PTSD vs CPTSD: Understanding Complex Post-Traumatic Stress Disorder

hey everybody my name is Dr Scott giacomucci I'm the director and founder of the Phoenix Center for experiential trauma therapy in Media Pennsylvania and my expertise is really in trauma and traumatic stress so in this video I want to talk about the difference between PTSD and complex PTSD so post-traumatic stress disorder and complex post-traumatic stress disorder so in talking about the difference here it's important to consider some of the history of these diagnoses of these conditions [Music] that post-traumatic stress disorder really came from the experience and research with combat veterans originally it was called soldier's heart or shell shock and it was based on a war trauma essentially adults experiencing War trauma and over the years PTSD at the diagnosis has evolved and changed it was originally recognized in the DSM the which is the the manual the recognized diagnoses in it it was originally recognized in 1980 so just a little over 40 years ago and over the years it's the criteria slightly changed complex PTSD is a bit different in that it's not recognized in the DSM yet there's many people advocating and trying to get it recognized which would uh really help validate the experience of many complex trauma survivors and help create avenues for treatment and resources funding and insurance approval for the diagnosis cptsd as of right now it's not recognized in the DSM however it has been recognized in the icd-11 which is put out by the World Health Organization so internationally cptsd is recognized but in the United States it's not recognized as a formal diagnosis so this complicates it a bit when we're talking about it cptsd is what we experience more often when we experience complex trauma complex trauma is a little different than General trauma or simple trauma in that complex trauma is when we experience reoccurring and repeated experiences of trauma usually of a similar nature and oftentimes within the context of a relationship many times this is in our childhood and the same type of adverse experience happens again and again and again this could be abuse or neglect or abandonment or bullying or violence or losses different types of adversity that we experience again and again and again so complex trauma really includes uh multiple experiences of a similar type of trauma and because complex trauma is usually happening in our informative childhood adolescent years it's happening before we fully developed a sense of self and before our brain is fully developed and so it has a much it can have a much more pervasive impact on us whereas classical PTSD especially in the history of the diagnosis something that manifests after an experience of trauma usually in adulthood or in the case of War trauma somebody's experiencing as an adult and so complex trauma often leads to complex PTSD now in the icd-11 complex PTSD is actually a add-on diagnosis for PTSD which means that you have to first meet criteria for PTSD diagnosis before you can be given a cptsd diagnosis however the criteria for PTSD is slightly different in the DSM in the United States and the icd-11 internationally so this really confuses things cptsd has three additional symptom clusters There's A disruption in her sense of self that comes when we are experiencing cptsd There's A disruption in our ability to regulate our emotions and there's a disruption in our social relationships so these are the three add-on cptsd and unique symptoms that get added on to PTSD diagnosis in 2013 the DSM-5 was published and they added a fourth criteria to PTSD which is not added in to the international PTSD diagnosis so this is where it gets confusing so the original Three PTSD symptom clusters which are the same three that are used in the icd-11 the basis for cptsd are at intrusions and re-experiencing this is the flashbacks the nightmares the intrusive disturbing images arouson reactivity this is our nervous system being left on edge we're looking over our shoulder not being able to sit with her back to the door jumping at loud noises or physical touch being irritable trouble sleeping or concentrating and third is avoidance avoiding thinking about the trauma avoiding discussions of the trauma avoiding going the trauma therapy these are the three symptom clusters of PTSD in the dsm-4 and in the icd-11 so these three categories of symptoms plus the three cptsd symptoms equal complex PTSD intrusions uh and re-experiencing add being one arousal reactivity avoidance and then for cptsd again we have the disruptions in our sense of self disruptions in our ability to regulate our emotions and disruptions in our social relationships so these six together equal cptsd complex post traumatic stress disorder the difference is in the DSM-5 is that we have those original Three symptom clusters intrusions and re-experiencing arousal reactivity and avoidance DSM-5 in 2013 the added a fourth symptom cluster which is not recognized internationally in the icd-11 and this is negative changes in cognitions and moods that there's persistent negative beliefs about ourselves about the world or about others or negative moods that we get stuck in so in DSM-5 these are the four symptom clusters of PTSD so I know that's a bit confusing but I hope that helps differentiate PTSD in the DSM and cptsd in the icd-11 if you're struggling with PTSD there's lots of different ways you can pursue healing there's different treatments that can be helpful for you and different non non-therapeutic Avenues of healing as well of course many people find traditional talk therapy to be helpful or cognitive behavioral therapies psychodynamic or psychoanalytic Therapies um as an EMDR therapist I want to give a plug for EMDR as one of the most effective trauma therapies especially for classical PTSD EMDR is one of the most researched trauma therapy treatments and one of the most recommended many people find that because trauma really impacts our nervous system and our body leaves us feeling unsafe in our body that somatic and body-based Therapies tend to be really helpful so there's things like sensory motor Psychotherapy or somatic experiencing which are really body based psychotherapies that help us find safety in our body and express work through Sensations that we might be experiencing in our body uh others find things like experiential therapies uh useful for for healing from trauma things like psychodrama Gestalt therapy internal family systems Therapies that these therapies allow us to go beyond just talking about trauma or talking about trauma recovery and allow us to look at the different parts of ourselves and renegotiate our relationship to the trauma in different ways so really step into and embody trauma recovery in action rather than just talking about it so many people find experiential therapies to be the treatment of choice when we're struggling with PTSD and especially cptsd other trauma therapies that are are highly recommended include trauma Focus cognitive behavioral therapy and prolonged exposure or cognitive processing therapy these are uh highly researched most of the research on trauma therapy is um in cognitive therapies because they're manualized and what's which makes them really easy to research many people find relief and help through cognitive therapies some people find them tough to engage in too because they often require us to tell the story of our trauma and to in some ways relive the trauma or in the case of prolonged exposure to expose ourselves to triggers or or memories related to the trauma which can be uncomfortable another type of treatment that's becoming