When we experience harmful or dangerous events, we can feel both psychological and physiological stress. If this stress overwhelms us and affects our ability to cope, it becomes trauma. This trauma can profoundly impact an individual’s life, reshaping how they understand themselves and the world around them. Over time, a person who has experienced trauma may develop Post-Traumatic Stress Disorder (PTSD). Additionally, a person who has experienced ongoing or chronic trauma may develop Complex-PTSD (C-PTSD). In this blog, we’ll discuss the differences between PTSD and Complex-PTSD, and how the evidence-based treatment of EMDR can help individuals heal from their trauma.
Defining PTSD vs Complex PTSD
According to the DSM-5, PTSD is diagnosed when an individual has been exposed to actual or threatened death, serious injury, or sexual violence, and is experiencing an impairment in functioning as a result. A mental health professional diagnosing PTSD would look for intrusive symptoms such as intense or prolonged distress, physiological stress reactions, avoidance of anything related to the traumatic event, and changes in mood or thought patterns, and impairment in functioning.
Unlike PTSD, Complex-PTSD is not recognized as a separate diagnosis in the DSM-5. However, it does differ from PTSD in the way it is diagnosed and treated, and in the way that it can impact an individual. Unlike PTSD, which typically involves single incidents (e.g., car accidents) or related incidents within a single context (e.g., active duty military), Complex-PTSD involves prolonged, repeated trauma. This ongoing trauma may last months or years and often occurs in childhood, though it can occur in adulthood as well. For example, chronic exposure to childhood abuse or neglect or to domestic violence (either as a witness or as recipient) can lead to C-PTSD.
Individuals who struggle with chronic trauma and C-PTSD can experience difficulty across several areas of their lives. They may struggle to develop and maintain healthy relationships with others. They may also struggle with regulating their emotions, and may find themselves often experiencing fight, flight, fawn, or freeze trauma responses. They may engage in frequent dissociation or high-risk behaviors (e.g., substance use) to cope with their internal distress. For the individuals who suffered profound interpersonal trauma, they may have learned that they are not allowed to feel their feelings or take care of themselves. As a result, they may experience challenges with their self-image, self-worth, and self-esteem. Additionally, chronic stress and trauma can lead to physical symptoms and chronic health concerns.
Impact of Childhood Trauma
One of the main contributing factors to Complex-PTSD is childhood trauma. The Adverse Childhood Experiences Study (ACES) has described several forms of childhood trauma that can have devastating long-term consequences. These traumatic experiences can include: emotional abuse and neglect, physical abuse and neglect, sexual abuse, witnessing domestic violence between adult caregivers, systemic trauma and discrimination, and attachment trauma.
Unfortunately, trauma can impact children on both a psychological and physiological level. On a psychological level, children can experience disruptions in important developmental processes. For example, trauma in the attachment relationship between caregiver and child can impact a child’s ability to form healthy relationships in the future. Trauma in the form of emotional abuse and neglect can negatively impact a child’s understanding of emotions, leading to difficulties with emotion regulation. Systemic trauma and discrimination can harm a child’s identity formation, leaving them unsure as to who they are and how they fit within their communities.
On a physiological level, trauma can negatively impact brain development during critical periods. Because the brain can change its connections in response to new knowledge and experiences, chronic stress can literally alter stress response systems. As a result, these early experiences can create long-lasting neurological patterns that can ultimately affect an adult’s thinking, coping, and mental and physical health. It is important to note that the brain, while vulnerable to traumatic disruptions, also possesses remarkable potential for healing and neural reorganization. Still, the high level of neuroplasticity (or the brain’s adaptability) in childhood highlights the impact of childhood experiences on lifelong psychological well-being.
