What is complex PTSD, and how does therapy help?
Many people come to counselling saying, “I don’t think I’ve been through anything big enough to have trauma.” Often what they describe isn’t one dramatic event but years of feeling unsafe. That kind of experience can lead to complex post-traumatic stress disorder, or complex PTSD.
What is complex PTSD?
Complex PTSD (C-PTSD) can develop after repeated or long-lasting trauma, especially when it was hard or impossible to escape. Common causes include childhood abuse or neglect, domestic abuse, coercive control, living with a parent’s addiction, or ongoing bullying.
How is complex PTSD different from PTSD?
PTSD often follows a single frightening event, such as an accident or assault, and involves flashbacks, nightmares, avoidance and feeling on edge. Complex PTSD includes these, plus difficulties that grow from long-term harm:
- Strong emotions that feel hard to manage, or feeling numb
- A deep sense of shame, worthlessness or being “broken”
- Difficulty trusting people or feeling close to others
- A harsh inner critic
- Feeling disconnected from yourself or the world
Only a qualified professional can diagnose PTSD or C-PTSD. Your GP can refer you for an assessment if you’d find that helpful.
What does complex PTSD therapy involve?
Good complex PTSD therapy usually unfolds in phases:
- Safety and stabilisation: learning ways to calm your nervous system and manage overwhelming feelings before going near painful memories.
- Processing: gently working with traumatic memories, at your pace, using approaches such as trauma-focused CBT, EMDR or the Rewind Technique.
- Reconnection: rebuilding relationships, self-worth and a sense of who you are beyond the trauma.
A trauma counsellor should never push you to tell your whole story before you’re ready. Feeling safe in therapy is part of the treatment, not a step before it.
Signs it may be time to seek help
- Flashbacks, nightmares or intrusive memories
- Being constantly on alert or easily startled
- Avoiding people, places or conversations
- Struggling in relationships because of fear, mistrust or shutting down
- Using alcohol, food or other things to cope
If you recognise yourself here, you’re not overreacting, and you don’t have to have it all figured out before reaching out. If your trauma came from a controlling relationship, you may also find my post on narcissistic abuse helpful.
Ready to talk?
If any of this feels familiar, you don’t have to work through it alone. You’re welcome to book a free 30-minute chat on Zoom to see whether we’re a good fit, or read more about online trauma counselling.
If you’re in crisis or at risk of harm, please call your local emergency number (999 in the UK, 112 in the EU). In the UK you can also call NHS 111 (option 2) or Samaritans free on 116 123.