If you’ve experienced ongoing trauma, especially in childhood or through repeated distressing events, you may at-risk for dealing with symptoms related to Complex PTSD (C-PTSD)—a condition that goes beyond the criteria of traditional PTSD. Understanding what C-PTSD is, how it affects the nervous system and what recovery can look like is the first step toward healing.
What Is Complex PTSD?
While PTSD typically develops after a single traumatic event (such as an accident, assault or natural disaster), Complex PTSD emerges after prolonged or repeated trauma—often involving emotional neglect, abuse or a lack of safety over time. This is especially common in situations where the person could not escape (such as childhood abuse, domestic violence relationships, kidnappings, war prisoners and/or long-term caregiving roles).
The ICD-11 (used by the World Health Organization) recognizes Complex PTSD (C-PTSD) as a separate diagnosis from PTSD. In contrast, the DSM-5 (used primarily in the United States by the American Psychiatric Association) does not yet list C-PTSD as a formal diagnosis. If you’ve survived prolonged or repeated trauma—especially trauma involving relationships, such as childhood abuse, kidnapping, been a war prisoner or survived a domestic violence relationship—you may have felt like your symptoms didn’t quite match the standard criteria for PTSD.
Unlike PTSD, which is typically rooted in a single traumatic event, C-PTSD reflects the impact of ongoing trauma, often within close relationships. In addition to the core symptoms of PTSD (re-experiencing, avoidance, hyperarousal), C-PTSD also includes:
- Persistent difficulties in emotional regulation
- Negative self-concept (e.g., shame, guilt, feelings of worthlessness)
- Interpersonal problems, such as difficulty trusting others, feeling disconnected, or struggling to maintain healthy boundaries
These relational wounds can profoundly affect your ability to feel safe with others and with yourself—often leading to misdiagnoses like Borderline Personality Disorder or Generalized Anxiety.
Recognizing the difference matters. If you’ve felt like therapy hasn’t quite addressed the root of your struggles, you’re not alone. Approaches like CPT, DBT, and trauma-informed care are evidence-based interventions that can help.
Common Symptoms of Complex PTSD
C-PTSD includes all the core symptoms of PTSD—such as flashbacks, nightmares, hypervigilance, and avoidance—but adds three more areas of difficulty:
- Emotional Regulation Challenges
- Intense emotions that feel hard to manage
- Difficulty calming down once triggered
- Emotional numbness or shutdown
- Negative Self-Concept
- Persistent feelings of guilt, shame, or worthlessness
- A belief that you are fundamentally broken or unlovable
- Harsh self-criticism and difficulty feeling proud of yourself
- Relational Difficulties
- Trouble trusting others
- Fear of abandonment or rejection
- Feeling disconnected from others or like no one truly understands you
The Impact on the Nervous System
When you've lived in environments where you couldn't relax, your nervous system adapts to that state of constant alert. You may find yourself stuck in fight, flight, freeze, or fawn mode even in safe situations. Over time, this can lead to:
- Chronic anxiety or panic attacks
- Trouble sleeping
- Feeling overwhelmed by daily tasks
- Avoiding relationships or clinging to unhealthy ones
- Living in a state of hyper-vigilance and/or dissociation
These symptoms are not character flaws—they areyour body doing its best to protect you. The key to healing is helping your nervous system feel safe and regulated again.
What Healing Looks Like
Healing from C-PTSD isn’t about "getting over" what happened to you. It's also not about trying to become a "better" version of yourself due to the traumatic event that you have experienced. Healing is about reclaiming your sense of safety, identity, and emotional balance. Here’s what that process often includes:
1. Creating Safety and Stability
Before diving into the past, therapy focuses on building present-day tools to help you feel calm and grounded. This includes:
- Nervous system regulation techniques (breathwork, grounding, somatic tools)
- Developing daily routines to create structure and predictability
- Learning how to self-soothe and cope when big emotions arise
2. Understanding and Naming Your Experience
So many people with C-PTSD don’t realize that what they experienced was trauma. Learning about trauma responses and how your brain and body adapted can be empowering. Psychoeducation is a key part of healing—it helps you realize, “This isn’t my fault.” Many people with C-PTSD find it incredibly helpful to learn about levels of fault and responsibility; allowing them to understand that they are survivors of abuse and not at fault.
3. Processing the Trauma
Evidence-based therapies like Cognitive Processing Therapy (CPT) can help you explore and reframe the painful beliefs you carry from the past. You’ll learn how to challenge narratives like:
- “It was my fault.”
- “I’ll never be safe again.”
- “I’m too damaged to be loved.”
Other helpful modalities may include:
- Dialectical Behaviour Therapy (DBT) – for emotional regulation and boundaries
- Acceptance and Commitment Therapy (ACT) – for values-based living and resilience
- Mindfulness and body-based work – to reconnect with yourself gently and safely
4. Rebuilding Identity and Relationships
As you heal, you start to rebuild your relationship with yourself—and others. You learn to trust your inner voice, set boundaries, and form relationships that feel mutual and safe. Therapy can help you:
- Understand how attachment wounds shaped your current relationships
- Reconnect with your values and sense of purpose
- Accept your emotional needs without shame
You Deserve to Heal
Living with Complex PTSD can feel exhausting—but healing is possible. With the right support, it’s entirely achievable to regulate your emotions, quiet your inner critic, and find a sense of peace in your body and mind.
💻 I provide online therapy for expats and international professionals across Europe, with a trauma-informed approach tailored to your unique story and goals.
If you’ve been feeling overwhelmed, misunderstood, or stuck, you don’t have to go through it alone.
🔗 Learn more or book a free consultation at www.christinababich.com
