Complex Post-Traumatic Stress Disorder
“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.” This quote by Laurell K. Hamilton illustrates that invisible, emotional pain can continue to weigh heavily on someone even after physical wounds have healed, which is often the nature and psychological impact of trauma. According to this quote by the National Institute of Mental Health, approximately half of Americans will experience a traumatic event, and many of these individuals will develop Post-Traumatic Stress Disorder (PTSD).
Trauma
Trauma is characterized by an individual’s response to a deeply distressing or life-threatening event that causes psychological harm and impacts their ability to cope. Symptoms of trauma include feeling fear, sadness, anger, shame, or even numbness and having difficulty with cognitive functioning such as impaired memory, poor executive functioning, and decreased ability to process information or regulate emotion. People who have trauma may also experience intrusive flashbacks, intense nightmares, or debilitating anxiety in addition to hypervigilance, appetite changes, and insomnia. Types of trauma include acute, chronic, complex, and secondary trauma. While acute trauma develops from a singular stressful event, chronic trauma and complex trauma stem from prolonged exposure to harmful events or multiple, varied traumatic events. Secondary trauma, however, involves indirectly being exposed to trauma through witnessing, hearing about, or supporting someone else’s firsthand experience.
PTSD VS CPTSD
Within the PTSD umbrella, there are two main subtypes: non-complex PTSD and complex PTSD (C-PTSD). While C-PTSD is not formally in the current Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V), C-PTSD is a kind of PTSD that forms from prolonged exposure to trauma such as childhood abuse, domestic violence, or ongoing neglect, captivity, or control. C-PTSD includes symptoms such as emotional dysregulation, interpersonal relationship struggles, and negative self-concept. The main difference between PTSD and C-PTSD is that PTSD is caused by an isolated event whereas C-PTSD results from compounded, multi-layered trauma that may interact with one another and can often stem from childhood experiences where a person’s identity and worldview are still being formed.
Trauma-Informed Care
The key to trauma-informed care is shifting away from attitudes that blame and retraumatize victims and instead moving towards compassionate understanding and collaboration that creates safety, cultivates a sense of trust, and empowers survivors. Navigating trauma in a therapeutic environment starts with developing a foundation of safety and trust where individuals feel they are in the driver’s seat and can, therefore, opt in or opt out of any techniques and interventions, thus giving choice and autonomy to one’s treatment. Coping tools such as mindfulness techniques, safe place visualization, distress tolerance skills, and emotion regulation exercises can be effective in soothing the nervous system in order to avoid retraumatization while also engaging in safe, culturally aware practices and pacing when exploring trauma narratives. Evidence-based modalities for treating trauma include Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT), Somatic Experiencing, Internal Family Systems (IFS), Dialectical Behavior Therapy (DBT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). If you or someone you know has experienced trauma, consider reaching out to Embrace Therapy or another mental health professional for resources and support.
