Combat Post Traumatic Stress Disorder (PTSD) and PTSD as a Result of Workplace Bullying…Is There a Difference?






Written by:  Ron Watkins CMC
President of Mountain Sky Consulting
December 22, 2014

During my presentations to professional organizations I’m frequently asked, “Is Post Traumatic Stress Disorder (PTSD) caused by bullies the same as PTSD experienced by combat service veterans?”  Unfortunately, the answer is typically “it depends.” It’s not an easy question since there are so many factors that influence the onset of PTSD, i.e. the type of bully behaviors experienced by the target, length of exposure to the toxic office environment, or psychological stamina of the target to name a few.  There is never enough time in the Q&A portion of the presentation to address the question adequately.

There are several definitions regarding how the PTSD condition is described. Dr. James Bender of the Deployment Health Clinical Center separates it into two separate categories, PTS and PTSD.  He believes that PTS is a common, normal and often adaptive response to experiencing a traumatic or stressful event such as car accidents, kidnappings, or witnessing traumatic events. Although the event can be momentarily intense, symptoms of PTS usually subside after a few days after the event and won’t cause a prolonged interference with normal life functioning other than to perhaps be more careful in a potentially dangerous situation in the future.

Post-Traumatic Stress Disorder is commonly described as reliving a traumatic event through nightmares, flashbacks, or constantly thinking about it. The individual might avoid situations or people that remind him/her of the event, constantly feel jittery, hyper-vigilant of the surroundings, problems sleeping, or nightmares.  Although the symptoms may sound similar to PTS the major difference is related to the duration and intensity.  There seems to be a common agreement among researchers and the medical profession that when the symptoms continue for more than one month, are severe, and interfere with daily functioning they to tend consider these symptoms to be major characteristics of PTSD.

Since December of 2013 there is a growing awareness that PTSD can also result from an accumulation of many small, individually non-life-threatening, incidents that has come to be referred to “Complex PTSD”.  It’s believed that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include recurring thoughts of being a captive, lack of any means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and crucial lack of control and dis-empowerment. These symptoms are considered severe and the effects will tend to effect the target’s quality of life for months and even years.  Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, or the possibility of mounting debt. The key feature of Complex PTSD is the aspect of feeling trapped and the trauma of being unable to escape the situation. The real killer is being unable to get a job reference from the bully that can possibly slander the target’s name for years.

A Few of the Health Effects of Bullying Under Complex PTSD:

  • One of  the key symptoms of prolonged stress is reactive depression; this causes the balance of the mind to be disturbed, leading first to thoughts, attempts and ultimately suicide
  • Sleeplessness, nightmares, and replays of  being bullied are common
  • Constant state of fatigue because the target is unable to switch the brain off which leaves the target often more tired than when they went to bed
  • Chronic anxiety, panic attacks (e.g. receiving threatening letters or emails from the bully)
  • Physical and emotional numbness (inability to feel joy)
  • Place of work holds such horrific memories that it becomes impossible to show up at the office
  • Reports of impaired memory which may be due to damage to the hippocampus (an area of the brain linked to learning and memory)
  • Target has an extremely short fuse and is permanently irritated
  • Target develops a sense of low self-esteem
  • A constant state of “fight or flight” which causes the body to become awash with cortisol which in high prolonged doses is toxic to brain cells (Cortisol kills off neuroreceptors in the hippocampus that is also the control center which impairs the fight or flight mechanism)
  • Stress is known to cause brain damage (Dr. John O’Brien at Newcastle General Hospital 1995) Employers that practice long hours, threats and coercion might find themselves on the wrong end of a string of expensive personal injury lawsuits)


Explanations as to the Differences Between Combat PTSD and Complex PTSD from a Toxic Workplace

