What Is Complex Trauma? Symptoms, Examples, and How to Heal (2023)

Complex trauma has a deep impact on the nervous system. By understanding how it develops, you can better understand how to treat it.

Most of us have a chapter in our lives we’d rather forget. Whether it’s a devastating breakup or the death of a loved one, many of us have felt the sting of heartbreak that comes with being a human.

But for those who live with complex trauma, the memories don’t just live in the past. They live in the present moment, too.

For a long time, complex trauma wasn’t well understood. Now researchers estimate that more than 3% of people meet the criteria for complex trauma, also called complex post-traumatic stress disorder (C-PTSD), in the United States. This is about the same percentage as people with traditional PTSD.

Trauma, the kind you’ve likely heard of, can develop after a distinct traumatic experience. It occurs when the brain and body are so overwhelmed that they have a hard time easing out of “fight, flight, or freeze” mode and coming back into a relaxed state.

Trauma may refer to a single incident, while complex trauma refers to a series of traumatic events that take place over a long period of time, like months or years.

First introduced in the 1990s by Judith Lewis Herman, PhD, complex trauma has a lot in common with the classic symptoms of PTSD, such as:

  • feeling anxious
  • having flashbacks
  • avoiding circumstances that remind you of the traumatic events

In addition, complex trauma can:

  • distort your sense of self
  • make it difficult to control your emotions
  • cause relationships challenges

How does complex trauma develop?

(Video) Complex PTSD (CPTSD) and Strategies to Cope

When you experience a traumatic event, it activates the limbic system in the brain. This “fire alarm” shuts down all nonessential systems (rest, digestion, sleep) and floods your body with stress hormones, like cortisol, so you can prepare for fight, flight, or freeze.

Once the danger passes, your parasympathetic nervous system provides inner calm, otherwise known as your “rest and digest” mode.

At this point, normal cognitive function returns, and you can go back to your day with relatively few side effects, perhaps only feeling a little jittery for a while, or a bit on edge.

But for people who live with complex trauma, this balance doesn’t quite return all the way.

The limbic system stays engaged most of the time. It’s a coping mechanism to try and stay safe in the face of ongoing adversity. It’s an experience of constantly being in survival mode, or on edge.

Over time, it becomes a “new normal” for the brain and body.

In his book, “The Body Keeps the Score,” trauma expert Bessel van der Kolk, MD, describes how trauma literally becomes trapped in the body and the brain rewires itself. These lasting effects create symptoms of complex trauma.

This bodily state of your nervous system being on “high alert” can affect your thoughts, actions, and relationships.

Some symptoms of complex trauma include:

  • flashbacks
  • lapses in memory
  • difficulty regulating emotions
  • hyperarousal, or being “on alert”
  • dissociation or lapses in memory
  • depersonalization or derealization
  • sleep disturbances or nightmares
  • struggling in interpersonal relationships
  • low self-esteem or negative self-perception
  • avoiding people, places, or scenarios that upset you

Somatic (bodily) symptoms, like unexplained headaches or an upset stomach, are also common with complex trauma. Since the body is under chronic stress, it can lower your immune system and lead to a range of chronic health conditions.

Examples of complex trauma

(Video) 6 Hidden Signs of Complex PTSD (cPTSD) | MedCircle

Complex trauma can arise in any situation where you feel an ongoing sense of fear, horror, helplessness, or powerlessness over an extended period of time, with the perceived or actual inability to escape.

It usually stems from trauma you experienced in childhood, though it can develop from trauma in adulthood as well.

Some possible causes of complex trauma include:

  • sexual abuse or incest
  • ongoing physical or emotional abuse
  • chronic neglect or abandonment
  • medical abuse or medical trauma
  • torture or being held captive
  • enmeshment or engulfment trauma
  • parentification (children taking on adult rules)
  • human trafficking
  • genocide campaigns
  • living in a war zone or area of civil unrest

Everyone’s story is unique — and so is their trauma. What works for one person may not work for another.

Also, keep in mind that what works at one point in time may not work later on down the line.

The great news is, as more is uncovered about complex trauma, more trauma treatment therapies are emerging as well. The goal of each treatment option is to provide a corrective emotional experience for healing.

