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Understanding PTSD and CPTSD: A Guide to Trauma Informed Interventions from a New York Therapist

ptsd, mental health counseling, Scarsdale, ny, emdr and ptsd

Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (CPTSD) are two diagnoses that frequently come up when dealing with trauma survivors. In this blog, we'll explore the differences and similarities between PTSD and CPTSD, examining their symptoms and causes. We'll also discuss trauma-informed interventions, including Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Parts-work interventions, and the Polyvagal Theory, which can be powerful tools for helping our clients on their healing journeys.

What is Trauma?

Trauma, in this context, refers to a distressing event or a series of events that can have a profound impact on an individual's mental and emotional well-being. Trauma can be something that happened to you, or in some cases something that didn't happen to you (that you needed).

What is PTSD (Post-Traumatic Stress Disorder)?

Post-Traumatic Stress Disorder is a mental health condition that may develop after a person experiences or witnesses a traumatic event. This diagnosis is often associated with single, discrete traumatic incidents, such as:

  • Car accidents

  • Natural disasters

  • Acts of violence

  • Military combat

  • Sexual assault

  • Physical abuse

  • Witnessing a severe accident

These experiences typically involve intense fear, helplessness, or horror.

Symptoms of PTSD:

  • Flashbacks or nightmares related to the trauma.

  • Avoidance of reminders of the traumatic event.

  • Negative changes in mood or cognition.

  • Hypervigilance

  • Increased arousal, including irritability, difficulty sleeping, and heightened startle response.

Trauma-Informed Interventions for PTSD:

  • EMDR (Eye Movement Desensitization and Reprocessing): EMDR is a therapy technique designed to help individuals process traumatic memories and alleviate the distress associated with them. By using bilateral stimulation, like guided eye movements or tactile sensations, EMDR helps reprocess and desensitize the emotional charge of traumatic memories. Click here to read more about EMDR.

  • Cognitive Behavioral Therapy (CBT): CBT helps individuals recognize and change distorted thought patterns and behaviors associated with their trauma. It is particularly effective in treating avoidance and negative thinking.

  • Dialectical Behavioral Therapy (DBT): DBT combines elements of CBT with mindfulness and emotional regulation techniques to address the emotional dysregulation commonly found in symptoms of PTSD and CPTSD.

What is CPTSD (Complex Post-Traumatic Stress Disorder)?

Complex Post-Traumatic Stress Disorder is a more severe and complex condition that often results from prolonged exposure to traumatic experiences, such as:

  • Adverse childhood experiences (ACE's)

  • Childhood abuse

  • Long-term domestic violence

  • Captivity

  • Long-term narcissistic abuse

  • Living in unsafe conditions (violence, lack of resources, etc.)

CPTSD is rooted in chronic, long-term trauma and often stems from situations where a person was repeatedly exposed to life-threatening events, lacked necessary emotional support, or experienced betrayal by trusted individuals.

Symptoms of CPTSD:

  • Flashbacks, nightmares, or intrusive thoughts.

  • Emotional dysregulation, including mood swings and difficulty with self-esteem.

  • Chronic feelings of emptiness and worthlessness.

  • Difficulties with interpersonal relationships.

  • Disturbances in self-identity.

  • A pervasive sense of hopelessness.

Trauma-Informed Interventions for CPTSD:

The same interventions used for the treatment of PTSD can be used for the treatment of CPTSD. When using EMDR therapy with CPTSD it can be necessary and greatly beneficial to spend additional time working in the first two phases of EMDR (Read more about Phase 1 & 2 here!). Integrating tools from CBT and DBT can be supportive in the beginning stages of working through CPTSD symptoms.

In addition to EMDR, CBT and DBT these two theoretical approaches can also promote the healing process:

  • Parts Work: This approach, also known as Internal Family Systems (IFS), helps clients understand and heal the fragmented parts of themselves that have developed as a response to trauma. By working with these parts, individuals can reintegrate their sense of self and address the complex symptoms associated with CPTSD.

  • Polyvagal Theory: The Polyvagal Theory, developed by Dr. Stephen Porges, explores how the autonomic nervous system responds to stress and trauma. Understanding the body's physiological reactions to trauma is crucial in helping clients regulate their nervous systems. Techniques like grounding exercises and deep breathing can help individuals with CPTSD regain control over their emotional and physical responses.

Comparing and Contrasting PTSD and CPTSD:

While both PTSD and CPTSD involve the experience of trauma, CPTSD is typically a more severe and chronic condition, often rooted in long-term exposure to traumatic events.

PTSD is often associated with a specific traumatic incident, whereas CPTSD results from ongoing exposure to trauma.

The symptoms of CPTSD are more complex and pervasive than those of PTSD, impacting a person's self-identity, relationships, and overall well-being.

Trauma-informed interventions, such as EMDR, can be effective for both PTSD and CPTSD, but CPTSD may require additional approaches like Parts Work and understanding the Polyvagal Theory to address the deeper layers of trauma.

In conclusion,

As mental health counselors in trauma-informed private practices, it is crucial to understand the differences and similarities between PTSD and CPTSD. Each diagnosis requires tailored interventions, and knowing when to employ techniques like EMDR, Parts Work, or the Polyvagal Theory can make a significant difference in the healing process of our clients.

By offering trauma-informed care, we can provide individuals with the support they need to navigate their unique journey to recovery and resilience.


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Annabella Lipson is a Licensed Mental Health Counselor at Peaceful Living Mental Health Counseling in Scarsdale, NY.

She enjoys working with young adults & adults who are dealing with grief, constant sadness, anxiety, PTSD and other heavy emotions that make it difficult to enjoy the present moment.

Annabella has an innate ability to make her clients feel comforted and cared for as they confront their grief and loss. She incorporates a combination of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), EMDR Therapy, Ego-state Interventions and Mindfulness practices in her counseling sessions.


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