CPTSD vs. PTSD: Understanding the Differences and Paths to Healing
CPTSD vs. PTSD: Understanding the Differences and Paths to Healing
I’ve often met clients who have already been told they have Post-Traumatic Stress Disorder, or PTSD. However, despite going to therapy, their symptoms persist. In these cases, what we often discover through working together is that they don’t have PTSD but something we call Complex Post-Traumatic Stress Disorder, or C-PTSD.
Along with symptoms such as hypervigilance and nightmares, someone with C-PTSD often also describes a persistent sense of shame, difficulty trusting others, chronic self-blame, emotional numbness, or a painful emptiness that feels woven through their relationships.
Understanding this difference matters—because the path to healing looks very different when trauma is woven into the fabric of early attachment and relationship, not just a single event.
PTSD: The Body’s Alarm System Stuck in “On”
PTSD most often develops after a specific traumatic event—a car accident, assault, natural disaster, combat experience or witnessing harm. The body’s alarm system, designed to protect, gets stuck in overdrive. Bessel van der Kolk calls this “the body keeping the score.” The brain and nervous system continue to signal danger even when the threat is long gone.
People with PTSD often experience:
Re-experiencing (flashbacks, nightmares, intrusive memories)
Avoidance (avoiding reminders of the event)
Hyperarousal (feeling on edge, startled easily, or unable to rest)
Negative mood changes (fear, guilt, loss of interest, or detachment)
Treatment for PTSD often focuses on helping the body learn that the danger has passed. Modalities like EMDR, Somatic Experiencing, and trauma-focused CBT can be powerful in helping the nervous system re-regulate.
But when trauma isn’t a single event—when it’s something that happened over and over, especially within relationships that were supposed to be safe—these methods need to be applied differently. What helps one person release a traumatic memory can overwhelm another whose trauma is rooted in chronic fear, neglect, betrayal, or harm.
C-PTSD: When Trauma Is Woven Into Relationship
C-PTSD develops from prolonged exposure to trauma, especially in situations where a person felt trapped or powerless to escape. Often, this begins in childhood through emotional neglect, ongoing abuse, chronic criticism, or growing up in an unpredictable or unsafe environment.
As clinicians like Bonnie Badenoch and Juliane Taylor Shore explain, our early relationships shape the way our brains and nervous systems develop. When caregivers are frightening, absent, or inconsistent, a child learns to adapt—not by feeling safe, but by shutting down parts of themselves in order to survive. Over time, this creates what Badenoch calls “a nervous system built for protection rather than connection.”
So while PTSD is usually about something that happened, C-PTSD is also about what was missing—the sense of safety, attunement, and repair that help us integrate painful experiences.
People living with C-PTSD might struggle with:
Chronic emotional dysregulation (feeling flooded, numb, or swinging between the two)
Deep shame or a sense of defectiveness
Difficulty trusting others or maintaining close relationships
Persistent self-blame and inner criticism
Dissociation or feeling detached from the body
As Dan Siegel reminds us, trauma isn’t just what happens to us—it’s also what happens inside us when we face pain alone. C-PTSD develops in that aloneness.
Why C-PTSD Is Often Misunderstood
Because C-PTSD can look like so many other things—anxiety, depression, ADHD, borderline traits, or even personality disorders—it’s frequently misdiagnosed. Many clients spend years trying to “manage symptoms” that are actually the nervous system’s way of protecting against deeper, relational wounds.
As Dr. Allison Miller and Sandra Paulsen have highlighted, complex trauma often hides beneath layers of high achievement, perfectionism, people-pleasing, or avoidance. The person appears functional on the outside but internally feels fragmented or unsafe.
Recognizing C-PTSD changes everything. Instead of asking, “What’s wrong with me?” the question becomes, “What happened to me—and what never got to happen?” That shift opens the door from self-blame to self-understanding.
Why EMDR and Other Modalities Must Be Applied Differently
At Logos Healing Institute, we often use EMDR, Brainspotting, and other evidence-based trauma therapies—but with C-PTSD, these tools require a slower, more relational approach.
As Dolores Mosquera and Sandra Paulsen have emphasized, people with complex trauma need a much longer preparation and stabilization phase before reprocessing traumatic memories. Jumping too quickly into EMDR or exposure work can actually re-traumatize the system rather than heal it.
The process we follow aligns with what Judith Herman first outlined and what Paulsen, Mosquera, and others have refined:
Stabilization and Safety – Building inner and outer safety first. This means learning grounding skills, practicing self-compassion, and developing supportive relationships.
Processing Traumatic Memories – Once stability is in place, we use EMDR or parts-based processing to help the body integrate traumatic memories within its window of tolerance.
Reconnection and Integration – The final phase focuses on reconnecting with self, others, and life in a new, more secure way.
We often remind clients that healing from C-PTSD is like learning to drive a car with both feet on the pedals—there must be balance between moving forward and knowing when to pause. Relationship first—reprocessing later. The goal isn’t to erase the past but to build enough safety that the past no longer defines the present.
The Role of Attachment and the “Parts” Within
C-PTSD is deeply tied to attachment wounds. It’s not only the trauma itself but the relational disconnection that shapes the injury.