popular is biofeedback and neurofeedback and there's a bunch of different types of biofeedback and neurofeedback this is where some sort of biological marker is used and measured in real time for example or breathing or brain waves or heart rate and it's put through a computer program that trains Us in real time to regulate our body our heart rate our breathing to regulate our brain waves in uh into more healthy and optimal functioning zones so biofeedback can be especially helpful if you're really struggling with physical Sensations related to trauma and or if engaging in any of the other trauma therapies feels like it would be too overwhelming for you in neurofeedback and biofeedback you're often not even going to have to think about or talk about the trauma it's just going to help you develop a better relationship with your body and better regulate your body similarly many people find that other body-based approaches such as yoga massage exercise can be incredibly helpful in terms of healing from trauma PTSD cptsd interestingly in one of the research studies they found that yoga was more effective in reducing PTSD symptoms than any medication that's ever been researched which is pretty spectacular if you think about it it makes sense yoga is a practice of learning how to find safety in our body learning how to befriend our body learning how to listen to our body and it's a practice of tolerating discomfort involved with the poses and stretches just a little bit longer and a little bit longer knowing that it's going to end soon and that practice of tolerating discomfort a little bit longer knowing that it's going to end soon helps us widen our window of tolerance for distress when we experience pain or distress uh in terms of the brain the way the brain looks and brain scans there's no difference between physical pain and emotional pain the same parts of the brain are activated regardless of if it's physical pain or emotional pain so this is probably one of the ways that yoga one of the reasons why yoga which is a very physical activity can really help us with our emotions as well other people find exercise to be really useful probably for similar reasons and many people find meditation to be another really useful Avenue of healing from trauma some trauma survivors find yoga or meditation to be really tough to engage in especially because some of the poses in yoga could be triggering or activating if you're going to pursue yoga as an option it'd be good to find a trauma-informed or a trauma-sensitive yoga class where they modify some of the poses and some of the processes uh to make them more comfortable for trauma survivors um meditation is another really useful tool for regulating our emotions learning how to notice our thoughts without attaching to them in some studies Neuroscience studies they find that when we practice mindfulness meditation where we're just breathing and noticing what's going on for us the parts of the brain that light up are the same parts of the brain that are active in brain scans when we're engaged in Secure healthy attuned relationships and it makes sense because when we're in in mindful meditation we're attuned to ourself into our experience we're tuned to what's going on around us and what's gone on within us so some experts including Dan Siegel who founded the field of interpersonal neurobiology are suggesting that meditation is one of the ways that we can really strengthen our ability to regulate ourselves we can deepen our sense of self we can improve our ability to be in relationships and that for those of us that have experienced uh traumatic relationships or attachment ruptures chaotic attachment Styles and secure attachment styles that mindfulness meditation might be a tool that can help train us for secure attachment in our relationships another Avenue for healing from trauma is through the spiritual world the religious world or the archetypal world and much of trauma is experienced because of other humans and so it only makes sense that we might look to religion we might look to spirituality in order to heal from trauma many people find relief through spirituality or religion other people might look to their Community might look to their culture cultural values cultural belief systems cultural rituals and ceremonies and find enormous healing and strength and restoration through their Community or through their culture some people engage in social activism essentially all social injustice is trauma and so being involved in trying to prevent or stop other people or communities from experiencing trauma can be really empowering and can be really healing for ourselves as well I think by itself it's not enough we can't just try to change the world without also changing ourselves but together doing both at the same time can be especially powerful and similar to that many people find that being in service and helping others who've experienced similar things can be especially healing and transformative and powerful and it's probably why most of us become therapists and work with trauma or addictions or grief and loss or mental health issues is because we've been impacted by similar issues or loved ones have been impacted by similar issues so when we talk about trauma therapy we're often talking about one-on-one therapies but I also want to put a plug in for group therapy as uh at least equally as effective as individual therapy for treating trauma PTSD cptsd and the research really backs that up so I really encourage you to consider all of these different options and of course there's many other options as well to help in your recovery healing from trauma from PTSD and cptsd in your process I also want to encourage you to look into the phenomenon that we call post-traumatic growth the post-traumatic growth is in many ways the opposite of post-traumatic stress post-traumatic growth is the phenomenon of growing in the aftermath of trauma and there's five different areas of post-traumatic growth which I outline in another video and we'll put a link to it in the description below learning about post-traumatic growth really provides a hopeful a hopeful thing to to strive for to think about a template for what trauma recovery can look like for you with trauma recovery might be like that in trauma therapy and in our process of healing from trauma it's not all about the trauma actually the specific details of the traumatic event are far less important in trauma healing and Trauma recovery than the way that the trauma impacts us today and the vision that we have for ourselves in trauma recovery going forward so we need to have a real balance of looking to the Past considering how we're impacted today in the present and looking to the Future what it might look like for us to heal from the trauma to grow from the trauma so I really encourage you to to look into post-traumatic growth uh as a template for trauma recovery as well so I hope this video is helpful in considering some of the differences between PTSD and cptsd and if you found this video helpful I hope you'll consider checking out some of the other videos on our channel here and leave a comment in the on the video here let me know what was helpful let me know if you feel like I missed something sometimes I forget to mention things or or other people have better ideas or additional thoughts that I might not have thought of and consider checking out some of the other videos on the channel here [Music]

Channel: Phoenix Trauma Center & Dr Scott Giacomucci

Views: 38,804

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Id: _7OqWLWH7pw

Length: 19min 51sec (1191 seconds)

Published: Sat May 13 2023