PTSD is reintegration. This entails using techniques and skills to assist the patient to have a better relationship with people. A patient who continues to feel unsafe after the therapy may require antidepressants.