Here are some effective therapies for complex trauma:

  • Cognitive behavioral therapy (CBT). In this form of therapy, you explore the relationship between your thoughts, feelings, and behaviors. Once you become aware of the connections, you may be able to change your actions.
  • Eye Movement Desensitization and Reprocessing (EMDR). With this treatment, you’re guided with gentle tapping (or tones) to reprocess traumatic events and form new beliefs around them.
  • Internal family systems (IFS). With this approach, you learn how to integrate the different parts of your personality into one whole “Self” to reprocess traumatic events in a way that can no longer harm you.
  • Somatic (body) therapies. Since trauma lives in the limbic area of the brain and not the frontal cortex (the part of the brain that talks in therapy), somatic therapies or body-centered therapies can teach your body that it does not have to be prepared for trauma all the time.
  • Dialectical behavioral therapy (DBT). This approach can be effective for people who live with borderline personality disorder (BPD), which has many overlapping symptoms with complex trauma. In this treatment approach, you learn mindfulness, radical self-acceptance, and distress tolerance.

There’s also a link between complex trauma and substance use as a way to cope with symptoms. If you’d like to cut back on using drugs or drinking alcohol, support is available.

Look for a local 12-step program, like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), or SMART Recovery.

(Video) Complex Trauma: Understanding and Treatment - Diane Langberg

Here are some additional resources for support:

Recovery from complex trauma can be a gradual process. But having a range of tools and self-care strategies can make the process a whole lot easier.

It’s a good idea to keep a few deep breathing exercises up your sleeve for those tough moments. This is a direct way to let your body know that you’re safe. Try these:

  • 4-7-8 breathing: Inhale for 4 seconds, hold for 7 seconds, exhale for 8 seconds.
  • Box breathing: Inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, hold for 4 seconds.
  • Alternate nostril breathing: Place your right thumb over your right nostril. Inhale and exhale eight times through your left nostril. Repeat on the other side.

A consistent mindfulness practice can help too. A 2018 study involving veterans with PTSD found that a regular meditation practice can reduce symptoms of trauma. Yoga has shown similar results, showing that both can be an effective complement to talk therapy.

It might help to access trauma-informed yoga sessions, where the yoga instructor is aware that trauma can be stored in the body, and that some body movements can trigger emotional reactions. They can help you navigate these reactions in a healing way.

Here are some lifestyle adjustments that can make complex trauma more manageable:

  • do tai chi or dance
  • journal your feelings
  • spend time in nature
  • eat a nutritious, balanced diet
  • sleep around 8 hours a night
  • “shake off” tough emotions by literally shaking your arms or your body to release tension
  • talk through your triggers with loved ones
  • practice progressive relaxation techniques
  • exercise five times a week, even if only a few minutes a day
  • try using the flashback halting protocol to manage flashbacks

Complex trauma may feel like it’s taking over your life. Perhaps you feel alone in your experience, wondering if it will ever feel like less of a big deal.

(Video) 12 signs you might be suffering from PTSD

Two thoughts: You’re not alone, and it will get better.

One of the best things you can do is to continue to educate yourself about complex trauma. You may be able to find a healing book club or support group in your area.

You can also join one online, like this one through the C-PTSD Foundation.

Here are some books to add to your reading list:

Also, here’s a great TED Talk on how childhood trauma affects health over a lifetime.

Finally, know that you will get through this. You’ve survived 100% of your worst days so far and, just like the other tough times, this will pass too.

You’re stronger than you know.

Suicide prevention

Complex trauma may increase your risk of self-harm. If you’re considering self-harm or suicide, help is available right now:

(Video) Integrative Treatment for Trauma and Complex PTSD

FAQs

Can you heal complex trauma? ›

Complex post-traumatic stress disorder is entirely treatable with the right combination of compassion, patience, and trust. Someone can work to disempower the trauma that cripples them and practice positive coping skills in the context of well-rounded support and guidance.

What is complex trauma symptoms? ›

The symptoms of complex PTSD are similar to symptoms of PTSD, but may also include: feelings of worthlessness, shame and guilt. problems controlling your emotions. finding it hard to feel connected with other people. relationship problems, like having trouble keeping friends and partners.

What is complex trauma example? ›

Examples of complex trauma

sexual abuse or incest. ongoing physical or emotional abuse. chronic neglect or abandonment. medical abuse or medical trauma.

How do you fix complex trauma? ›

Options for treatment include:
  1. Psychotherapy. Psychotherapy may take place on a one-to-one basis or in a group setting. ...
  2. Eye movement desensitization and reprocessing. Eye movement desensitization and reprocessing (EMDR) is a technique that may help people with PTSD or complex PTSD. ...
  3. Prolonged Exposure therapy. ...
  4. Medication.

How do you heal yourself after being traumatized? ›

Ways to Heal from Emotional Trauma
  1. Movement and Exercise. As trauma disrupts your body's natural equilibrium, exercise and movement can help repair your nervous system. ...
  2. Connect with Others. ...
  3. Ask for Support. ...
  4. Volunteer.

