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    Learn more about complex PTSD

    Complex PTSD (C-PTSD) is a trauma-related condition that develops in response to prolonged, repeated, or inescapable traumatic experiences, typically involving a power imbalance such as childhood abuse or neglect, domestic violence, torture, or prolonged captivity. Recognised in the ICD-11 as a distinct diagnosis, C-PTSD encompasses the core symptoms of post-traumatic stress disorder (PTSD), including intrusive memories, avoidance, and hyperarousal, alongside a second cluster of difficulties known as disturbances in self-organisation: profound difficulties with emotional regulation, deeply held shame or worthlessness, and pervasive problems in relationships. These additional features reflect the impact of trauma that occurred over time rather than as a single event, and they require a different treatment approach from standard PTSD.

    C-PTSD can be difficult to recognise because its effects extend well beyond the symptoms most people associate with trauma.

    Core trauma symptoms

    • Intrusive memories, flashbacks, or nightmares related to traumatic experiences
    • Strong avoidance of reminders, people, or places associated with the trauma
    • Feeling constantly on guard, easily startled, or unable to relax

    Disturbances in self-organisation

    • Intense and rapidly shifting emotions that feel difficult or impossible to control
    • Persistent shame, guilt, or a deep sense of being fundamentally damaged or worthless
    • Feeling detached from yourself or from others, including people you are close to
    • Difficulty trusting others, or a pattern of relationships that repeat earlier harmful dynamics
    • A fragmented or unstable sense of identity
    Only a qualified mental health professional can assess whether these experiences meet the criteria for C-PTSD, and can distinguish it from related conditions such as borderline personality disorder (BPD). If you are experiencing thoughts of suicide or self-harm, please contact a crisis line or your nearest emergency service.

    Treatment for C-PTSD follows a phased model: stabilisation and safety first, trauma processing second. Skipping the stabilisation phase increases the risk of overwhelm and retraumatisation.
    • EMDR (Eye Movement Desensitisation and Reprocessing) EMDR adapted for complex trauma helps process traumatic memories at a careful, titrated pace, reducing their emotional charge without requiring extensive verbal recounting.
    • Trauma informed care Trauma-informed care shapes the entire therapeutic relationship around safety, transparency, and the client's sense of control, which is foundational for people with histories of relational trauma.
    • Somatic experiencing Somatic experiencing addresses the physical dimension of complex trauma, including the chronic tension, numbness, or dysregulation held in the body after prolonged threatening experiences.
    • IFS (Internal Family Systems) IFS works with the fragmented internal parts that develop in response to complex trauma, including protective and exiled parts, moving toward a more integrated and self-led internal system.
    • DBT (Dialectical Behaviour Therapy) DBT builds practical skills in emotional regulation, distress tolerance, and interpersonal effectiveness, which are particularly useful in the stabilisation phase when distress is intense.
    Choosing an approach isn't something you have to do alone. IC's matching can pair you with a therapist whose approach suits your situation. Get matched.

    It's Complicated is a therapist-founded mental health platform connecting clients with verified practitioners across Europe and globally, in over 60 languages. We work with over 2,500 vetted therapists, with in-person availability in Berlin, Amsterdam, Barcelona, Lisbon, Vienna, and other major cities, alongside online sessions worldwide. It's Complicated is free to use, and you pay your chosen therapist directly at rates they set. Finding a therapist who understands complex trauma specifically, and who knows how to pace the work safely, is more important here than in almost any other context. Our matching service is built to remove that friction. You complete a short survey, our psychologists combine data-driven insights with human judgement to identify the right therapists for your situation, and you choose from a shortlist of strong candidates. You can also browse our directory directly if you'd prefer to choose yourself. Get matched with a therapist who specialises in complex PTSD, or browse the directory.
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    Our therapist network for complex PTSD

    Finding the right therapist can make all the difference. Explore 2,500+ carefully selected professionals to find yours.

    Our therapist network for complex PTSD

    Finding the right therapist can make all the difference. Explore 2,500+ carefully selected professionals to find yours.
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    Related topics

    Mental health is rarely just one thing, and different topics often go hand in hand. If you're exploring help with complex PTSD, these areas might be worth a look too.
    PTSD
    PTSD
    Trauma
    Trauma
    Transgenerational trauma
    Transgenerational trauma
    Dissociative disorders
    Dissociative disorders
    Borderline personality disorder
    Borderline personality disorder

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    FAQs about complex PTSD

    Post-traumatic stress disorder (PTSD) typically follows a single or discrete traumatic event and involves intrusive memories, avoidance, and hyperarousal. Complex PTSD (C-PTSD) develops after prolonged or repeated trauma, often involving captivity or entrapment such as childhood abuse, domestic violence, or prolonged neglect. In addition to PTSD symptoms, C-PTSD involves disturbances in self-organisation: chronic shame, difficulty regulating emotions, and problems in relationships.

    Complex PTSD requires a phased approach. Initial work focuses on stabilisation and building safety before trauma processing begins. EMDR (Eye Movement Desensitisation and Reprocessing) and trauma-informed care are central to most treatment models. Internal Family Systems (IFS) therapy works well with the fragmented sense of self common in C-PTSD. DBT helps build emotional regulation skills, particularly when distress is intense.

    Complex PTSD treatment is typically longer term than for single-incident PTSD, often spanning two or more years of regular work. The phased model means the first period focuses on stabilisation rather than trauma processing, which takes time but reduces the risk of retraumatisation. Progress is not always linear. Many people notice meaningful improvements in daily functioning well before the deeper trauma work is complete.

    It's Complicated can match you with therapists experienced in complex trauma. You complete a short survey about your situation, and our psychologists identify practitioners with relevant experience available online or in person. Finding a therapist who understands C-PTSD specifically, rather than applying standard PTSD protocols, is important, and our matching is designed to make that distinction. It's Complicated is also free to use.

    Complex PTSD and borderline personality disorder (BPD) share significant overlap, including emotional dysregulation, relational difficulties, and identity disturbance, and are frequently confused or co-diagnosed. The key difference is aetiology: C-PTSD is understood as a response to prolonged trauma, while BPD is a personality disorder with a broader range of causes. Some clinicians argue the two are related conditions; others treat them as distinct. A thorough assessment by an experienced clinician can clarify the picture.

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