Symptoms of posttraumatic stress, complex or otherwise, can have a significant impact on quality of life. The effects can extend not only to emotional and physical wellness but also to relationships and school or work performance.
A trained, empathic mental health professional can offer support as you begin to address the source of trauma and any symptoms you’re experiencing. Symptoms often get worse as time goes on, so it’s important to get help as soon as you can. Start your search for a counselor today through our therapist directory.
If you are experiencing a mental health emergency, please visit our crisis resources page.
C-PTSD and Mental Health
C-PTSD shares similar features with several other mental health conditions, which is one reason some experts may feel reluctant to identify it as a separate condition. Some mental health professionals may diagnose C-PTSD symptoms as other conditions, such as borderline personality disorder (BPD), depression, or dissociative identity disorder (DID).
Although borderline personality and C-PTSD have a lot in common, research suggests they are distinct diagnoses. A BPD diagnosis may be more likely when a person’s dominant symptoms include emotional dysregulation, troubled relationships, or an unstable sense of identity. In addition, BPD has two diagnostic criteria that C-PTSD does not. The first is a pervasive fear of abandonment. The second is a tendency to alternate between idealizing and devaluing the same person.
A diagnosis of depression may seem more appropriate when the main symptoms include a persistently low mood, irritability, hopelessness, or thoughts of suicide. Symptoms such as flashbacks or hypervigilance generally aren’t part of a depression diagnosis.
Dissociative episodes or states aren’t uncommon with C-PTSD, particularly in children or people who experienced abuse as children. It’s been suggested that dissociative identity may develop in response to severe, prolonged trauma similar to C-PTSD. Yet DID is rare, so it’s less likely C-PTSD will be mistaken for it.
While diagnosis can have an important role in treatment, what really matters is getting help that addresses symptoms. Working with a therapist who offers compassionate support that helps reduce or eliminate symptoms may, in the end, matter more than having a specific diagnosis.
However, sometimes diagnosis can make a difference in the type of approach a therapist uses. If one type of treatment doesn’t seem to help, don’t hesitate to mention this in therapy. A range of treatments can help improve C-PTSD symptoms.
Complex PTSD Treatment
Therapy for C-PTSD can take many forms, but any treatment should include an approach that specifically focuses on the trauma experienced. The following treatments are known to have benefit in PTSD and C-PTSD treatment:
Some professionals recommend residential treatment to address severe symptoms, especially in the beginning of treatment. But this may not always be necessary. Sometimes, it simply isn’t possible.
In any case, forming a strong therapeutic bond is essential for healing to take place. People living with C-PTSD often struggle with trust issues. Learning to trust a safe and caring professional, such as a therapist, can be an important first step toward building trust in other relationships.
Another key component of C-PTSD treatment involves working to regain a sense of self. The experience of repeated trauma can damage both self-esteem and self-identity. It may also affect personal values and goals. Therapy can provide space to:
- Reconnect with the self
- Overcome distorted beliefs and self-blame
- Explore strategies to break out of self-isolation
- Work through thoughts of revenge
- Address any unhealthy relationship ideas that develop after long-term abuse
While some medications can help address certain symptoms that occur with C-PTSD, it’s important to note medication doesn’t address the condition itself. It can only help relieve symptoms such as depression or anxiety. A care provider might recommend medication to help relieve distress that’s so severe it makes therapy difficult.
Coping with C-PTSD
The only certain way to improve C-PTSD is to address symptoms in therapy with the help of a trained professional. But alongside therapy, some self-care and self-help strategies may help reduce distress and improve quality of life.
It can help to talk about feelings and experiences that occur with C-PTSD in a safe space with other people who’ve experienced something similar. Try connecting with an in-person or internet-based support group, or ask your therapist to recommend one.
It may seem difficult to get involved in everyday activities, such as school or work, but maintaining a regular routine can help promote feelings of normalcy and stability in life. Similarly, withdrawal and avoidance may seem like good ways to avoid pain or broken trust, but healthy, positive relationships can encourage healing.
Music, art, or other creative hobbies can also serve as useful ways of redirecting anger, fear, and other emotional distress.
