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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
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.
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.
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