Complex Post Traumatic Stress Disorder (CPTSD)

Many traumatic events (e.g., car accidents, natural disasters, etc.) are of time-limited duration. However, in some cases Survivors experience multiple traumas, that continue or is repeated over many months or years at a time. The current PTSD diagnosis does not fully capture the severe psychological harm that occurs with prolonged, repeated trauma. People who experience chronic trauma often report additional symptoms alongside formal PTSD symptoms, such as changes in their self-concept and the way they adapt to stressful events.

Complex Post Traumatic Stress Disorder (CPTSD) differs from Post Traumatic Stress Disorder (PTSD) in that a traumatic event occurs multiple times over an extended period of time. Examples of CPTSD include:

*Concentration camps
*Prisoner of War camps
*Prostitution brothels
*Long-term domestic violence
*Long-term child physical abuse
*Long-term child sexual abuse
*Organized child exploitation rings

* Abduction/Kidnapping (including parental)

* Any form of neglect/abuse while in a situation where escape is not possible

An individual who experienced a prolonged period (months to years) of chronic victimization and complete control by another/others may also experience the following difficulties:

Emotional Regulation. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
Consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one's mental processes or body (dissociation).
Self-Perception. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
Distorted Perceptions of the Perpetrator. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
Relations with Others. Examples include isolation, distrust, or a repeated search for a rescuer.
One's System of Meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.

CPTSD Survivors are often diagnosed with Dissociative Identity Disorder (DID), DDNOS, and other dissociative disorders.  Because people who experience chronic trauma often have additional symptoms not included in the PTSD diagnosis, clinicians may misdiagnose PTSD or only diagnose a personality disorder consistent with some symptoms, such as Borderline or Dependent Personality Disorder.

Chronic trauma survivors may experience any of the following difficulties:


Survivors may avoid thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming.

Survivors may use alcohol or other substances as a way to avoid and numb feelings and thoughts related to the trauma.

Survivors may engage in self-mutilation and other forms of self-harm.

Survivors who have been abused repeatedly are vulnerable to further exploitation and abuse, and can be unfairly blamed for the symptoms they experience as a result of victimization.

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