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  • Writer's pictureHeather Steele

Complex PTSD: Who Suffers and How to Heal

Complex Post-Traumatic Stress Disorder (C-PTSD) is a condition that results from enduring complex trauma, typically chronic and repeated traumatic events over months or years, rather than a single incident.

This guide aims to deepen your understanding of C-PTSD, including its causes, symptoms, and treatments. Whether you or a loved one is affected, gaining knowledge about this condition can be the first step towards recovery.

What is Complex PTSD?

Unlike PTSD, which usually stems from a singular traumatic incident, Complex PTSD is caused by prolonged exposure to distressing situations.

This could include long-term abuse, captivity, or exposure to warzones.

Those with C-PTSD often experience a broader range of emotional, psychological, and behavioral issues, which can pervade all areas of life.

Causes of Complex PTSD

The root cause of C-PTSD is prolonged exposure to a traumatic environment. This could include:

  • Childhood neglect or abuse: Both physical and emotional abuse during childhood can lead to C-PTSD. 

  • Domestic violence: Long-term abuse from a partner or family member is a common cause.

  • Living in a conflict zone: Extended exposure to war and conflict can result in C-PTSD.

  • Being held captive: Kidnapping or long-term imprisonment can trigger the development of C-PTSD.

Symptoms of C-PTSD

Complex PTSD encompasses a range of symptoms that can affect an individual's emotional and psychological health profoundly. These symptoms often include:

Persistent Sadness or Hopelessness

Long-term trauma can lead to a persistent feeling of sadness or despair. For example, a middle-aged woman, who experienced prolonged domestic abuse, might find herself in a constant state of melancholy that doesn't seem to lift, even in objectively happy moments with friends or family. She may struggle to envision a future where happiness or peace is possible, feeling trapped in her current emotional state.

Emotional Dysregulation

This refers to difficulty in controlling emotions which may manifest as sudden bursts of anger, persistent sadness, or feelings of emptiness. A practical example of this could be a young man who survived repeated bullying throughout school may experience intense, unpredictable emotional responses. He might lash out in anger over minor frustrations or become inexplicably overwhelmed with sadness during what should be a routine work meeting, finding it difficult to maintain steady emotions.

Detachment from Reality

Individuals may feel detached from themselves or the real world, a condition known as dissociation. After enduring years of childhood neglect, an individual may often feel detached from reality, as if they are watching their life from the outside. During periods of high stress or reminders of past trauma, they might even lose touch with the present moment, experiencing spells where they are not fully aware of their surroundings or what they are doing.

Avoidance Behaviors

Avoiding places, people, or activities that remind them of the trauma. A real life example of this could be a veteran, exposed to long-term combat situations, may avoid watching war movies or attending public events like fireworks displays that could trigger memories of trauma. This avoidance extends to social interactions where discussions about their military service might arise, leading to social withdrawal.

Negative Self-Perception

People with C-PTSD often struggle with feelings of helplessness, guilt, or shame, believing they are different from others. For example, a survivor of prolonged sexual abuse might harbor deep-seated feelings of guilt and shame, believing they are somehow flawed or unworthy of love and happiness. This can manifest in their interactions, where they may feel undeserving of success or hesitant to engage in relationships, fearing they are not enough as they are.

What are common groups of people that can be affected by C-PTSD?

Complex PTSD (C-PTSD) often arises from prolonged exposure to traumatic circumstances where escape seems impossible. In the United States, several groups and situations commonly lead to the development of C-PTSD:

Child Abuse Survivors

Individuals who experienced prolonged physical, emotional, or sexual abuse during childhood are at high risk for C-PTSD. The continuous trauma in a setting where they should feel safe—like a home—can lead to deep psychological scars.

This can also include childhood neglect (abandonment by parent or caregiver, unattended medical needs, consistent lack of supervision, etc.)

Domestic Violence Victims

Those who endure long-term domestic violence often develop C-PTSD. The repeated trauma and the complex dynamics of power and control within such relationships significantly impact mental health.

Human Trafficking Survivors

People who have been victims of human trafficking experience extreme and prolonged abuse, exploitation, and manipulation, making C-PTSD a common outcome.

Military Personnel

Veterans and active-duty members who have been in combat zones for extended periods or have been prisoners of war may develop C-PTSD. The chronic stress and life-threatening nature of these situations leave a lasting impact.

