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Understanding Complex Trauma And Living With CPTSD


Complex trauma describes a person’s exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term effects of this exposure. These events are severe and pervasive, such as abuse or profound neglect. They usually occur early in life and can disrupt many aspects of the child’s development and the formation of a sense of self. Since these events often occur with a caregiver, they interfere with the child’s ability to form a secure attachment. Many aspects of a person’s healthy physical and mental development rely on this primary source of safety and stability.

What is Complex Post-Traumatic Stress Disorder?

Most people are familiar with post-traumatic stress disorder (PTSD), an anxiety disorder that results from a traumatic event, such as a natural disaster or car accident. However, a closely related condition called complex post-traumatic stress disorder (CPTSD) is becoming more widely recognized by doctors in recent years. CPTSD results from repeated trauma over months or years, rather than a single event.

Complex Trauma Disorder

Trauma can come in many forms. The soldier returning from active duty in a war zone, the child who lives with physical, sexual, or emotional abuse or neglect, the first responder who must deal with human suffering on a daily basis, and the adult who endures domestic abuse all are experiencing trauma. Complex trauma occurs repeatedly and often involves direct harm to the victim. Its effects are cumulative and generally transpire in a specific setting and, frequently, within a particular time frame or within a specific relationship.

Going through trauma can make an individual experience intense feelings of guilt as if they are somehow responsible for the event(s) that are so terrifying to them. This altered sense of shame and painful self-perception is crippling. It can make the person feel isolated and hopeless, and as if they are no longer in charge of themselves.

A closely related condition called complex post-traumatic stress disorder (CPTSD) is becoming more widely recognized by doctors in recent years.
A closely related condition called complex post-traumatic stress disorder (CPTSD) is becoming more widely recognized by doctors in recent years.

Complex Trauma Symptoms

By itself, trauma can produce feelings of anger, persistent sadness, and despair. In addition to these symptoms, complex trauma can include:

  • Becoming preoccupied with revenge or, conversely, giving total power to the perpetrator
  • Episodes of feeling detached from one’s body or mental processes
  • Isolation, guilt, shame, or a feeling of being totally different from other people

What are the Symptoms?

The symptoms of CPTSD usually include those of PTSD, plus an additional set of symptoms.

Symptoms of PTSD

Reliving the traumatic experience: This can include having nightmares or flashbacks.

You may have heard of post-traumatic stress syndrome or PTSD, but you may not be familiar with Complex Trauma, sometimes known as c-PTSD.
You may have heard of post-traumatic stress syndrome or PTSD, but you may not be familiar with Complex Trauma, sometimes known as c-PTSD.
  • Avoiding certain situations: You might avoid situations or activities, such as large crowds or driving, that remind you of the traumatic event. This also includes keeping yourself preoccupied to avoid thinking about the event.
  • Changes in beliefs and feelings about yourself and others: This can include avoiding relationships with other people, not being able to trust others, or believing the world is very dangerous.
  • Hyperarousal: Hyperarousal refers to constantly being on alert or jittery. For example, you might have a hard time sleeping or concentrating. You might also be unusually startled by loud or unexpected noises.
  • Somatic symptoms: These refer to physical symptoms that don’t have any underlying medical cause. For example, when something reminds you of a traumatic event, you might feel dizzy or nauseated.
Symptoms of CPTSD

People with CPTSD typically have the above PTSD symptoms along with additional symptoms, including:

  • Lack of emotional regulation: This refers to having uncontrollable feelings, such as explosive anger or ongoing sadness.
  • Changes in consciousness: This can include forgetting the traumatic event or feeling detached from your emotions or body, which is also called dissociation.
  • Negative self-perception: You may feel guilt or shame, to the point that you feel completely different from other people.
  • Difficulty with relationships: You might find yourself avoiding relationships with other people out of mistrust or a feeling of not knowing how to interact with others. On the other hand, some might seek relationships with people who harm them because it feels familiar.
  • Distorted perception of the abuser: This includes becoming preoccupied with the relationship between you and your abuser. It can also include preoccupation with revenge or giving your abuser complete power over your life.
  • Loss of systems of meanings: Systems of meaning refer to your religion or beliefs about the world. For example, you might lose faith in some long-held beliefs you had or develop a strong sense of despair or hopelessness about the world.

It’s important to note that symptoms of both PTSD and CPTSD can vary widely between people, and even within one person over time. For example, you might find yourself avoiding social situations for a period of time, only to start seeking potentially dangerous situations months or years later.

If you’re close to someone with CPTSD, it’s also important to remember that their thoughts and beliefs might not always match up with their emotions. They might know that, logically, they should avoid their abuser. However, they might also hold onto a sense of affection toward them.