As the mind and body support each other, taking care of physical health can also promote emotional healing. Maintaining physical wellness might include:
- Eating regular, balanced meals
- Getting enough sleep
- Making time for physical activity
- Spending time outside in natural settings
It may take time to find the right coping strategies, but continuing to practice the things that work can lead to recovery.
Any of the empathic therapists in our directory can offer compassionate guidance and support in a safe space. Reach out today.
References:
- Böttche, M., Ehring, T., Krüger-Gottschalk, A., Rau, H., Schäfer, I., Schellong, J., Dyer, A., & Knaevelsrud, C. (2018, September 7). Testing the ICD-11 proposal for complex PTSD in trauma-exposed adults: Factor structure and symptom profiles. European Journal of Psychotraumatology, 9(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136389
- Complex PTSD. (2018, September 27). National Health Service. Retrieved from https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/complex
- Complex PTSD symptoms, behavior, and treatment. (n.d.). Retrieved from https://www.bridgestorecovery.com/post-traumatic-stress-disorder/complex-ptsd-symptoms-behavior-and-treatment
- Dissociative identity disorder. (2016, April 20). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder
- Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014, September 15). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165723
- Ford, J. D., & Courtois, C. A. (2014, July 9). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotional Dysregulation, 1(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579513
- Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018, March 22). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World Journal of Psychiatry, 8(1), 12-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862650
- Rosenfield, P. J., Stratyner, A., Tufekcioglu, S., Karabell, S., McKelvey, J., & Litt, L. (2018). Complex PTSD in ICD-11: A case report on a new diagnosis. Journal of Psychiatric Practice, 24(5), 364-370. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30427825
- Symptoms of PTSD. (n.d.). Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/symptoms
For those of us who have sought treatment for the symptoms of complex post-traumatic stress disorder, here at CPTSD Foundation, know how difficult it is to find a therapist trained to treat us. In fact, in the United States, finding a therapist specifically for CPTSD is exceedingly arduous.
This set of articles will explore the mental health disparities displayed in finding help for one of the nation’s most significant and fastest-growing mental health disorders.
Attempting to Find Treatment
We have already discussed the futility of searching Google to find a specialist in CPSD, what about the other resources out there to find a therapist.
There are dozens of websites, including the site for the Substance Abuse and Mental Health Service Administration (SAMHSA). However, most, if not all, of these sites do not search for complex post-traumatic stress disorder. Instead, they may search for therapists who are trauma-informed or treat post-traumatic stress disorder instead.
Finding a therapist who is trauma-informed or treats PTSD is enormously easier than searching for someone who treats CPTSD specifically. Psychology Today has its own search program to help one find a therapist that treats PTSD and is trauma-informed.
Trauma-informed care (TIFC) done by a trained therapist offers an approach to understanding the entire person who is seeking treatment. Since trauma affects one’s sense of self and their beliefs about the world, TIFC serves to directly challenge the assumptions that a trauma victim may have about themselves and others.
The therapist who is trained in trauma-informed care will strive to aid their client in recognizing how the events changed how they see themselves but also fights not to retraumatize the person seeking treatment.
The Differences in Treatment
So far, the treatment for complex post-traumatic stress disorder and post-traumatic stress disorder are strikingly the same.
The treatment options commonly adopted for the care of post-traumatic stress disorder include trauma-focused psychotherapies, including cognitive processing therapy (CPT) and prolonged exposure (PE).
Cognitive processing therapy teaches trauma victims to reframe their negative thoughts about what happened during the traumatic event. CPT involves victims talking with a therapist about their negative thoughts and doing short writing assignments to change the story of what happened to them.
Prolonged exposure therapy (PE) teaches victims of trauma living with PTSD to gain control by talking about the trauma in treatment. During therapy, the client will be encouraged to go ahead and do the things they have avoided. This intentional exposure to triggers will desensitize the brain of victims, calming the fight/flight/freeze response.
To treat complex post-traumatic stress disorder, therapists often take a drastically different approach. They may use cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing therapy (EMDR).
Cognitive-behavioral therapy involves talking to a therapist who will help steer one away from the traumatic events in the past. They will then replace those memories with new methods of thinking to help the client navigate their way through the trauma to health.
EMDR is a treatment option that is available for both CPTSD and PTSD. Eye movement desensitization and reprocessing therapy help people who live with the diagnosis of CPTSD by using the movements of their eyes to process and deal with the emotions and flashbacks that occur during treatment.