First Responders

Police, firefighters, and emergency medical technicians (EMTs) are repeatedly exposed to traumatic events. Over time, the accumulation of such experiences without adequate mental health support can result in C-PTSD.

Survivors of Chronic Illness or Severe Medical Trauma

Individuals who undergo prolonged medical treatments or who live with chronic debilitating illnesses can experience trauma from continuous pain, fear, and uncertainty about their future.

Cult Survivors

Those who escape from controlling groups or cults where abuse (physical, emotional, or sexual), manipulation, and complete control are common may also show signs of C-PTSD.

Residents of High-Crime Areas

Living in an environment where violence is frequent and safety is constantly threatened can lead to C-PTSD, particularly if the individual feels powerless to change their circumstances or escape.

These situations involve prolonged exposure to stress, fear, and often physical danger, which can disrupt the individual's sense of security and self, leading to the development of Complex PTSD. Early intervention and access to mental health services are crucial for individuals at risk to help mitigate these effects.

Treatment Options for Complex PTSD

Treatment for C-PTSD must be multifaceted to address the various aspects of the condition:


Therapies like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, and Somatic Experiencing (SE)  have been effective.


While not a cure, medication can help manage symptoms such as depression and anxiety.

Support Groups

Joining groups where members share similar experiences can provide emotional support and coping strategies.

Holistic Therapies

Techniques such as yoga, meditation, and acupuncture can help restore emotional balance and reduce stress.

How Therapy Can Help with C-PTSD

Therapy plays a crucial role in the treatment and management of C-PTSD. The therapeutic process for C-PTSD is comprehensive, often involving multiple modalities to address the diverse symptoms and underlying issues associated with long-term trauma exposure.

Here's a detailed look at how therapy can assist individuals with C-PTSD:

Understanding the Role of Therapy

Therapy provides a safe space for individuals to explore and express their feelings, understand their experiences, and start the healing process.

For someone with C-PTSD, the therapeutic environment offers consistency and security, which are often missing from their traumatic experiences.

Therapeutic Modalities Used to Treat C-PTSD

Cognitive Behavioral Therapy (CBT)

CBT is effective in helping individuals identify and challenge unhelpful patterns of thinking and behavior. It addresses distorted perceptions and beliefs about oneself and the world, which are common in C-PTSD. CBT also teaches practical skills for managing symptoms like intrusive thoughts and emotional dysregulation.

Dialectical Behavior Therapy (DBT)

This therapy is particularly useful for emotional regulation. It combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is another powerful treatment for trauma that involves processing distressing memories and beliefs. It's particularly noted for its ability to help patients reduce the vividness and emotion associated with trauma memories.

Somatic Experiencing

Developed to address the physiological effects of trauma, Somatic Experiencing helps individuals become more aware of their body sensations and learn to release tension, anger, and other emotions held in the body after trauma.

The Therapy Process

The process typically begins with the establishment of safety—creating a safe psychological space for the individual. Therapists often focus on building a trusting relationship and providing tools to stabilize the person before delving into trauma processing. This may include teaching grounding techniques, mindfulness, and other coping strategies.

As therapy progresses, the focus shifts to trauma processing, where individuals confront and reframe their traumatic experiences in a controlled, therapeutic setting. This phase is crucial and can be intense as it involves revisiting and working through trauma-related memories and emotions.

Finally, therapy aims to help individuals integrate their new skills and perspectives into their daily lives, enhancing their relationships and functionality. This stage also emphasizes relapse prevention and resilience-building.

Living with Complex PTSD

Living with C-PTSD requires a comprehensive management strategy that includes professional help, supportive relationships, and personal coping strategies. Education about the disorder can empower individuals and their loved ones to understand the condition better and advocate for appropriate care.

There is Help and Hope for People Struggling with C-PTSD

Complex PTSD is a challenging and persistent condition, but with the right support and treatment, individuals can manage their symptoms and lead fulfilling lives.

If you suspect you or someone you know may be suffering from C-PTSD, it's crucial to seek professional help. Local therapists and counselors are invaluable resources for those affected by C-PTSD.

For residents of Morrisville and surrounding areas struggling with Complex PTSD, reaching out for professional help is a crucial step toward recovery.

Contact our team at Morrisville Counseling and Consulting for a consultation to discuss your symptoms and start on the path to healing.


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