Causes of CPTSD

Researchers are still trying to figure out exactly how traumatic stress affects the brain and leads to conditions like CPTSD. However, studies on animals that trauma can have lasting effects on the amygdala, hippocampus, and prefrontal cortex. These areas play a big role in both our memory function and how we respond to stressful situations.

Any type of long-term trauma, over several months or years, can lead to CPTSD. However, it seems to appear frequently in people who’ve been abused by someone who was supposed to be their caregiver or protector. Examples include survivors of human trafficking or ongoing childhood sexual abuse by a relative.

CPTSD is believed to be caused by severe, repetitive abuse over a long period.
CPTSD is believed to be caused by severe, repetitive abuse over a long period.

Other examples of long-term trauma include:

  • Ongoing physical, emotional, or sexual abuse
  • Being a prisoner of war
  • Living in an area of war for long periods of time
  • Ongoing childhood neglect

Programs, services, and treatments vary. We Level Up rehab facilities do not provide EMDR therapy. Because patient stability should come prior to EMDR treatment. That’s why EMDR therapy to process trauma for patients actively drinking and abusing drugs should await their stability phase of treatment. EMDR phases 3 – 8 therapy is best enacted for patients that feel and experience a safer, trustful connection with their treatment team.

We Level Up rehab centers treat the entirety of behavioral health disorders including secondary corresponding illnesses to improve long-term recovery outcomes. Get a free substance abuse and or mental health assessment and find out what treatment options are most suitable for you. Call to learn more.

Complex Trauma Treatment

Complex trauma therapy utilizes several modalities to address different symptoms. The current method for treating complex trauma is a combination of talk therapy, cognitive behavioral therapy, and exposure therapy. According to Dr. Bessel Van Der Kolk, medical director and founder of the Trauma Center at Justice Resource Institute and professor of psychiatry at the Boston University School of Medicine, the current treatment for complex trauma only deals with one aspect of the trauma – the memory portion. And, while treating the memory is helpful, it isn’t enough.

Because trauma also impacts the portion of the brain responsible for survival, a person who suffers from complex trauma either becomes numb (hypo-aroused) to the trauma or hyper-react to the slightest hint of danger.  Dr. Van Der Kolk notes, “In the long term the largest problem of being traumatized is that it’s hard to feel that anything that’s going on around you really matters. It is difficult to love and take care of people and get involved in pleasure and engagements because your brain has been re-organized to deal with danger.”

Since complex trauma affects both the conscious and unconscious portions of the brain, we need to also work to heal the unconscious. Recently, we have found that body-oriented approaches such as yoga, mindfulness, and EMDR can help the body and mind reconnect. The assessment for adults should be conducted by a clinically trained provider who understands development and complex trauma. Ideally, the assessment should involve a multi-disciplinary team.

In 2014, the National Institute for Mental Health (NIMH) funded a study on the effects of EMDR (Eye Movement Desensitization and Reprocessing) on adults with post-traumatic stress disorder (PTSD). At the conclusion of this study, Dr. Van Der Kolk reported that “the facts are that the EMDR study was spectacularly successful in adults” for awakening a person’s sensory modality to help them sense pleasure and feel engaged.

In addition, neurofeedback (a type of biofeedback that focuses on brain waves) has shown promise in helping patients with complex PTSD learn to change the activity of their brain waves to help them become calmer, more self-observant, and better able to engage with others.

Healing from Complex Trauma

By restoring self-awareness and learning to focus on what’s happening between your rational and emotional brains, you gain control of your reactions.  Dr. Van Der Kolk states, “People get better by befriending themselves. People can leave the trauma behind if they learn to feel safe in their bodies—they can feel the pleasure to know what they know and feel what they feel. The brain does change because of trauma and now we have tools to help people be quiet and present versus hijacked by the past.”

Living with CPTSD

CPTSD is a serious mental health condition that can take some time to treat, and for many people, it’s a lifelong condition. However, a combination of therapy and medication can help you manage your symptoms and significantly improve your quality of life.

If starting treatment sounds overwhelming, consider joining a support group — either in person or online, first. Sharing your experience with people in similar situations is often the first step toward recovery.

Reclaim your life from Complex Post-Traumatic Stress Disorder

At We Level Up Florida Treatment Center, we provide world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about the complex trauma and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and will answer any of your questions.

Your call is private and confidential, and there is never any obligation.


[1] HealthDirect. (2017). Complex post-traumatic stress disorder (PTSD).

[2] The National Center for PTSD. (2017). PTSD and DSM-5.

[3] The National Center for PTSD. (2015). Symptoms of PTSD.

[4] The National Center for PTSD. (2016). Complex PTSD.

[5] Taycan O, et al. (2015). An alternative approach to the effects of multiple traumas: Complex post-traumatic stress disorder.