Recently, a colleague and mentor of mine, Arielle Schwartz, PhD, published a much-needed workbook for complex post-traumatic stress disorder (C-PTSD), an often-misunderstood diagnosis. In fact, it’s not yet an official diagnosis, as it is not listed in the Diagnostic and Statistical Manual for Mental Disorders. In this blog, I will talk briefly about the characteristics of C-PTSD and some of the methods for treatment.
PTSD or C-PTSD?
Thanks to mental-health advocacy, particularly for armed services veterans, post-traumatic stress disorder is becoming a more familiar term in our lexicon. While PTSD and C-PTSD have some similarities, they are also distinct diagnoses. PTSD typically refers to symptoms that result from a single, identifiable incident while C-PTSD results from lengthy exposure to traumatic stress. This type of traumatic stress, which typically is experienced during their childhood, can take the form of chronic physical, sexual, or verbal abuse; neglect; abandonment; or more subtle forms of persisting stress, such as being raised by a parent with a mental disorder or even being raised in poverty.
Of course, PTSD and C-PTSD share some common symptoms:
Experiencing a sense of threat from neutral environmental cues
Avoiding situations that trigger the emotional impact of the trauma (this strategy often appears as depressive symptoms)
Invasive memories, images, and thoughts related to the trauma
However, C-PTSD has some symptoms that are not typically present in PTSD:
Pervasive negative beliefs about oneself or about the universe (for example, “I am a bad person,” “I don’t deserve love,” or “people want to hurt me”)
Greater difficulties with interpersonal interactions, which may include hypervigilance in reading others cues to continually assess for danger
An experience of shame about the causes of the C-PTSD
Treatment for C-PTSD
In her book, The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole, Dr. Schwartz outlines several modalities that have proven effective for C-PTSD:
Cognitive-Behavioral Therapy (CBT): helps clients develop awareness of thoughts and feelings connected to the trauma and works to create positive beliefs to replace the negative beliefs that resulted from the trauma
Dialectical Behavior Therapy (DBT): designed to assist clients in developing skills in mindfulness, emotional regulation, and distress tolerance, as well as skills to become more effective in interpersonal relationships, such as learning how to address conflict
Eye Movement Desensitization and Reprocessing (EMDR) Therapy: incorporates several phases to help clients develop resources to successfully process through the traumatic memories in order to reduce the amount of emotional activation caused by the memories
Somatic therapies: body-based modalities emphasize attention to sensations in the body, which can allow the body to sequence in a way that releases tension patterns associated with the trauma
While any of these approaches may be helpful, it’s important to find the approach that feels most helpful to you. Often, therapists who work with C-PTSD will draw from several therapeutic modalities in order to facilitate clients’ healing.