Stacie Later, LCSW

Some people come to therapy saying, “I’ve done trauma work, I should be over
this by now.” Others quietly wonder if what happened to them even counts as
trauma. Many aren’t sure how to explain what they’ve experienced. PTSD and Complex PTSD (CPTSD) are related, although they are not the same. Understanding the difference can make all the difference in your healing journey.

PTSD

Post-Traumatic Stress Disorder (PTSD) often follows a single, overwhelming
event such as an accident, assault, disaster, or combat. Symptoms of PTSD include flashbacks, nightmares, emotional numbness, hyper-vigilance, and avoidance of reminders.

The trauma has a clear before-and-after. Treatments like EMDR or ART work well
for PTSD because they help the brain process a specific memory that disrupted
your sense of safety.

CPTSD

Complex PTSD comes from repeated, ongoing trauma especially relational trauma that often begins in childhood. This includes neglect, repeated abuse, chronic criticism, betrayal, and situations where connection was unsafe.

CPTSD includes PTSD symptoms, along with:

• Chronic shame or guilt
• Difficulty regulating emotions
• Deep relationship struggles
• Negative self-concept
• Persistent self-doubt or inner criticism
• Chronic dissociation or emotional shutdown

There’s often no single event. Instead, the trauma is a part of everyday life, shaping your sense of safety, and identity.

Why Understanding the Difference Matters

Healing CPTSD takes more than reprocessing memories. Many people feel
frustrated when traditional trauma treatments don’t seem to have lasting
transformative change. If that sounds familiar, it doesn’t mean you’re doing
something wrong; it means your healing needs a different approach.

CPTSD healing focuses on:

• Creating safety in your body and nervous system
• Rebuilding trust in relationships
• Learning to regulate emotions
• Grieving what was missing
• Restoring a sense of identity and autonomy

This work unfolds more slowly because the injury happened over time. Quick fixes may ease some symptoms, though deeper healing comes from re-wiring a nervous system that was painfully installed. Your nervous system is not broken. It adapted.

Treatment approaches such as EMDR and ART are fantastic for some symptom
relief with CPTSD, specifically the symptoms that overlap with PTSD. These
modalities however are better partnered with additional approaches such as Critical Memory Integration (CMI), Coherence Therapy, Deep Brain Reorientation (DBR) and Internal Family Systems Therapy (IFS) in the treatment of CPTSD. This is
because healing is also unlearning and relearning about the Self, relationships, and the world around you.

CPTSD often hides beneath anxiety, depression, perfectionism, people-pleasing, or chronic burnout. You may have learned to fawn, freeze, or stay small to survive.These patterns are not flaws. They are protective responses that made sense in unsafe environments.

Knowing the difference between PTSD and CPTSD can help you understand
yourself more clearly. It also helps you choose the kind of support that will help
you move forward. You deserve more than symptom relief. You deserve healing
that honors what you’ve lived through and embraces who you are discoveringwithin yourself.