Early on in my work, I saw a lot of PTSD right off the bat and it was something I was trained heavily to work with. PTSD is, like most things, typically presented in layers. The first layer is the traumatic event and then there are corresponding belief systems and cyclical reinforcement of those beliefs. There may also be a physical component, where the nervous system remains in a heightened state if the trauma remains unaddressed because your body stores the memory of the trauma. Treating this disorder was like a lasagna that I was proficient at deconstructing. More recently, I am getting a closer glimpse of Complex PTSD and want to share a side-by-side comparison.
First, I created this awesome visual about those layers and it is very relevant when we are talking about the "single trauma PTSD":
When we are talking Complex PTSD, this whole thing looks quite a bit different. Imagine if you threw 20 more boxes on this couch and then wrapped them in a tangle of thorny rose bushes. I want to break this concept down a little for people who are either struggling with Complex PTSD or perhaps just want to understand what it's all about and how I see it in my work with trauma healing.
By definition: Post-Traumatic Stress Disorder is a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock, typically involving disturbance of sleep and constant vivid recall of the experience, with dulled responses to others and to the outside world.
Many people view PTSD as only resulting from of being a combat veteran or severe abuse survivor. While I have certainly seen it in such cases, I see it most with childhood trauma. Let's dive in to that definition a little so we can have a better understanding of who may actually be included in this category. What if disturbance of sleep doesn't mean horrific nightmares? What if it also means having trouble falling asleep, turning off the mind, staying asleep, or feeling rested upon waking. What if a dulled response to others and the outside world also means being generally withdrawn, dissociating or having social anxiety? And what if the constant recall of the experience is something that happens in more of a metaphorical sense - like we keep attracting abusive men into our life to mimic the abuse we received from our father?
Are we starting to see how many people this can encompass?
When I put my hands on someone I can see the impact of PTSD. I can see the nervous system lit up like a Christmas tree and how it affects every inch of the body and mind. In most cases, this is fairly simple to treat if the person is in a position to dive in. In no specific order, we identify the trauma and belief systems and release the stored memories from the body. We work to deprogram those beliefs through fairly straight forward exercises designed to bring acknowledgement and acceptance to the traumatic event. We work with the body to show it that it is a safe through Cranioascral Therapy and assist it in releasing stored memories and emotions. Finally, we go back to the trauma to unpack it, often through Psilocybin Ceremony or Shamanic Journeying. I would say that the treatment in total can take 6 months depending on where the person is in their process, but sometimes it only takes weeks. In my book, that's a generous amount of time that is also way shorter than many Western therapy techniques.
Complex PTSD (CPTSD)
By definition: Complex PTSD is a condition where you experience some symptoms of PTSD along with some additional symptoms, such as: difficulty controlling your emotions. feeling very hostile or distrustful towards the world.
So we have our trauma lasagna, only this time it's 50 lasagnas and they are all crammed on to one pan.
With CPTSD, you don't have just one trauma, you have a recurring trauma, as well as many belief systems and coping mechanisms created to survive the ongoing incidents. This treatment is much more complex, involving peeling back all the layers of the trauma and systems around it. Which layer gets peeled back first is very unique to the individual and where they are at this point in their life.
Examples of Presentation:
PTSD: You are 4 years old and you witness another child being brutally spanked by their parent. I know that this is normalized by our society, but trust me when I tell you that to a child, this is traumatic AF to all parties involved. The horror and panic you experience as this 4 year old cannot be fully processed at the time because you are too young to do so. Instead, you store those emotions in your body and you may block out the event from your conscious mind. Since you can't reconcile it in your immature mind, it is often best locked in a closet of your mind palace. Fast forward twenty years. As an adult, you have phantom shoulder pain and this core belief that you deserve to be punished. There is no known cause for the shoulder pain, but your doctors tell you it's stress or maybe a disc issue in your upper back - so you write it off as the general pain of adulthood and get a prescription. Seemingly separate is your constant creation of circumstances in your life and relationships that cause you to feel like you are being punished. The truth is that deep down, you think you deserve to be punished and so you continue to create/manifest those events to reinforce your belief. At some point, you realize that you have had enough of the self-sabotaging and decide to do work on your core beliefs through inner child work. The aforementioned events come up through doing this work and the memories of that event come forward. The unprocessed emotions flow free and the shoulder pain disappears. You have a new perspective on why you've created the circumstances you have in your life and you can move forward with the knowledge, forever changed. Sounds amazing, doesn't it? Well, it is.
CPTSD: You are that same 4 year old child, but these events continue to happen until you are 7. As a reminder, children are master internalizers & empathizers, so even if the trauma isn't occurring directly to them, they often experience it as if it is and in turn use it to create their own belief systems about the world. So you see this child being hit regularly. Not only is every single occurance something you cannot reconcile in your mind, but you also see that there is no consistency (that you understand) for which these occurrences happen, making them more confusing. You may even end up with three years of repressed memories as a result. You form multiple core beliefs based off these events - "I deserve to be punished", "The world is not a safe place", "If I stay quiet and withdrawn I will not be noticed", and "I don't do anything right". You naturally withdraw from the touch of your own parents because adults aren't safe. As a result of this withdrawing, you don't allow people to show you that you are loved and then the beliefs of "I am not lovable" or "something is wrong with me" are created. As an adult you may be triggered or dive into self-sabotage when you encounter a partner who displays love in ways you don't think you deserve. Now don't forget, each of these core beliefs also lead us to make decisions in our life based on those beliefs so that we subconsciously reinforce them as truth. For Example: I think I am not lovable. Well then, I will subconsciously do these shitty things to my partner to prove that they can't love me because I think I am unlovable. Do you see how quickly this can become very complex and multi-layered? Before you know it, you are riddled in physical pain from all of the unprocessed emotions that have been stored for later and your life feels like a black hole. To some this can present as treatment resistant depression or an anxiety disorder, and to others it could be general hopelessness and a lack of fulfilment in life. All of these things start with trauma and they are healed through confronting and releasing those traumas.
I'll say it again, 50 lasagnas layered into one pan.
The treatment for CPTSD is the same, but can involve a bit more time and patience. Sometimes we have 10 layers of core beliefs and adult trauma we need to get through before we even touch the childhood stuff - and sometimes we go right to it! There is no one way to do it because everyone is different and therefor healing must look different as well.
But I will tell you one thing, and it's important. Both of these "disorders" can be healed with the right practitioner and the willingness to do the work.