Using EMDR involves remembering the trauma while paying close attention to a back and forth movement of fingers or a repetitive sound. This combination of remembering and movement somehow has been found to desensitize the brain to the trauma of the past.
Doing a Google Search
Like many of us who live with the effects of CPTSD on our lives, you have probably conducted a search on Google to try and find a therapist. When you do carry out a search for a CPTSD trained therapist, one is met with a long list of ads for therapists with treatment options for post-traumatic stress disorder.
There are distinct differences between complex post-traumatic stress disorder and post-traumatic stress disorder, such as the following.
Post-traumatic stress disorder is caused by a single event such as a natural disaster, a terrorist attack, or a rape.
Unlike PTSD, Complex post-traumatic stress disorder is caused by a series of brutal, traumatic events that may last decades. These traumatic events may include:
- Emotional abuse
- Neglect
- Sexual abuse
- Mental abuse
- Human trafficking
- Physical abuse
- Domestic violence
- Being a prisoner of war
- Surviving a concentration or internment camp
- Living in a war zone
The symptomology of each of these chronic mental health disorders is also different. While some do overlap, the difference between the two disorders is striking.
A few of the host of symptoms of PTSD:
- Intrusive and distressing memories of the traumatic event
- Intense distress when triggered by a similar event to the traumatic event
- Persistent and exaggerated negative expectations about oneself or the world
- Have distorted blame of self or others for the consequences or cause of a traumatic event
- Persistent anger, shame, horror, and guilt
A few of the host of symptoms of CPTSD:
- Difficulty regulating emotions especially rage
- Losing memories of the trauma
- Depression
- Suicidal thoughts or actions
- Feeling ashamed
- Having difficulty forming or maintaining relationships
The list above contains only a few of the myriad of symptoms of both post-traumatic stress disorder and complex post-traumatic stress disorder.
As one can see, many of the symptoms of post-traumatic stress disorder are more outwardly focused while the symptoms of complex post-traumatic stress disorder are focused inward.
Follow the Money
The reason behind this difficulty in even finding a listing for a therapist in the United States who treat complex post-traumatic stress disorder is that it is not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
The DSM-5 is the bible, published by the American Psychological Association, that all therapists follow to diagnose and treat mental health disorders. It is also, unfortunately, where therapists get their diagnosis codes for payment from insurance companies, Medicare, and Medicaid.
This lack of listing in this crucial reference for therapists means that therapists will not get paid by insurances if they treat CPTSD. All the more reason to lobby the American Psychological Association to include complex post-traumatic stress disorder under its own heading.
A Call To Action
Are you a survivor or someone who loves a survivor and cannot find a therapist who treats complex post-traumatic stress disorder? Please, contact CPTSD Foundation. We have a staff of volunteers who have been compiling a list of providers who treat CPTSD.
Are you a therapist who treats CPTSD? Please, consider dropping us a line to add you to our growing list of providers. You would not only get aid in finding clients but also you would be helping someone find the peace they deserve.
If you or a loved one are living in the despair and isolation that comes with complex post-traumatic stress disorder, please, come to us for help. CPTSD Foundation offers a wide range of services including:
All our services are reasonably priced, and some are even free. So, to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it, sign-up, we will be glad to help you. If you cannot afford to pay go to www.cptsdfoundation.org/scholarship to apply for aid. We only wish to serve you.
References:
Harris, M. & Fallot, R. D. (Eds.) (2001). Using Trauma Theory to Design Service Systems. New Directions for Mental Health Services. San Francisco: Jossey-Bass.
Substance Abuse and Mental Health Services Administration (2014). A Treatment Improvement Protocol: Trauma-Informed Care in Behavioral Health Services, Tip 57. U.S. Department of Health and Human Services, 14-4816.
My name is Shirley Davis and I am a freelance writer with over 40-years- experience writing short stories and poetry. Living as I do among the corn and bean fields of Illinois (USA), working from home using the Internet has become the best way to communicate with the world. My interests are wide and varied. I love any kind of science and read several research papers per week to satisfy my curiosity. I have earned an Associate Degree in Psychology and enjoy writing books on the subjects that most interest me.
