PTSD & CPTSD…What’s the difference?
What’s the difference, and what does treatment look like?
I remember years ago at a trauma training, the presenter said “if the DSM-5 took into consideration the impact of trauma, it would be the size of a pamphlet”.
AKA, much much shorter than its current 900+ pages. There would be less “disorders” to consider, because so many “disorders” can also be explained as an understandable presentation of unprocessed trauma and attachment ruptures.
The DSM-5 is a book that lists mental disorders and their criteria. It has been revised several times over the years as research progresses and we have more information about mental health and the brain. It’s used for diagnosis, and can be really helpful in understanding a person’s presentation and treatment planning, and it severely lacks a deep consideration of how trauma really impacts a person and their life.
With that being said, many clients who choose to work with me meet DSM-5 criteria for PTSD (Post-Traumatic Stress Disorder) or C-PTSD (Complex Post-Traumatic Stress Disorder) when starting treatment*.
What’s the difference between these?
Simplified, PTSD is a group of symptoms a person might experience after a traumatic event(s). Common PTSD symptoms include flashbacks, dissociation, avoidance of reminders of the trauma, frequent scanning for danger, etc. Common examples that might cause PTSD might be a car accident, surviving a natural disaster, or an assault.
C-PTSD is a group of symptoms a person might experience after long-term, repeated experiences of traumatic events that generally are more relational in nature, and (in addition to common PTSD symptoms) can have a significant impact on a person’s ability to have healthy relationships, boundaries, sense of self, and more. Something happened to impact a person’s experience of safety and trust in relationships. Common examples that might cause C-PTSD might be ongoing physical or sexual abuse, neglect, or growing up with inconsistent caregivers.
*Although I’m trained to do so, being in private practice gives me the privilege of opting out of providing a diagnosis to clients unless they would like one, or if it feels helpful for them in understanding their experience.
C-PTSD is not listed in the DSM-5 (however, I do wonder if it might be in future revisions!), but regardless, it’s a real thing, and it impacts many people.
Is treatment different for each one?
Yes and no. Typical trauma modalities (i.e. EMDR, IFS, SP, etc.) are extremely helpful for both, and people do heal from both! The length of treatment can vary, however, and truly varies person to person.
Treatment for PTSD can (sometimes, not always) seem more “clear” (i.e. something happened in the past, and it’s over) with a beginning, middle, and end.
Treatment for C-PTSD can (sometimes, not always) seem more “blurry” (not necessarily always having a clear beginning, middle, and end, and not always completely “over”). With C-PTSD, it’s common for treatment to include healing attachment wounds, practicing healthy boundaries, exploring healthy relationships, and improving overall self-worth.
As a therapist who specializes in working with survivors of trauma, I’ve been privileged to witness folks heal from both PTSD and CPTSD. If any of this resonates with you, please reach out to see if we might be a good fit.