CPTSD vs. PTSD: Understanding Attachment Trauma

Both CPTSD and PTSD are mental health conditions which result from significant trauma; generally resulting in feelings of being trapped in this trauma, long after it occurred. However, whereas PTSD often results from a singular traumatic event, CPTSD often develops when trauma is prolonged, such as in the case of childhood trauma or abuse – including insecure attachment.

This article discusses the similarities and differences in CPTSD vs PTSD symptoms, including the association between PTSD and complex PTSD and attachment issues.

What Is PTSD?

First officially recognized in war veterans, post traumatic stress disorder (PTSD) is a mental health condition that people can develop after experiencing or witnessing a traumatic event, series of events, or set of circumstances.

Originally referred to as “shell shock” or “combat fatigue”, after soldiers presented with specific symptoms after World War II, it was realized that people other than those involved in combat could also present with symptoms. In fact, PTSD can happen to anyone, anywhere, regardless of age, ethnicity, culture, and sex. However, research demonstrates that women are twice as likely to demonstrate symptoms of PTSD than men, and certain cultures such as U.S. latinos, african americans, and native americans also seem to be disproportionately affected.

The symptoms of PTSD include intense, disturbing thoughts, feelings, nightmares, and flashbacks of the event(s) which caused trauma, all of which can persist long after the incident(s) occurred. People with PTSD often struggle to relate to others, and can end up feeling increasingly detached and isolated, due to how intense they experience these symptoms.

People suffering from PTSD are sometimes triggered by people or situations which remind them of their trauma. This may lead to them experiencing strong emotional and physical reactions to seemingly normal, ordinary situations. Therefore, they may attempt to avoid everyday situations to prevent being triggered.

DISCOVER YOUR ATTACHMENT STYLE

What is CPTSD?

Complex post traumatic stress disorder (CPTSD) is a mental health condition which results from experiencing chronic trauma such as persistent childhood abuse, domestic violence, or involvement in wars. The symptoms of CPTSD are similar to those of PTSD, such as experiencing intense and intrusive thoughts, feelings, nightmares, and flashbacks of traumatic events, but people with CPTSD also experience additional symptoms including, but not limited to:

• Emotional dysregulation issues, such as impulsiveness and aggression.
• Feelings of resentment, anger, and distrust towards the world.
• Negative self view.
• Avoidance of and detachment from friendships and relationships.
• Feeling as though they are inherently damaged or of low-worth.
• Dissociation from the world and others.
• Beliefs of being completely different from others.
• Difficulties sustaining healthy relationships.
• Physical sensations such as headaches, dizziness, nausea, and stomach aches.
• Hopelessness and despair.
• Suicidal ideation.

CPTSD vs PTSD Symptoms

Many people refer to CPTSD as simply a “more complex version of PTSD.” In many ways, they are not incorrect in assuming this. However, we need to dig deeper to understand the similarity and differences.

The Similarities Between CPTSD and PTSD

At the core of CPTSD is PTSD, so there are naturally many similarities. Like we mentioned, symptoms such as intense disturbing thoughts, feelings and nightmares are common in both, as well as a difficulty in relating to others, which can sometimes be made more difficult due to the way in which they are emotionally triggered by specific events and or experiences.

The Differences Between CPTSD and PTSD

Though the core is similar, the main difference between CPTSD and PTSD relates to the duration of events which cause the conditions. PTSD can be caused by singular events, such as a difficult childbirth, car accident, or an assault.

CPTSD develops due to sustained and repeating traumatic events, such as childhood abuse, being a citizen in a war affected country, and being bullied.

Importantly, CPTSD is distinct from PTSD because it is highly associated with a particular stage of development. It is more often seen in people who have experienced prolonged trauma in childhood. This includes significant abuse by a person in a trusted position, such as a caregiver. As a result, the attachment bond is affected, creating an internal working model about how relationships function and how they will be treated by others, which becomes deeply ingrained in the nervous system.

CPTSD is distinct from PTSD due to how people with complex trauma are often preoccupied by the person who abused them or inflicted trauma. For example, someone with CPTSD may become consumed by exacting revenge on an abuser.

However, there are occasions where those who have experienced frequent or prolonged abuse are diagnosed with PTSD; it’s not fully understood why some people who have experienced prolonged trauma don’t exhibit the additional characteristics of CPTSD, but it does lead to complications in diagnoses.

Furthermore, CPTSD, despite gaining attention as a disorder since the 1980s, is not currently recognised as a mental health condition in the Diagnostic and Statistical Manual of Mental Health, Fifth Edition (DSM-5-TR).

DISCOVER YOUR ATTACHMENT STYLE

Why are PTSD and CPTSD Core to Attachment Trauma?

