Complex PTSD (C-PTSD): Causes, Symptoms and Treatment

Complex PTSD

Complex Post-Traumatic Stress Disorder (C-PTSD) is fundamentally the same as regular Post-traumatic Stress Disorder but with additional complications - PTSD symptoms such as avoidance, reliving, and arousal are all present, as are those of anxiety, however additional symptoms are also present that occur as a result of the nature of the trauma.

Unlike PTSD which sometimes develops from exposure to a single traumatic event (e.g., rape, witnessing a dangerous, terrifying incident), C-PTSD, on the other hand, develops from chronic, repetitive trauma where there is generally no possibility of escape from the perpetrator and oftentimes when the victim is kept under the control of the abuser. Examples include those subjected to captivity, torture, concentration camps, a victim/refugee of human trafficking, organized child exploitation rings, or victims of long-term domestic violence or child abuse – most notably that of physical and sexual abuse.

The symptoms specific to complex PTSD are the loss of a sense of self, the loss of a sense of safety, feeling of captivity, inability to trust, low self worth, and increased likelihood of suffering further victimization. It is clear how all of these are directly attributable to the longer and more chronic form of the trauma experienced by these sufferers. The loss of a sense of self is perhaps the most significant symptom associated with this particular variety of the disorder. Detachment from oneself and reality bring with them a whole host of other symptoms which have huge impacts on the sufferer.

Attachment disorder is also associated with chronic PTSD sufferers, which results in them having difficulty relating to others; particularly their children who they fail to develop a proper emotional connection with. They may not be able to relate to and deal appropriately with their child, or other people.

Complex PTSD Causes

Complex post traumatic stress disorder occurs when a person is exposed to some severe trauma for a long period of time, and they are unable to escape from it. Some of the first cases of this came to light in the Vietnam War, after soldiers were fighting, or held in captivity for a long periods of time or were held in a traumatic environment with no means of escape. Another example of complex post traumatic stress disorder is of children suffering domestic or physical abuse for a long period of time and again having no means to escape.

Complex PTSD Symptoms & Behaviors

The symptoms of complex PTSD are much more severe than the usual PTSD. These symptoms include severe behavioral difficulties.

Individuals suffering from Complex PTSD often resort to alcohol or drug abuse. They also often develop eating disorders and experience extreme aggression. They also find it very difficult to control intense emotions such as panic and anger. They may experience persistent sadness and depression. Suicidal thoughts also enter their minds. They also feel unsafe most of the time, if not all the time. Distrust eats up their thoughts and they become preoccupied with the idea of revenge.

Other mental difficulties and disorders also start to manifest. Some suffer from amnesia and dissociation. Because patients lose their coherent sense of self, some find themselves having Dissociative Identity Disorder, also known as Multiple Personality Disorder, a serious mental condition. Borderline Personality Disorder is also highly indicative of Complex PTSD. (See also: Personality Disorders)

Complex PTSD Treatment

Treatment for Complex PTSD is a little different from the usual PTSD in several important ways. Treatments for PTSD focus on the impact of specific events in the past and the processing of trauma memories. Treatments for Complex PTSD should also focus on problems that lead to more functional impairment. These problems are dissociation, interpersonal problems, and emotional dysregulation.

Some patients with Complex PTSD are treated with Cognitive Behavioral Therapy along with psychoeducation and other approaches. For some patients, especially children, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is used and is considered to be highly effective. This treatment focuses on post-traumatic, depressive, and anxiety symptoms. It also addresses trauma-associated cognitive distortions. TF-CBT includes several core components which include psychoeducation, cognitive processing, creation of a trauma narrative, and Affect Regulation skills.

How long does therapy take for complex PTSD?

Treatment for complex post traumatic stress disorder involves the usual treatments for PTSD but requires its own treatments as well. Complex PTSD sufferers must regain their sense of trust and safety, usually before they can undergo other therapies. Therapists must make the sufferer feel safe and recognize the distinction between the present and the traumatic past. The therapist must also help the sufferer rebuild their sense of emotional engagement with others, and to help deal with the sense of isolation and detachment they experience. Cognitive behavior therapy can also be used to help deal with the problems presented by complex PTSD e.g. learning how to recognize and deal with irrational or negative thoughts.

  Read also: PTSD Test, Treatment & Coping with Flashbacks

Complex post traumatic stress disorder is not recognized as a separate disorder by all medical organizations; however it is argued by many to be significantly different enough in terms of the chronic and repetitive nature of the trauma and its effects that it warrants its own classification.