In 2020, I had the immense privilege of working with a neuropsychologist in one-on-one cognition counseling. Our work was less like talk therapy—the open-ended style of counseling that allows patients to process big-picture emotions and personal history through dialogue—and more practical. One way I’ve described it to people is, "Regular therapy is about long-term change and getting better; cognition therapy is about concrete strategies to function better despite being a mess." He was aware of my background in psychology research, so sometimes I’d distract him from whatever problem of mine we were supposed to discuss by talking shop. One week, I asked him how he felt about the idea of complex post-traumatic stress disorder (CPTSD) as a diagnosis.
There is a lot of debate in the psychology community about whether or not this diagnosis should exist. At the time of writing, the World Health Organization recognized it in their diagnostic manual, the ICD-11, but the American Psychiatric Association chose not to in the DSM-5-TR, which was published second. Medical records, billing statements, and other documentation must refer to codes attached to the diagnoses in this manual, so exclusion prevents a disorder from formally existing, though clinicians may still talk about it with their clients. The disagreement is primarily around if it’s "too similar" to the existing PTSD diagnosis.
My neuropsychologist told me that he didn’t love the implication that "regular" PTSD is simple. Still, there is a documented difference in symptoms between people whose PTSD is prompted by a single traumatic incident and those who were stuck in consistently traumatic circumstances for long periods of time.
Fortunately, there are more resources and treatment options than ever and, therefore, more pathways to recovery. Unfortunately, the majority of these options present severe challenges with scheduling, insurance coverage, cultural competency, or all three.