Complex PTSD--The Result of Long-Term Trauma

Complex PTSD (posttraumatic stress disorder) results from experiencing prolonged trauma, over which the person has little or no control, and from which escape seems hopeless. Many times, complex PTSD affects those who suffered ongoing physical, emotional, or sexual abuse during childhood and victims of long-term domestic violence.

Causes of Complex PTSD

Any long-term trauma that causes severe interpersonal stress can result in developing complex PTSD. Typically, it involves circumstances where the victim has (or perceives that there is) little chance of escape, such as:

• domestic violence
• childhood physical, sexual, or emotional abuse
• kidnapping
• enslavement, enforced labor, or sex trafficking
• long-term imprisonment and torture
• exposure to long-term crisis situations
• long-term objectification

The Difference Between Complex PTSD and Simple PTSD

PTSD and complex PTSD are very similar, but they do differ in cause, severity, and some symptoms. PTSD can result from experiencing one traumatic event, while complex PTSD results from ongoing trauma and extreme stress. For example, you can consider that a soldier may suffer from PTSD due to exposure to the intense battle of war, while a soldier who was held as a prisoner of war for an extended amount of time may exhibit the additional symptoms of complex PTSD (What Is Combat PTSD?).

Similarly, a woman who was a victim of a rape may develop PTSD, while a woman forced into sex trafficking for a period of time may suffer from complex PTSD.

This isn't to say the soldier of a single battle or the survivor of a single rape cannot develop complex PTSD symptoms, only that simple PTSD is the more likely diagnosis.

Characteristics of Complex PTSD

Complex PTSD can cause people to feel like their emotions are out of control like they may have a breakdown at any moment. They often feel unloved and unworthy of positive feelings from others toward themselves--that they can never be good enough. They may have feelings of being overwhelmed like they cannot possibly handle even one more thing. Additionally, they may feel like they are just waiting for the other shoe to drop, even when things are going well.

Other common characteristics include:

• Rage: This can be turned inward causing things like eating disorders, substance abuse, depression, promiscuity, and codependence; or turned outward causing violence, destruction of property, and being overly controlling.
• Avoidance: A person with complex PTSD may withdraw from relationships with others to lessen the chances of rejection, criticism, and exposure.
• Catastrophizing: This is the practice of assuming the worst case scenario and feeling like even the most minor problems are catastrophic events.
• Denial: A person may believe that a traumatic event or memory didn't happen, when in fact, it did.
• Dependency: This it the reliance on someone else for a person's own personal and emotional well-being.
• Fear of Abandonment: This can be the unsubstantiated feeling that one is in danger of being rejected or replaced.
• Hypervigilance in relationships: This manifests when a person maintains an unhealthy level of interest in the behaviors, comments, and thoughts of others.
• Learned helplessness: This happens when someone believes that they have no control over a situation, even when they do.
• Low self-esteem: This is when a person has a self-perception which is negative and inconsistent with reality.
• Self-loathing: This is an extreme hatred of one's self.

Complex PTSD Treatment

Like PTSD, complex PTSD is usually treated with a combination of therapy and medication. However, the most important aspect of treatment for complex PTSD is that the sufferer is removed and protected from the source of the abuse or trauma. Therapy for complex PTSD is often more long-term and intensive than it is for PTSD, and may include more childhood work if that is when the trauma occurred.

The good news is, complex PTSD is treatable and manageable. Many people who have experienced horrible, long-lasting trauma, have been able to go on and lead happy and fulfilling lives once receiving proper treatment. The key is asking for and accepting the help needed to heal.

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