Understanding PTSD, Complex PTSD, and Borderline Personality Disorder
Many people come to therapy after years of living with symptoms of trauma, but aren’t sure how to make sense of them. Terms like PTSD, Complex PTSD, and Borderline Personality Disorder are often used interchangeably, yet they describe different patterns of response to pain and survival. Understanding these distinctions helps guide the right treatment, one that’s not only evidence-informed, but also compassionate and culturally-informed.
Post-Traumatic Stress Disorder (PTSD)
PTSD can develop after a single traumatic event or a series of time-limited incidents, such as a serious accident, assault, or natural disaster or finding out about these events happening to someone close to you.
The nervous system remains in a state of alarm, leading to symptoms such as:
Intrusive memories or nightmares
Avoidance of reminders
Feeling constantly on edge or easily startled
Emotional numbness or detachment
Treatment:
Therapies such as Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and EMDR (Eye Movement Desensitization and Reprocessing) have strong research support. These approaches help the brain safely integrate traumatic memories and teach the body and mind to feel safe again.
Complex PTSD (C-PTSD)
Complex PTSD, on the other hand, develops after prolonged or repeated trauma in environments where escape is difficult or impossible, such as childhood abuse, domestic violence, war, or imprisonment. It can deeply affect one’s sense of self and ability to trust others.
In addition to the core symptoms of PTSD, people with C-PTSD may experience:
Persistent shame, guilt, or self-blame
Emotional dysregulation
Chronic fear of abandonment
Relationship difficulties and social withdrawal
Treatment:
Healing from complex trauma takes time and happens in stages:
Stabilization: building safety, emotional regulation, and grounding skills
Processing: gradually working with traumatic memories when the nervous system is ready
Reconnection: strengthening self-compassion and rebuilding safe relationships
Different trauma-informed therapeutic approaches are often necessary to treat Complex PTSD at each stage. Typically, a combination of Dialectical Behavioural Therapy (DBT), Acceptance & Committment Therapy (ACT) and other trauma-focused approaches (e.g., CPT, EFT, somatic therapy, mindfulness) are often combined within a phased, relational framework.
Borderline Personality Disorder (BPD)
BPD involves patterns of intense emotion, unstable relationships, and a shifting sense of identity. It often arises from a combination of biological sensitivity and early invalidation or trauma. There is much overlap between BPD and Complex PTSD in both symptoms and the approach to treatment.
Common features of BPD include:
Fear of abandonment
Rapid mood shifts
Impulsivity or self-destructive behaviours
Feelings of emptiness or instability in self-image
Treatment:
The most effective and well-studied approach is Dialectical Behaviour Therapy (DBT), which helps individuals regulate emotions, tolerate distress, and develop stable, healthy connections with others.
Finding the Right Fit for Treatment
While PTSD, C-PTSD, and BPD share some overlapping symptoms, the underlying causes and the path to recovery differ slightly. A trauma-informed assessment can clarify what’s happening beneath the surface and guide an approach that supports both emotional safety and long-term healing.
At Trauma Care Psychology, we integrate evidence-based treatments with compassion and cultural sensitivity. We recognize that trauma doesn’t occur in isolation and that it’s shaped by relationships, identity, and the environments we come from.
By: Dr. Arela Agako, C.Psych.
Founder | Clinic Director | Psychologist
