What is the Difference Between PTSD and C-PTSD?
Updated: Mar 18, 2021
By Karolina Christopher
Clinical labels related to trauma and post-traumatic stress can be confusing. Find out more about different types of trauma and how they relate to symptoms of PTSD and C-PTSD.
Sophie* did not think that her life had been anything out of the ordinary. Things hadn’t always been easy, but she told herself that it probably wasn’t that bad and that others had it worse. It wasn’t until she came to therapy to get help with her panic attacks that she began to reflect on some events that had happened while she was in secondary school.
With her therapist’s help, Sophie was able to recognise how her step-dad’s harsh expectations of her had led to excessive worry and debilitating perfectionism.
* Names and details have been changed.
What is the Definition of Trauma?
The word trauma is no longer unusual in everyday conversation, yet it can sound big and scary. You might also have heard it used all too readily to describe a mishap: ‘I thought I’d forgotten the tea bags – I was traumatised!’
Perhaps you believe that trauma must be caused by some extreme event – one that you haven’t experienced. In therapy, many people are surprised to learn that the difficulties they struggle with may be symptoms of PTSD (post-traumatic stress disorder) or C-PTSD (complex PTSD). So, what’s the lowdown?
Put simply, a trauma is a frightening or distressing event that surpasses our ability to cope. As you probably know, when we are faced with stress, our nervous system activates the fight/flight system (there are further aspects to this response, but let’s keep it simple for now).
This survival mechanism, fine-tuned by evolution to keep us safe, is automatic and happens in milliseconds. In the wild, for example, animals depend on it when they need to fight off a rival or flee from a predator. Once the danger has passed, calm ensues as the animal’s physiology returns to its resting state.
The brilliant mind and my late psychology lecturer, Elizabeth Sykes, liked pointing out that ‘humans, too, belong to the animal kingdom!’ – that is to say, our initial alarm response functions in pretty much the same way.
On the other hand, human brains are a great deal more complex, which makes us more susceptible to post-traumatic stress.
Occasional stress is a normal part of life and without it, we might not get much done! However, stress caused by life-threatening or distressing events can cause long-lasting negative effects.
What Is the Difference Between PTSD and C-PTSD?
The difference between PTSD and C-PTSD is not completely clear-cut, but as a guiding principle it can be said that PTSD stems from a one-off traumatic event or experience, while C-PTSD is the result of prolonged or repeated exposure.
So, for example, someone may develop PTSD after surviving a life-threatening illness or accident, sexual assault, or a natural disaster. Symptoms of PTSD can also follow an experience of being a victim of crime, witnessing violence, or having a difficult childbirth,
By contrast, C-PTSD typically stems from trauma in the early attachment relationship or other close relationship; therefore, it is also known as ‘developmental trauma,’ ‘early relational trauma,’ or ‘interpersonal trauma.’
In the case of early relational trauma, symptoms come from living through a recurring trauma such as growing up in a family context that is abusive in some way, including neglect and verbal abuse.
In addition, it is now well documented that a wide range of experiences can constitute complex trauma, including bullying, infertility and pregnancy loss, and any forms of abuse including discrimination or harassment, and racism.
While early trauma may not be physically life-threatening (though it could be), it seriously undermines the child’s sense of safety, acceptance, and belonging. This can leave deep, long-lasting wounding and affect areas such as self-esteem, healthy boundaries, and emotional regulation.
It is important to note that, for a small child, loss of safety or acceptance does feel life-threatening. The abuse can be subtle, including excessive criticism or even ‘unspoken’ disapproval of the child. Complex trauma is not always easy for the sufferer to recognise as it is often embedded in the life story itself.
Many of the symptoms of PTSD and C-PTSD are similar and may include heightened anxiety, physical sensations, intrusive thoughts, difficulty concentrating, and distress when encountering reminders of the traumatic event (known as ‘triggers’). The symptoms can vary from mild to severe.
PTSD was first diagnosed in war veterans, who experienced flashbacks and other debilitating symptoms after returning from battle. One reason why people dismiss their own experience of trauma, or do not recognise it as such, is that compared to war it doesn’t seem ‘as bad.’ Remember, however, that what causes trauma is any stressor that overwhelms the nervous system to the point that we feel feel unable to cope.
There is also a lesser known trauma response known as PTED, which follows an experience of great injustice. I have written about PTED here.
Sophie’s Story in Context
Let’s now briefly return to Sophie’s story. Sophie reported that she had suffered ‘inexplicable’ panic attacks during her teenage years, but that things got better when she moved away from home.
Recently, her panic attacks had returned. Sophie had just landed her dream job, but the work atmosphere was pressured, and something about the way that her boss spoke to her leading up to a deadline seemed to trigger these attacks, which had now become debilitating.
Sophie blamed herself for not being able to cope, especially as she wanted to make a good impression in her new job.
In therapy, Sophie was able to join the dots when she reflected on how her step-dad had frequently berated her for not achieving top marks in her tests at school. He had been verbally abusive towards her and her mother over a period of several years, especially after a few drinks.
Sophie identified the ‘emotional flashbacks,’ where her boss made her feel a rush of similar feelings of fear and shame that she had experienced at home.
Understanding that her reaction was a normal response to an overwhelming situation helped Sophie take some steps towards self-care and self-compassion, and her panic attacks gradually eased.
Do People React Differently To Traumatic Events?
Not everyone is affected in the same way by a traumatic event. Everyone is different and no one person’s reaction is more valid. Suffering post-traumatic stress is not a sign of weakness, and it won't help being told to just ‘pull yourself together.’
What influences our capacity to recover from trauma is very personal and can depend on the support available to us at the time, as well as the circumstances of our wider life situation. In addition, having suffered early trauma can make us more vulnerable to adverse life events later on.
Recovery happens at a different pace for different individuals, and it is important to not put pressure on yourself or think that you ‘should’ feel better after a certain time has passed. Each person’s journey is different. There can also be a delay between the traumatic incident and the stress reaction.
What’s Next? Where To Turn For Practical Help And Support
What matters is that you get the help you need, so that you can begin to heal. Many people feel a sense of relief when they find out that their symptoms make sense and that their experiences can be understood. If you would like to learn more, you can find helpful information on the Mind website: Symptoms of PTSD | Mind and What is complex PTSD? | Mind .
You can also discuss your symptoms with your GP, who will be able to advise you of different treatments. Most importantly, don’t suffer in silence – talk to someone. If you experience any of these symptoms it is not your fault, and help is available. Even if the traumatic event happened a long time ago, it is never too late to seek help.
Many people, like Sophie, think that what they are struggling with isn’t ‘big enough’ to bring to therapy. Or, they have struggled for so long that they are resigned to things being this way. However, coming to therapy can be a first step towards feeling better.
Talking through your experiences with a trained professional can bring clarity and help you disentangle your feelings. There are also ways of dealing with the physical symptoms of trauma. I work from a trauma-informed perspective with extensive knowledge of childhood trauma and abusive relationships. If you would like to find out more, you are welcome to contact me for a free initial consultation at www.karolinachristopher.com.