What is CPTSD? Complex Post Traumatic Stress Disorder
When most people hear the word trauma, they think of one-time, acute events: accidents, natural disasters, or assaults. These experiences are undeniably traumatic and can have a profound impact. But there’s another kind of trauma that’s quieter, more nuanced, and often overlooked. People can live with complex trauma for years or even decades without realizing they have experienced trauma.
What is complex trauma?
At its core, complex trauma refers to repeated or prolonged exposure to traumatic events (often beginning in childhood) that happen in the context of relationships. It’s the kind of trauma that accumulates over time and often includes emotional neglect, chronic misattunement, abuse, or growing up in an environment where you had to consistently suppress your needs to stay safe or loved.
Unlike single-incident trauma, complex trauma isn’t always about what happened to you -- it can also be about what didn’t happen. The safety that wasn’t there. The nurturing you didn’t receive. The sense of being seen and known that was never offered.
What is the impact of complex trauma?
Complex trauma tends to shape not just how we feel, but who we are. It embeds itself in our nervous systems, our beliefs about ourselves, and our relationships. It can show up as chronic shame, emotional dysregulation, hyper-independence, or deep fears of abandonment. It can make intimacy feel threatening and stillness feel intolerable. And often, people living with complex trauma don’t even realize that what they’ve experienced is trauma. They just assume they’re broken or too much.
What is the difference between CPTSD and PTSD?
While both PTSD (Post-Traumatic Stress Disorder) and CPTSD (Complex Post-Traumatic Stress Disorder) develop in response to trauma, they often stem from different kinds of experiences. PTSD usually follows a single, life-threatening or deeply distressing event, like an accident, assault, or natural disaster. CPTSD, on the other hand, often develops after long-term or repeated trauma, especially in relationships where you couldn’t escape, such as childhood abuse, neglect, or domestic violence.
People living with CPTSD experience the core symptoms of PTSD, but may also struggle with long-lasting effects on their emotions, sense of self, and relationships. In other words, CPTSD reflects not just what happened to you, but how it shaped the way you see yourself and connect with others.
PTSD Symptoms (DSM-5-TR)
A PTSD diagnosis generally includes exposure to a traumatic event plus symptoms from four main clusters:
Re-experiencing: Intrusive memories, flashbacks, or nightmares.
Avoidance: Avoiding reminders of the trauma (people, places, thoughts).
Negative changes in mood or beliefs: Shame, guilt, detachment, loss of interest, or persistent negative self-beliefs.
Hyperarousal: Feeling on edge, irritable, easily startled, or having sleep difficulties.
Symptoms must last at least one month and cause significant distress or impairment in daily life.
CPTSD Symptoms (ICD-11)
CPTSD includes all of the symptoms of PTSD, along with three additional areas of difficulty called “disturbances in self-organization” (DSO):
Emotional regulation: Difficulty managing emotions or feeling emotionally shut down.
Negative self-concept: Deep feelings of shame, guilt, or worthlessness.
Relational difficulties: Challenges trusting others, feeling safe in relationships, or maintaining closeness.
These added layers reflect how chronic, relational trauma can deeply affect one’s inner world — not just causing fear, but also shaping the way we feel about ourselves and others.
Healing is possible
Healing from trauma, whether it’s PTSD or CPTSD, takes time, care, and the right kind of support. In therapy, we work to gently reconnect with safety in your body and your relationships, helping the parts of you that had to survive learn that it’s safe to rest. Over time, it becomes possible to hold your experiences with more compassion, feel more grounded in who you are, and rebuild a sense of trust, both in yourself and in others.
Healing from complex trauma is not about “just thinking differently”, which is why top-down approaches like CBT are often not enough for those who have experienced complex trauma. Healing from complex trauma happens in safe, consistent, attuned relationships. Whether that’s in therapy, community, or chosen family, we need spaces where all our parts can show up and be met with compassion. Through this, we can begin to unlearn the shame-based narratives we have been living in our entire lives.
CPTSD Resources
Connect with others who have similar experiences:
Therapeutic Books:
Memoirs:
Therapy for CPTSD
If you resonate with this post, you’re not alone, and there is nothing wrong with you. Your responses make perfect sense in light of what you’ve lived through. And there is a way forward — one that is slower and kinder than the world often makes room for. If you are looking for a therapist who specializes in CPTSD, you can learn more about my approach here. If you are ready to connect, you can reach out via the contact form below, or click the button below to book in a free 20-minute consult.
