Complex PTSD
Complex PTSD, otherwise referred to as C-PTSD, is closely related to post-traumatic stress disorder (PTSD) though may include some additional symptoms and the causes may be different.
Where PTSD usually results from a specific event, such as a natural disaster, major accident or assault, complex PTSD is caused by ongoing or repeated stress or trauma (known as complex trauma), particularly if this happens in your younger years. Repeated relational trauma is often part of C-PTSD sufferers' experience.
The developmental and psychological impact of repeated, complex trauma can often be more significant than the effects of a single traumatic event. The symptoms of complex PTSD may not show up for years and may only become clear to people in adulthood.
Complex PTSD is more likely to arise in cases where:
- the trauma was repeated or prolonged
- the trauma happened in childhood
- you felt unsafe for a long period of time
- you were subjected to harm by someone you trusted and who was close to you
Experiences that may contribute to complex PTSD:
- neglect and/or abuse in childhood
- witnessing or being the victim of domestic abuse or violence
- being forced or manipulated into prostitution
- living in an area affected by war
- torture, kidnapping or slavery
- other adverse childhood experiences
What are the symptoms of complex PTSD?
Some of the symptoms of PTSD may also be present in people with complex PTSD. These might include flashbacks, disturbing memories, engaging in numbing behaviours like drinking, difficulty sleeping and/or concentrating.
Someone with complex PTSD may or may not have those more recognisable symptoms of PTSD like flashbacks, and instead may experience more of the following:
- feelings of guilt or shame and/or having a negative self-view
- feeling like you may be permanently damaged or that you are different to other people
- feeling distrustful towards the world, or angry
- dissociative symptoms (feeling outside of your body)
- feeling numb, empty or hopeless
- trouble in relationships, whether romantic or platonic
- avoiding friendships and relationships, or finding them very difficult
- experiencing emotional flashbacks, where you feel similarly to during the trauma (for example, scared, ashamed, helpless)
How can therapy help with C-PTSD?
NICE recommends EMDR (eye movement desensitisation and reprocessing) for the treatment of PTSD, and it can also be used to support people who have complex PTSD. However, it is thought to be less effective in cases of complex PTSD rather than single-event trauma.
As complex PTSD is usually the result of prolonged distress or lack of safety in childhood, a mode of therapy that helps you explore and understand your childhood may be more beneficial. This might be psychodynamic therapy, but many other humanistic therapies also take early experiences into account, like gestalt therapy and person-centred counselling.
If part of your complex PTSD experience is feeling mistrustful of other people, you will likely need to engage in relatively long-term therapy in order to build a trusting and robust relationship with your therapist.
Last updated 7 October 2024
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