Complex PTSD: What CPTSD is and How it Informs Therapy

By Spencer Goldy

Complex PTSD: What CPTSD is and How it Informs Therapy

Complex PTSD: What CPTSD is and How it Informs Therapy

What is Complex PTSD? 

    Complex PTSD or “CPTSD” is a new variation of the well-known Post-Traumatic Stress Disorder or “PTSD” diagnosis as defined by both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). As of the most recent edition of the ICD, a new diagnosis - CPTSD - was added to support the ongoing development of accurate awareness, study, and treatment of trauma. Currently, the diagnosis of CPTSD is only utilized outside of the United States because our diagnostic text, the DSM, has not been updated to include this new variant of PTSD as of yet. Nonetheless, the growing differentiation and study of CPTSD has moved it towards more broad societal awareness to better explain the ways in which when traumas occurred and/or how consistent traumas were, influences how the symptoms of PTSD can persist. 

Diagnostic Differences 

    PTSD is a disorder primarily defined by having “exposure to actual or threatened death, serious injury, or sexual violence” (American Psychiatric Association [APA], 2022). CPTSD is defined by “exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible.” (World Health Organization, 2022). The small nuance is the prolonged or repetitive nature which has been observed as being correlated with important variations in symptom presentation. In particular, complex PTSD is associated with the additions of “affect dysregulation, negative self-concept, and difficulties forming and maintaining relationships (Beckord, et. al., 2025). In essence, this means for those with CPTSD they may find it more regularly difficult to manage overwhelm resulting in extreme or atypical reactions to day to day life or people as well as a persistent sense of worthlessness or that they are somehow broken. 

CPTSD Treatment

    Treatment options for complex PTSD are widely overlapping with our current PTSD interventions. EMDR and other specialized trauma therapies continue to be effective for post-traumatic stress regardless of type. Notably however, with complex PTSD, the time it may take to prepare for and process through traumas may be extended due to the particular influence of complex trauma on affect/emotional regulation. More time than compared to PTSD may be needed to learn and reinforce emotional regulation tools and slow the process to avoid overwhelm. Another way of looking at it is that those with complex PTSD have experienced such regularity in traumatic experiences that engaging in trauma therapies may bring up many more memories and feelings than those who experienced a single traumatic event. Thus, it is important to maintain a pace that is supportive of consistent engagement with treatment without destabilizing and causing a flood of traumatic revelations in quick succession. 

What Does This Mean for Me? 

    If you are someone who is dealing with symptoms associated with trauma such as: distressing memories or dreams that are intrusive or involuntary, experiencing a trauma recur in the current moment even though it happened in the past, intense reactions (both psychological and physiological) to things that remind you of a traumatic event, avoidance of things that remind you of the event, feeling detached, have negative thoughts about yourself, feel less interested in things than you were before, have concentration issues, sleep issues, are irritable, or have a strong startle response - consider seeking out professional support to help provide a space that is safe to explore them. 

In the U.S. mental health professionals are still working off of the diagnostic text that only includes PTSD at the current time. However, working to understand the cause, consistency, and severity of such experiences can support a more individualized approach that is considerate of the nuances of trauma regardless of the specificity within a diagnosis. Since therapeutic interventions overlap between PTSD and complex PTSD, you are not without options and you can still get the care and support you need. Beyond this, due to the deepening understanding of PTSD there are also studies being conducted to look at more variations of PTSD that may be valuable in separating out. When it comes to mental health, there is constant research occurring that gives us more insight into the human brain and how different experiences influence our minds through perception and reaction. Complex PTSD is one in a long line of changing vocabulary related to mental conditions. The naming systems mean less than the actual experience of the individual needing support. The goal with these new inclusions is to have accurate knowledge and efficient pathways for treatment while maintaining the same standard of care in every case.

The Useful Nuance of CPTSD

    Complex PTSD is a new subset of PTSD diagnosis that allows for more individualization within the therapeutic setting to both study more effective treatment options and give voice to experiences that may not fit within the current diagnostic category. Through growing knowledge and building vocabulary to define these nuances, it is hoped that you may be able to find comfort in awareness, confidence in knowledge, and optimal support based on those individualized circumstances.
  
 At RAFT Counseling, we want to support you in pursuing compassionate understanding of trauma. If you or a loved one is searching for help in understanding and/or seeking treatment for PTSD simply visit our website or contact us to get connected and on the path towards wellness. 

Resources for Further Reading












 

Go Back