Attachment trauma results from ruptures to the bond in the caregiver-child dyad. A secure attachment style results from a childhood in which a child perceives their needs (emotional and physical) to be met consistently and sensitively. As a result, the child feels valued, safe, supported, and loved.

In contrast, if a child perceives their caregiver to inconsistently meet or consistently reject their needs, they can form an anxious or avoidant attachment style. If a child feels fear towards their caregiver, due to chaotic conditions or trauma, they can develop a disorganized attachment style (fearful-avoidant in adulthood).

Avoidance of commitment, intimacy, and deep connections due to the stress and anxiety relationships create could be indicative of PTSD and CPTSD resulting from attachment trauma. However, according to findings from research, the type of insecure attachment style may influence whether or not someone develops PTSD or CPTSD.

The Association Between Insecure Attachment and PTSD

Studies have found that the dimension of attachment someone forms may influence whether or not they develop PTSD or CPTSD. For example, the avoidant-dismissive attachment style has been particularly associated with both PTSD and CPTSD. This association is reflected in how people with avoidant attachment tend to cope with reminders of their childhood trauma; by avoiding or withdrawing from relationships as their early years taught them that others would reject their needs.

In contrast, no relationship was found between the anxious attachment style and PTSD or CPTSD, which could indicate that the severity of the disruption to the attachment bond and the manner in which the child perceives their needs to be rejected could influence how trauma is felt and expressed. In many ways, this finding makes sense, as both PTSD and CPTSD are associated with avoidance of relationships due to how they can trigger reminders of childhood trauma. Instead, people with anxious attachment are more likely to seek out relationships in attempts to bolster self-worth and feel more validated.

Surprisingly, despite the assumption that severity of childhood trauma could impact whether or not someone develops PTSD or CPTSD, no association was found between the disorganized/fearful-avoidant attachment style and either CPTSD or PTSD. However, people with fearful-avoidant attachment can demonstrate significant difficulties with self-organization, which could be considered a symptom of CPTSD.

Treatments and Therapy Approaches

PTSD and CPTSD can feel overwhelming; as if there’s no escape from the situation(s) which traumatized and hurt you. However, it is entirely possible to heal and move past trauma.

If you understand your attachment style, this can help to get to the root of the issue. This helps you to start building awareness, reflecting, and understanding the “whys” of your symptoms.

There are a number of therapies which have proven to be effective in the treatment of both PTSD and CPTSD. If you’re contemplating therapy to cope with your issues due to past trauma, it’s important to choose someone who is trained in the area and licensed to practice.

Talking Therapy

Research has shown that targeting negative thoughts and attachment representations in people who have PTSD and CPTSD (especially resulting from attachment trauma) has strong potential for alleviating symptoms. Talking therapy, such as cognitive behavioral therapy (CBT), may be of particular benefit, as it helps promote skill acquisition and improve feelings of mastery, while simultaneously targeting subconscious negative thoughts and beliefs.

Exposure Therapy

Exposure therapy can also help people who avoid situations (or people) that trigger fears associated with their trauma. Exposure therapists help the individual to create a plan which involves a hierarchy of anxiety-provoking situations. To start, they expose themselves to a slightly anxiety-provoking situation, and, over time, increase the amount of time they stay in this situation. In time, the individual learns that they can manage their feelings and cope with the situation.

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) is a form of psychotherapy that can be used to help clients process past trauma. EMDR combines talk therapy with side-to-side eye movements in a structured manner to help process the negative imagery, emotions, beliefs, and bodily sensations that result from traumatic experiences. This process is especially helpful for people who tend to feel “stuck” in the negative feelings of their childhood, and it helps people to gain a more objective perspective.

Attachment Based Therapy

Attachment-based therapy is a form of counseling that helps people overcome the adult perceptions and behaviors that result from their childhood experiences. If PTSD or CPTSD is the result of childhood trauma, an attachment-based therapist can help someone learn how to heal, trust others, and form healthy, mutually fulfilling relationships as an adult.

HEAL YOUR ATTACHMENT DISTURBANCES

Final Words on CPTSD vs PTSD

CPTSD and PTSD are mental health conditions which can have serious consequences for an individual’s quality of life. Both conditions result from significant trauma and can leave someone feeling like they can’t escape the negative feelings associated with their past. One of the core defining differences in CPTSD vs PTSD is the duration of trauma; PTSD tends to result from a singular event, while the trauma associated with CPTSD is prolonged, and often occurs early in life.

If you’re struggling with PTSD, CPTSD, or insecure attachment, there are many options for recovering and moving past your trauma. Whether that is through therapies like cognitive-behavioral therapy, exposure therapy, or EMDR, make sure you work with a licensed mental health practitioner to discuss your symptoms and for advice.