Understanding Complex PTSD: Part 1
Complex Post-Traumatic Stress Disorder (CPTSD) is a deeply complex mental health condition that arises from prolonged exposure to traumatic events, often during childhood or adolescence. Unlike PTSD, which typically results from a single, isolated incident, CPTSD stems from sustained trauma over a longer period. This chronic exposure profoundly impacts emotional, physical, and psychological well-being, shaping the way individuals perceive themselves, others, and the world around them.
The path to healing from CPTSD may feel overwhelming, but with the right therapeutic support, individuals can make meaningful progress toward recovery. In this blog post, we’ll explore CPTSD from a therapeutic perspective—understanding symptoms, identifying causes, and discussing treatments that help individuals regain a sense of safety, self-worth, and connection.
Recognizing the Difference Between PTSD and CPTSD
From a therapeutic viewpoint, understanding the distinctions between PTSD and CPTSD is critical for creating effective treatment plans (because nothing is worse than someone claiming they specialize in supporting your specific needs and then actually not have a clue of how to help you).
While both conditions involve trauma-related symptoms, such as flashbacks and anxiety, CPTSD encompasses more complex emotional and relational challenges that require a deeper level of intervention.
Emotional Dysregulation: This symptom of CPTSD often manifests as either intense emotional responses or emotional numbness. Therapy can focus on helping clients build emotional awareness and learn strategies to manage these overwhelming feelings without becoming consumed by them. Dialectical Behavior Therapy (DBT), for example, can help individuals tolerate and regulate emotional extremes through practical, skills-based interventions. While other therapies such as Eye Movement Desensitization and Reprocessing (EMDR) or Brainspotting can help the brain actually process past memories so that the emotions don’t feel as intensive overall (say “bye” to your laundry list of coping skills that you won’t need to rely on).
Negative Self-Concept: Individuals with CPTSD often develop a deeply ingrained sense of worthlessness or shame. Effective therapies for CPTSD work to challenge these internalized beliefs by reframing negative self-perceptions and reinforcing the truth that survivors are not to blame for their trauma. Fostering self-compassion is a key aspect of this healing process, helping clients redefine their identity apart from their traumatic experiences. Internal Family Systems is often a helpful approach to learn how our inner critic is trying to protect us from future harm (but actually causing harm along the way), and this therapy can be utilized to help younger “parts” of you realize they’re no longer living in the past.
Interpersonal Difficulties: Establishing and maintaining healthy relationships is another core challenge for individuals with CPTSD. In therapy, the focus can shift toward building trust in others and oneself. Therapists may use relational approaches such as Emotionally Focused Therapy (EFT) to help clients develop secure attachments and healthier relational patterns. Gradually, this process can enable survivors to feel safe in relationships and reduce fear of abandonment or rejection.
Uncovering the Root Causes of CPTSD
A significant aspect of CPTSD therapy involves exploring the underlying causes of the condition. Traumas rooted in childhood abuse, neglect, or prolonged exposure to violence can leave deep emotional wounds, and compared to PTSD it’s not always clear which “one event” set up the domino effect of how you feel and think the way you do today. Understanding the full picture of the origins of your thoughts and feelings helps individuals contextualize their pain and begin the journey of healing.
Childhood Abuse and Neglect: Therapy offers a safe space for individuals to revisit and process memories of childhood abuse, whether physical, emotional, or sexual. Approaches such as Eye Movement Desensitization and Reprocessing (EMDR) or Brainspotting are particularly helpful in reprocessing traumatic memories, enabling individuals to diminish the emotional grip these experiences hold.
Domestic Violence: Survivors of prolonged domestic violence often internalize feelings of helplessness and fear. Therapy here is focused on reclaiming personal agency and rebuilding a sense of safety. Techniques like Sensorimotor Psychotherapy can help survivors reconnect with their bodies and release trauma held within physical tension, while CBT can challenge distorted beliefs formed during the abuse.
Human Trafficking and War Trauma: For survivors of extreme and ongoing trauma, such as human trafficking or war, the therapeutic approach must address both the profound sense of loss and the pervasive fear associated with their experiences. Group therapy or trauma-focused therapy can provide survivors with both personal and collective healing, offering them a supportive community as they rebuild their lives.
Healing Through Understanding the Symptoms of CPTSD
In therapy, it's crucial not just to identify symptoms but also to nurture a compassionate understanding of them. Symptoms are not merely "problems to fix," but signs of deep pain that need gentle and consistent care. Through therapeutic work, individuals can learn to approach their symptoms with empathy instead of judgment, fostering healing in the process.
Emotional Symptoms
Chronic Sadness or Despair: Therapy can help individuals understand that their persistent sadness is a valid response to prolonged suffering. Techniques like Acceptance and Commitment Therapy (ACT) encourage individuals to embrace difficult emotions without judgment, while also fostering hope and creating meaning in their lives.
Suicidal Thoughts: Suicidal ideation often stems from feeling overwhelmed by emotional pain. In therapy, individuals are provided a safe space to express these thoughts while learning coping strategies to navigate their emotions safely. Therapists may also work with clients to develop safety plans and reduce distress while building emotional resilience over time.
Emotional Numbness: Numbness can act as a survival mechanism to avoid overwhelming pain. Therapies such as Sensorimotor Psychotherapy help clients gently reconnect with their bodies and emotions, creating a sense of safety and ease within themselves.
Check back next week for Part 2!
Looking to connect with a trauma therapist who specializes in helping individuals navigate Complex PTSD?
Take your first step towards rebuilding safety, self-worth, and connection in your life.
(Oregon & Washington residents only)
About the author
Amanda Buduris is a licensed psychologist providing virtual Brainspotting sessions in Oregon and Washington. In-person services are available for therapy intensives only. She is trained in multiple modalities of trauma-focused healing to best support clients who are looking to feel better faster.