A study conducted by Janoff-Bulman (1992), referred to as cognitive theory of trauma, proposes that post-traumatic stress caused by victimization may be due to the shattering of basic assumptions, or expectations, victim’s evaluation of themselves, other people, and the world.  Based on these positive assumptions and expectations determine how people cope during their daily functioning. Both are cognitively and effectively potent.  For an example, the combat soldier is exposed to rigorous training prior to being deployed.  One of their expectations regarding being a soldier during their training is that they will be placing themselves and their comrades in “harm’s way” due to conditions in which they will be exposed. Even though they may be totally unaware as to when that will occur they will have learned to expect it and know how to act accordingly. In contrast to the soldier, the potential target in the workplace arrives at the office with an attitude of benevolence of the impersonal world and benevolence of people.  They are typically excited about how their skills will serve to contribute to the organization, perhaps the challenge of learning new skills, and their expectation of working with new management in a positive environment.  The former assumption entails that the world is seen as a good place where misfortune tends to be uncommon, the latter assumption entails that people are considered as basically kind, caring, and helpful. Unlike the soldier, when the target is exposed to traumatic causing behaviors, whether personally or situationally, the target is shocked to realize their expectation is no longer viable. The incongruity between the traumatic events and the prior expectation leads the target totally confused and overwhelmed as to how he/she should respond. For those who are unable to re-evaluate their position and adjust accordingly they remain in a state of confusion, stress, and anxiety that are the initial characteristics of PTSD.

Secondly, during the basic training period there is a strong emphasis on what might be viewed as teambuilding and the appreciation of what duties and skills each soldier contributes to the team. Although a soldier may not bond with another, the importance regarding the support of one team member for another trumps the personal relationship.

This is not to say that complex PTSD will not develop but the condition of PTS can be, and usually is, the precursor for a more dramatic condition of PTSD during the soldier’s tour of duty. The point that needs to be emphasized is that PTSD, whatever level of PTSD that develops for the soldier, most frequently evolves from the results of combat situations and not from personal attacks during the soldier’s tour of duty.  Personal attacks are more indicative of PTSD that results from a toxic office environment.

A frequent complaint that bullied targets report is an ongoing lack of social support from co-workers, peers, relatives, etc. There is a host of professional studies that reveal that isolation, ostracism, and/or lack of involvement with peers in the workplace are linked to a variety of ill effects on health, adjustment, and lack of sense of well-being. The need to belong and the reassurance of emotional support are fundamental and extremely powerful motivators.

In an office perpetrator/target scenario the bully attacks an individual’s thinking regarding personal attitudes, beliefs, sense of self-worth or self-esteem which has little or no relevancy to the target’s performance of their job responsibilities. The bully’s behavior is focused on violating and redefining the target’s assumptions that people and the world (workplace) are benevolent. During the onset of new employment the target, unfortunately, is inclined to share more personal information with the bully and, as a result, the target fails to initially establish limits or boundaries as it pertains to the bully’s behavior. The Workplace Bully Institute (WBI) reported that when counseling women in particular, the most common description of how the bullying relationship makes them feel is, “I feel like I have been psychologically raped repeatedly and slowly over a long period of time.” This comment adds credibility to the study that was conducted involving 160 Army women upon returning from the Persian Gulf (Wolfe, 1998) reported the sexual assaults they experienced during their tour had a larger impact on PTSD symptomatology than combat exposure.


When asked whether PTSD experienced by a combat soldier is the same when compared to the PTSD experienced in a toxic work environment the answer remains the same: “It depends”.    The conditions and variables related to the psychological and physiological  damages that occur when struggling with PTSD, whatever level of PTSD (PTS, PTSD, or Complex PTSD),  are major determining factors in the treatment process.  There are no uniform standards, definitions, explanations, or common cures in treating the condition and must be addressed on a case by case basis.


Ron Watkins, President of Mountain Sky Consulting is a Certified Management Consultant (CMC) which represents a distinction of the highest global standards for performance, knowledge, and ethical principles in the consulting profession.  He is the Carolina affiliate of the Workplace Bullying and Research Institute located in Bellingham, Washington and a member of the Institute of Management Consulting.