Trauma disrupts the brain and nervous system’s capacity to process and integrate memories effectively. When trauma goes unaddressed, it can turn into Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder (C-PTSD).
Both share similar symptoms, such as intrusive memories, flashbacks, and avoidance of trauma; however, complex trauma often stems from ongoing trauma and causes deep identity issues, negative self-esteem, and attachment-related relationship problems.
Understanding the difference between the two is essential for effective and personalized treatment.
What is PTSD?
PTSD is a mental health disorder that develops through interactions between the brain, the body’s stress response systems, and an individual’s environment. Trauma activates brain circuits related to fear, emotional regulation, impulse control, and memory [1]. Common symptoms include flashbacks, nightmares, and avoidance of people, places, or things that remind them of the trauma.
PTSD affects nearly 7% of Americans and often comes from a single, isolated experience of trauma. With PTSD, the brain understands that trauma has stopped and does not internalize the trauma as part of their core identity, such as with complex trauma [2].
Experiences that can lead to PTSD include:
- Natural Disaster
- School Shooting
- Serving in Combat
- Car Accident
- Medical Injury
- Physical Assault (isolated incident)
- Rape (isolated incident)
- Witnessing murder, assault, or violence and being unable to help (e.g., sometimes known as “moral injury” and common among first responders)
What is C-PTSD?
CPTSD or complex trauma comes from long-lasting, ongoing trauma that often happened during childhood or later development, or at the hands of someone you trust. Complex trauma often arises when people can’t escape an unsafe or harmful situation. They may feel like they have fully lost control of their lives, bodies, autonomy, and ability to regulate.
To cope with these feelings, nearly 50% of people with C-PTSD report dissociating as a way to escape reality. Sometimes this results in co-occurring conditions such as dissociative identity disorder (DID), where multiple personalities called “alters” are present. However, this can lead to emotional numbness and an impaired ability to integrate thoughts, memories, and experiences. Complex trauma is also linked to higher rates of isolation, addiction, psychosis, and poor physical health outcomes [3][4].
Although some symptoms of PTSD and CPTSD are similar, complex trauma affects our ability to relate, emotionally regulate, and can shape entire identities. Experiences that can lead to C-PTSD include:
- Childhood physical or sexual abuse destroys the ability to trust and build safe or secure attachments
- Ongoing childhood neglect, possibly if parents struggle with addiction and mental illness
- Domestic abuse or assault from a trusted person or loved one (e.g., partner, family member, mentor)
- Workplace harassment, discrimination, or trauma
- Kidnapping, torture, or living in a combat zone
- Chronic illness, ongoing medical trauma
- Sexual exploitation, human trafficking, or smuggling
- Religious or spiritual abuse (e.g., cults that control and manipulate through fear, or physical punishment)
CPTSD vs PTSD: Key Differences
| PTSD vs CPTSD | PTSD | CPTSD |
| Cause | Usually, a single, isolated event (e.g., school shooting) | Prolonged or repeated trauma (e.g., childhood abuse) |
| Core Symptoms | Flashbacks, nightmares, avoidance of trauma, hyperarousal | All PTSD symptoms plus difficulty regulating emotions, negative self-perception, and problems maintaining relationships |
| Additional Symptoms | Intrusive symptoms of “re-experiencing” the one-time event | Dissociation, detachment, emotional numbing, loss of meaning, existential depression |
| Treatment Approaches | Trauma-Focused CBT, EMDR, medication if needed, wellness activities for emotional healing (e.g., dance, yoga, massage) | Similar to PTSD, but may require longer or more specialized approaches. DBT, ketamine therapy, and internal family systems (IFS) can be helpful |
How Diagnosis Can Determine The Effectiveness of Treatment
Although both disorders share similar therapeutic approaches, complex trauma often requires additional, long-term interventions and more integration (attachment therapy, medication, peer support).
Complex trauma has additional symptoms that are often addressed through interpersonal therapy or DBT skill training, such as emotional regulation, mindfulness, addressing feelings of shame, and building safe relationships.
Additionally, those with CPTSD may have more trouble trusting their therapist, requiring extra preparation and effort during the rapport-building stage.
Treatment Approaches for PTSD and CPTSD
Trauma-focused treatment programs focusing on elements such as safety, trust, empowerment, collaboration, and transparency are essential to helping those recover from PTSD and CPTSD.
Data also show that trauma-focused therapies such as Eye Movement Desensitization and Reprocessing (EMDR), Trauma-Focused CBT, and Prolonged Exposure Therapy can significantly reduce symptoms of both PTSD and CPTSD [5].
CPTSD treatment also addresses trauma at a physical level through somatic integration, movement therapy, yoga, and activities for emotional expression. “The body keeps the score: If the memory of trauma is encoded in our senses, in muscle tension, and in anxiety, then the body must also be involved in the healing process.”—Dr. van der Kolk
Some of the ways we treat trauma at Maple Mountain include:
- EMDR and Accelerated Resolution Therapy are two promising treatments for helping trauma survivors process traumatic memories and reduce emotional distress via bilateral stimulation of the brain.
- Creative Expression with therapies like dance, music, and art helps convey feelings that can be difficult to put into words.
- Somatic therapy and experiences such as massage, reiki, and acupuncture can help calm the nervous system and release built-up tension and trauma stored deep in the body.
- Activities for healthy emotional release and fostering social connections include rage rooms, car bashing, hiking, snow tubing, rock climbing, and jiu-jitsu.
Transform Trauma Into Strength and Find Balance at Maple Mountain
At Maple Mountain Mental Health and Wellness, we are committed to following the principles of trauma-informed care to address the physical, mental, and spiritual needs of our clients. Healing doesn’t just mean symptom management; it involves mental processing and somatic integration.
Through a blend of evidence-based therapies, including EMDR, Accelerated Resolution Therapy, and Somatic Experience, combined with integrated wellness activities such as ceramics, painting, car bashing, and rage rooms, we work with you to address the impacts of unprocessed trauma and achieve lasting emotional growth and well-being.
“Trauma robs you of the feeling that you are in charge of yourself. The challenge of recovery is to reestablish ownership of your body and your mind — of your self.” —Dr. van der Kolk
Contact our admissions team today to regain control and begin your healing journey.
Sources
[1] Bessel, Van der Kolk. 2014. The Body Keeps The Score.
[2] National Institute on Mental Health. Post-Traumatic Stress Disorder (PTSD).
[3] Edwards, K. et al. (2022). Trauma-Related Dissociation and the Dissociative Disorders: Neglected Symptoms with Severe Public Health Consequences. Delaware journal of public health, 8(2), 78–84.
[4] Costello, J. et al. (2018). Association of Childhood Trauma Exposure With Adult Psychiatric Disorders and Functional Outcomes. JAMA Network Open, 1(7), e184493.
[5] Ross, A. et al. (2021). A Review of PTSD and Current Treatment Strategies. Missouri medicine, 118(6), 546–551.