EMDR Therapy for Complex-PTSD
Eye Movement Desensitization and Reprocessing (EMDR) therapy offers a unique approach to treating Complex-PTSD. As an evidence-based treatment, EMDR uses bilateral stimulation to help clients process traumatic events. A trauma-informed EMDR therapist will typically follow the general treatment approach as described by the International Society for Traumatic Stress Disorders (ISTD) guidelines. This comprehensive approach has three main stages:
- Establish Safety: In the first stage, the therapist will work with their client to build trust and therapeutic rapport, and to manage any immediate symptoms. For example, they may need to work together to manage any high risk behaviors like disordered eating or substance use. The therapist will also help the client learn coping skills and strategies so that they can begin to regulate their nervous system independently. These skills can include trauma-informed mindfulness, grounding mind-body connection exercises, somatic exercises, and EMDR-specific resource strategies.
- Process Traumatic Memories: In the second stage, the therapist and their client will confront, work through, and ultimately integrate traumatic memories. The therapist will use bilateral stimulation, through eye movements or somatic tapping, to help the client process traumatic memories and any associated painful feelings. The therapist may also integrate other trauma-informed therapy modalities, such as inner child work, narrative therapy, acceptance and commitment therapy, or internal family systems. Throughout this stage, the therapist is aiming to help their client move through the feelings associated with the trauma, understand the ongoing impact of their past, and begin to develop a more coherent understanding of their personal history.
- Reclaim Identity: In the third stage, the therapist and their client will begin to move beyond the traumatic memories by adopting and applying more adaptive ways to understand previous experiences. In doing so, the client will be able to feel less ‘stuck’ in their past, and more grounded in their present and future. As the client develops a more solid sense of self, they will feel more confident in practicing self-care, setting boundaries, and prioritizing their own wants and needs. In this stage, the therapist’s goal is to empower the client to reclaim their sense of self and their agency in their life.
EMDR can be effective because it helps individuals engage with their trauma in a way that is safe, contained, and intentional. It can be particularly effective for PTSD and Complex-PTSD because it allows the therapist and individual to address multiple traumatic memories, including memories that may be hard to recall verbally. For example, for individuals who experience difficulty in recalling specific childhood memories, an EMDR therapist can approach these memories in pieces or in more general themes. Because EMDR intentionally focuses on fostering nervous system regulation and adaptive thinking patterns, it can be helpful for creating a base for a healthier relationship with oneself as well.
Healing from Complex Trauma
Healing from complex trauma is possible at any age. While the journey can be challenging, it can also be profoundly transformative. With proper support, therapeutic interventions, and personal commitment, individuals can begin to heal from PTSD and Complex-PTSD. They can learn to create healthier self-care routines, develop supportive relationships, learn nervous system regulation, and reconstruct their personal identity. As they become more and more confident in understanding and managing their traumatic stress, they can also build personal resilience and experience post-traumatic growth in their sense of self.
Remember, trauma does not define you—it is something that happened to you, not who you are. Every step toward healing is a courageous act of self-compassion and self-empathy. As trauma expert Peter A. Levine poignantly notes, “Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.” With yourself and your therapist as your witnesses, you can learn to let go of trauma’s impact on you.
Seek A Trauma-Informed EMDR Therapist in Los Angeles, CA or New York at Yellow Chair Collective
If you are seeking therapy specifically tailored to your needs, consider reaching out to the therapists at Yellow Chair Collective. We understand that there may be unique contextual factors that may influence your experiences.
At our Los Angeles, CA, and New York City, NY-based therapy practice, we have many skilled, trauma-informed, and culturally sensitive therapists who can provide an empowering therapeutic experience. For your added convenience and simplicity, we offer online therapy for anyone in the state of California or New York. We know that navigating your work and career can be challenging, and we want to support you on your journey. Follow the steps below to begin.
- Fill out the contact form to get connected with us.
- Get matched with one of our individual EMDR therapists.
- Start the next step in your healing journey today.
Other Services at Yellow Chair Collective
There are many options for treatment using online therapy in California and New York, it just depends on what you’re needing. And while we certainly service Asian American folks, we also work with individuals from other cultures, too. So, whether you’re needing support in overcoming anxiety, burnout, trauma, or PTSD, we can help. Likewise, we serve teens and couples in need of support, too. So when you start online therapy with us, you can bring your whole self, including past struggles, cultural impacts, and more.