In Richard Schwartz’s Internal Family Systems (IFS) model, which Frank Anderson has expanded for complex trauma, these wounds show up as inner parts that hold specific emotions or roles. There might be a part that’s terrified of rejection, another that’s angry and protective, and another that shuts everything down to survive.
The healing task isn’t to get rid of these parts—it’s to build a relationship with them. As Anderson says, “The parts aren’t the problem; the lack of relationship between them is.”
IFS and attachment-based therapies help clients gently meet each part with compassion, curiosity, and understanding. Over time, this internal relationship becomes the foundation for external relationships that feel safer and more secure.
The Body as the Pathway Back to Safety
As Bessel van der Kolk reminds us, “the body keeps the score.” The body carries the memory of what happened, long after the mind has moved on. That’s why so many people with C-PTSD feel tension, numbness, gut pain, or chronic fatigue without clear medical causes. The body is still guarding against threat.
Healing requires helping the body remember that it’s now safe. Practices like somatic mindfulness, breathwork, gentle movement, and nature-based therapy can all help widen what Siegel calls the “window of tolerance”—the range in which we can feel and process emotion without being overwhelmed.
At Logos, we often bring this somatic awareness into the therapy room. It might be as simple as noticing how a client’s breath changes when a painful topic arises or helping them sense the ground beneath their feet. Over time, these micro-moments of safety rewire the nervous system far more effectively than words alone.
Nature, Spirit, and Belonging
While therapy happens in a room, healing often extends beyond its walls. For many survivors of C-PTSD, nature offers a kind of re-parenting—steady, rhythmic, and nonjudgmental. The wind doesn’t rush your story, the trees don’t flinch when you cry, and the earth holds you without condition.
That’s part of why our work at Logos Healing Institute includes nature-based trauma therapy and wilderness intensives. In the quiet of the mountains, many clients begin to feel something they haven’t in years—connection without fear.
As Bonnie Badenoch writes, “When our systems can finally rest into connection, the world itself begins to feel like home again.” Whether through time in nature, meditation, or spiritual practice, reconnecting with something larger than oneself can restore a deep sense of belonging that trauma once took away.
The Neurobiology of Healing
According to Dr. Dan Siegel, healing involves integration—bringing together the parts of the brain that trauma disconnected. The emotional limbic system, the rational prefrontal cortex, and the body’s felt sense must learn to communicate again.
Bruce Ecker’s Coherence Therapy helps us understand why trauma responses persist: because, at some deep level, they make sense. The nervous system believes those responses are still necessary for survival. Healing doesn’t come from fighting those parts but from uncovering their logic and teaching the body a new pattern.
When clients experience this realization within a supportive relationship, the nervous system can release old defensive structures. What once felt like permanent damage begins to reorganize into coherence and trust.
At Logos, we often see this moment of transformation—the point where someone realizes the very symptoms they’ve hated (numbing, avoidance, perfectionism) were actually acts of survival. That understanding becomes the foundation for true compassion.
The Importance of Relationship in Healing
C-PTSD is a relational wound, so it requires relational repair. Healing doesn’t happen in isolation—it happens in safe connection.
Bonnie Badenoch describes therapy as “a meeting of nervous systems.” The therapist’s calm, attuned presence helps the client’s brain and body learn new rhythms of safety.
At Logos Healing Institute, we focus on:
Attuned pacing: Moving as quickly as the slowest part of the system feels safe.
Embodied presence: Healing happens through being with, not doing to.
Repairing ruptures: When disconnection occurs, we name it and mend it together.
This kind of therapy models the very thing that was missing in early life—a relationship that is safe, consistent, and nurturing.
Integrative Modalities That Support C-PTSD Recovery
There’s no single path to healing complex trauma. That’s why we integrate multiple modalities at Logos Healing Institute:
EMDR and Brainspotting (adapted for complex trauma and attachment injury)
Internal Family Systems (IFS) for understanding and befriending inner parts
Somatic Experiencing and Sensorimotor Psychotherapy for body regulation
Attachment-based and relational therapy inspired by the work of Siegel, Badenoch, and Taylor Shore
Nature-based therapy and mindfulness for grounding and reconnection with self and environment
Each of these tools supports the same goal: helping the nervous system remember what safety and connection feel like. Healing happens not by pushing through trauma but by turning toward ourselves with compassion and curiosity.
From Surviving to Living
For many survivors, healing from C-PTSD is not about “getting back to who I was before”—it’s about discovering who I might have been if safety and love had always been present.
As Bessel van der Kolk writes, recovery means “learning to inhabit your body again.” That process can feel slow and nonlinear. There are days when progress feels invisible and others when a small shift—feeling joy, allowing someone to care—marks profound change.
At Logos Healing Institute, we see healing not as a straight line but as a spiral—returning to old wounds each time with more compassion, capacity, and grace. Every step toward safety, even the smallest one, matters.
Closing Thoughts
If PTSD is like a wound that needs tending, C-PTSD is more like a garden that was never nurtured. Healing means slowly cultivating what should have been there all along—safety, connection, and belonging.
Recovery doesn’t erase the past. It rewires how the body, mind, and heart relate to it. Through the steady presence of an attuned relationship and trauma-informed therapy, even the most fragmented parts of the self can begin to find their way home.
At Logos Healing Institute, our work is rooted in this belief: every nervous system can learn safety again. Healing is not only possible—it’s the natural direction of the human heart when given the right conditions.
