PTSD vs c-PTSD: what’s the difference?

Both Post-traumatic stress disorder (PTSD) and Complex PTSD (c-PTSD) occur in response to trauma.

PTSD and c-PTSD share the following symptoms:

*Intrusive memories, flashbacks and/or nightmares related to the trauma.*
*Frequent changes in mood and thinking, including feeling distant from other people and having overwhelming negative emotions . Distorted thoughts and beliefs.*
*Avoidance of people, places, situations, or thoughts related to the trauma.*
*Hyperarousal -this can look like sleeplessness, hypervigilance, angry outbursts, and difficulty concentrating.*

While the two have various overlapping symptoms, the main difference between the disorders is that PTSD is caused by a single traumatic event, whereas c-PTSD is caused by long-lasting trauma that continues repeatedly.

**Events causing PTSD include:** *isolated acts of violence, near death experience, sudden death of a loved one, a natural disaster, and war.*
**Events causing c-PTSD include:** *ongoing childhood abuse or neglect, domestic violence, verbal abuse, and sexual abuse.*

**Symptoms of c-PTSD include:**
**Cognitive distortions** - inaccurate and irrational perception of situations that manifest in intense and distorted thoughts. Examples include emotional reasoning, magical thinking, black and white thinking, catastrophizing, etc.
**Frequent emotional dysregulation** - difficulty controlling emotions. This looks like explosive anger, persistent sadness, depression, and suicidal thoughts.
**Negative self-view** - increased feelings of shame and guilt, which can lead to feeling alien from others.
**Interpersonal difficulties**- a tendency to distrust others and/or gravitate toward unhealthy relationships.
**Detachment from the trauma -** disconnecting from oneself (depersonalization) and the world around them (derealization), or suppressing and forgetting the trauma entirely.
**Identity disturbance** -losing one's core beliefs, values, and experiencing a shaky foundational sense of self.

c-PTSD and Intimacy

If you live with c-PTSD symptoms, you likely find it challenging to experience intimacy within your relationships. The psychological distress caused by c-PTSD can be a tough barrier to overcome. It can feel like the closer you are to someone, the greater the perceived threat. Your symptoms may manifest as emotional or relational avoidance, lack of trust, and/or a cycle of toxic relationships that resemble the past trauma at its roots.

One way to heal from your trauma and build trust in your relationships is to establish healthier coping mechanisms. The following is a chain link analysis exercise that will help you become more cognizant of not only your triggers and trauma responses, but also how they impact your relationship.

Identifying Triggers

Trigger Chain Link Analysis

Follow each step to map out your specific triggers, emotional states, behaviors, symptoms, and new behavior patterns. Let this exercise serve as a launching pad for new and improved habits that can eventually replace your trauma responses.

Step 1: Write down at least one trigger you experience in your relationship. Here are a few examples to get you going.

**Examples:**
*→Not receiving a text within two hours of sending a text*
*→Receiving negative feedback*
*→Going on a first date*

Step 2: Connect the trigger to an emotional state + behavior pattern. Think back to previous conflicts regarding this trigger. What thoughts did you have? How did you feel? How did you react?

**Examples:**
When not receiving a text within 2 hours of sending a text → **you felt abandoned and rejected** (emotional state), which led to **avoiding and giving the silent treatment** (behavior).
When receiving negative feedback → you dissociated from your body (emotional state), which led to suppressing your feelings and lashing out (behavior).
When going on a first date → **you felt anxious and paranoid** (emotional state), which led to **performing and mirroring the other person’s beliefs, interests, and lifestyle in order to avoid rejection** (behavior).

Step 3: Connect the emotional state + behavior pattern → to the c-PTSD symptom(s) that fits.

**Examples:**
You felt abandoned and rejected (emotional state), which led to avoidance/silent treatment (behavior) → **You experienced cognitive distortion + interpersonal difficulty** (symptoms).
You felt dissociated from your body (emotional state), which led to suppressing your emotions and lashing out (behavior). → **You experienced detachment from the trauma + emotional dysregulation** (symptoms).
You felt anxious and paranoid (emotional state), which led to performing/mirroring (behavior). → **You experienced identity disturbance** (symptom).

Step 4: Write out new behavioral patterns in place of your usual trauma response. Don’t pressure yourself to implement the new behavior right away. Remember this exercise is a launching pad meant to map out alternative and healthy habits to practice in the future.

**Example:**
You used to avoid and give the silent treatment (behavior) → because you experienced cognitive distortion + interpersonal difficulty (symptoms). →Now you will choose to cool off before reaching out again -listen to a podcast, exercise, play video games, text a friend, etc. (new behavior pattern).
You used to suppress your emotions and lash out (behavior) →because you experienced detachment from the trauma and emotional dysregulation (symptoms). → Now you will choose to **step away and return to the conversation when grounded** (new behavior pattern).
You used to perform and mirror in order to avoid rejection (behavior) → because you experienced identity disturbance (symptom). →Now you will choose to **determine 5 core values and journal about it before meeting someone in person** (new behavior pattern).

View the full chain link analysis below for an example of how to map out triggers, unwanted behavior patterns, and the new habits you’ll form in the future.