Posttraumatic Stress Disorder (PTSD) can develop after exposure to a traumatic event. Symptoms include [1]:

  • Intrusive thoughts, memories, or nightmares of the trauma
  • Avoidance of trauma reminders
  • Adverse changes in beliefs and mood
  • Hyperarousal symptoms like irritability and hypervigilance

Symptoms last over a month and cause significant distress or impairment.

Complex PTSD (CPTSD) may develop after prolonged, repetitive trauma, especially in childhood. In addition to PTSD symptoms, CPTSD includes [2]:

  • Severe problems with emotional regulation
  • Disturbed sense of self
  • Difficulty sustaining relationships
  • Loss of systems of meaning

The Voyage Acadamy ( penned a concise explanation of PTSD vs. CPTSD as follows:

I wanted today to explore and explain a little bit about the differences and similarities between PTSD (Post-Traumatic Stress Disorder) and C-PTSD (Complex Post-Traumatic Stress Disorder). It’s something I get asked a lot of questions about, and so I thought it might be helpful and useful to look at and discuss them both, alongside the various types of trauma someone might experience, and consider their effects on individuals. When we’re working with or healing from trauma, understanding the differences between PTSD and C-PTSD is crucial.  

However, before elaborating on this, it’s important to remind ourselves that trauma manifests in various forms, none of which are ‘lesser’ or ‘greater’ than any of the others and also they are NOT mutually exclusive either: 

Direct Trauma: Experienced firsthand, such as abuse or natural disasters.
Vicarious/Indirect Trauma: Experienced by those who help trauma victims, leading to secondary traumatic stress.
Developmental Trauma: Occurs in childhood due to a hostile or neglectful environment, impacting long-term development.
Complex Trauma: Results from prolonged exposure to traumatic events, often from childhood with more episodic trauma layered on top. 

It is also important to recognise that trauma is about the internal experience of the event, not the event itself, therefore, what is and feels traumatic for one person may not be for another.

Similarly, trauma is not just about the event or experience, it is also about the absence of something.  Therefore, essential developmental experiences such as emotional attunement, can be as traumatic, if not more so sometimes, than other overt types of abuse; particularly when experienced consistently and over an extended time.
While PTSD and C-PTSD share common symptoms, their roots and manifestations differ significantly. C-PTSD’s complexity often requires a more prolonged and nuanced therapeutic approach, addressing deep-seated issues of trust, and self-worth. This means that the therapeutic relationship often needs to be built over time so that deeper relational healing can occur. 

PTSD: Understanding the Impact of Singular Traumatic Events
PTSD typically arises from a single, identifiable traumatic event. Symptoms can include flashbacks, avoidance behaviours, and heightened reactions. PTSD encapsulates the acute response to a traumatic moment in one’s life. 

C-PTSD: The Result of Prolonged and Repeated Trauma
In contrast, CPTSD develops from chronic, repetitive trauma, often occurring over years, such as in cases of prolonged abuse, neglect or unsafe experiences. Its symptoms extend beyond those of PTSD, including difficulties in emotional regulation, a distorted sense of self, and challenges in forming relationships.

Ketamine has shown promise in treating PTSD and CPTSD symptoms through its effects on neural plasticity and consolidation of traumatic memories [3].

Studies have found IV ketamine rapidly reduces all PTSD symptom clusters within hours for up to 7 days [4]. This allows engagement in psychotherapy while symptoms are dampened.

For CPTSD, ketamine may also rapidly reduce emotional dysregulation and improve the sense of self by increasing prefrontal connectivity [5].

With repeated dosing, ketamine’s benefits are extended, especially when paired with psychotherapy. One study found sustained remission of PTSD symptoms for over 3 months in veterans who received 6 ketamine infusions alongside prolonged exposure therapy [6].

While more research is needed, ketamine therapy brings hope for quicker recovery and improved functioning for those suffering from PTSD and CPTSD.


[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

[2] World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision).

[3] McGhee LL, Maani CV, Garza TH, Gaylord KM, Black IH. The correlation between ketamine’s antidepressant and fear extinction effects in treatment-resistant posttraumatic stress disorder. Exp Clin Psychopharmacol. 2021;29(4):431-437. doi:10.1037/pha0000479

[4] Feder A, Parides MK, Murrough JW, et al. Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry. 2014;71(6):681–688. doi:10.1001/jamapsychiatry.2014.62

[5] Abhari AA, Baxter L, Belenko S, et al. A Systematic Review of Ketamine Trials for Treatment Resistant Depression: Efficacy Limitations and the Valuation of Heterogeneity. Front Psychiatry. 2020;11:72. Published 2020 Feb 28. doi:10.3389/fpsyt.2020.00072

[6] Albott CS, Lim KO, Forbes MK, Erbes C, Tye SJ, Grabowski JG, Shiroma PR, Thuras P, Wels J, Shiroma E. Efficacy, safety and durability of repeated ketamine infusions for comorbid posttraumatic stress disorder and treatment-resistant depression. J Psychiatr Res. 2018;104:148-155. doi: 10.1016/j.jpsychires.2018.06.012.

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Multiple trauma since being Child and trauma still happen till this day. Do 2 people need for money and easy come up? It’s unfortunate iPhone victim of have a sexual assault and many other thanks. And maybe cause I’m still just a good person. And I don’t believe in violence so somehow it just keeps happening to me But I’ve tried this once before through therapy. And it has helped me come to another understanding of people, and that that’s not my fault and that there are still good people. But there are still things that I could have done different. And I hope to try this again and maybe this will help me in a different understanding. Not you’re therapy but through my own therapy at home


Thank you for your comment. Ketamine therapy (as well as MDMA or psilocybin/magic-mushroom therapy) is excellent for enabling the body-mind to come to resolve and accept the fact of traumas. But, by itself, it’s not usually sufficient.

It is best, in my opinion (widely held) to have an empathetic psychotherapist work with yo concurrent with pharma-co-therapy. It’s difficult to find such a psychotherapist. I suggest the book The Audacity to be You. It explains what a really effective psychotherapist looks like and feels like in therapy.

I can, in particular, suggest the modalities: EMDR and Coherence-Therapy (based on Memory Reconsolidatin theory). They are particularly effective for trauma.

If you need any specific comments or suggestions, feel free to comment or write to