What’s the difference between Complex Trauma and PTSD?

Complex Trauma is often completely different than Post-Traumatic Stress Disorder (PTSD). It’s often used interchangeably, but the felt experience can be completely different. The interchangeable use may be due to DSM-5 criteria, as complex trauma has yet to be added. In my experience as a psychiatric nurse practitioner, we often have to default to PTSD even though the presentation is often better explained as complex trauma.

PTSD is usually one traumatic event resulting in a set of symptoms that were not present before the traumatic event. This event leads to symptoms such as nightmares, flashbacks, hypervigilance, avoidance, self-blame, and negative beliefs.

Complex trauma can present with similar symptoms. However, complex trauma can often be invisible for a prolonged period of time before presenting with these symptoms. Complex trauma occurs due to environments with repeated events of trauma, usually beginning in childhood. Because it often occurs in childhood and is often invisible for many years, it gets carried into adulthood. Like PTSD, negative beliefs are often a hallmark; however, the person adapts their entire life around these beliefs. It shows up in their relationships and in their career. It shapes how they see the world and how they see themselves.

The felt experience of PTSD is dysregulating and painful. However, for complex trauma, the adaptations get them through many years of their life until the pain becomes so unbearable that their way of functioning unravels. The symptoms become louder and harder to ignore.

It’s easy to think that all it takes is moving on from the past. However, it’s much more complicated. It’s witnessing yourself and all that you became to survive the circumstances you were given.

Trauma healing is piecing together the parts of you that you lost along the way and learning how to come home to yourself.