What does complex trauma do to a person? ›

Emotional Responses

Children who have experienced complex trauma often have difficulty identifying, expressing, and managing emotions, and may have limited language for feeling states. They often internalize and/or externalize stress reactions and as a result may experience significant depression, anxiety, or anger.

How long does it take to heal Cptsd? ›

Recovery from C-PTSD is a long slog, with survivors sometimes requiring more than ten years of psychotherapy for resolution. There are some C-PTSD programs offered through residential psychiatric programs that offer specialized treatment for this disorder and accompanying dissociative disorders.

How long does Cptsd take to heal? ›

Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic. A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

How do therapists treat complex trauma? ›

Complex trauma is treated through a combination of psychotherapy (talk therapy), eye movement desensitization and reprocessing (EMDR), medications, and the development of strong coping mechanisms.

Does CPTSD go away? ›

PTSD does not always last forever, even without treatment. Sometimes the effects of PTSD will go away after a few months. Sometimes they may last for years – or longer. Most people who have PTSD will slowly get better, but many people will have problems that do not go away.

How is CPTSD diagnosed? ›

Criteria for Diagnosis

To receive a diagnosis of PTSD, a person must have at least one re-experiencing symptom, at least three avoidance symptoms, at least two negative alterations in mood and cognition, and at least two hyperarousal symptoms for a minimum of one month.

Is CPTSD worse than PTSD? ›

The difference between CPTSD and PTSD is that PTSD usually occurs after a single traumatic event, while CPTSD is associated with repeated trauma. Events that can lead to PTSD include a serious accident, a sexual assault, or a traumatic childbirth experience, such as losing a baby.

What is the best medication for complex PTSD? ›

What are the best medications to treat PTSD?
  • Sertraline (Zoloft) is FDA-approved for treating PTSD, and it's one of the most common medications prescribed for this condition. ...
  • Paroxetine (Paxil) is the only other FDA-approved medication for PTSD. ...
  • Fluoxetine (Prozac) is used off-label for treating PTSD.
6 Jul 2021

What do you do when a complex PTSD pushes you away? ›

It's important to respond with kindness if they continue to push you away. Do your best to do so without judgment. Continue to show them that you do care for them and love them. Allow them to see you want them to know they are not alone and you can see they are struggling right now.

How do you know you're healing? ›

6 Signs You May Notice As You're Healing From Trauma
  1. You Begin Feeling Your Emotions (Rather Than Minimizing Them) ...
  2. Practicing Living Mindfully (Rather Than Mindlessly) ...
  3. Your Body Releases Tension & Trauma. ...
  4. You Reach Out More For Support & Ask For Help (Rather Than Isolating)
25 Aug 2022

How do you know you've healed from trauma? ›

"Looking forward to the future and being able to create a renewed sense of self. The traumatic event is no longer the primary event in one's life. Therefore, being able to reconnect with oneself and embrace the future without feeling overwhelmed is also a positive sign in trauma healing," Dr Parul told HT.

Does crying heal trauma? ›

It won't rid you of PTSD and your fears, but let your tears flow and you'll maybe feel a little better afterwards. 'Crying for long periods of time releases oxytocin and endogenous opioids, otherwise known as endorphins. These feel-good chemicals can help ease both physical and emotional pain.

How do you heal past trauma spiritually? ›

HOW TO SPIRITUALLY CLEANSE YOUR LIFE POST-TRAUMA
  1. AWARENESS. “If (burnout) happens once, you're more vulnerable to it again,” gently warned Hanekamp. ...
  2. CLEANSE YOURSELF AND YOUR SPACE. @MAMAMEDICINE. ...
  3. EMBRACE ALONE TIME. @MAMAMEDICINE. ...
  4. RELEASE WITH INTENTION. ...
  5. SPEND TIME IN NATURE.
8 Apr 2020

How can I heal myself emotionally? ›

Tips for healing from emotional wounds
  1. Take baby steps. ...
  2. Remember that you dont have to heal 100% to improve the quality of your life. ...
  3. Be patient and persistent. ...
  4. Set realistic expectations. ...
  5. View setbacks as part of the process and learning opportunities. ...
  6. Prioritize self-care and self-compassion.
4 days ago

What is complex trauma in mental health? ›

Complex trauma describes both children'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.

What types of behaviors come from trauma? ›

Traumatic reactions can include a variety of responses, such as intense and ongoing emotional upset, depressive symptoms or anxiety, behavioral changes, difficulties with self-regulation, problems relating to others or forming attachments, regression or loss of previously acquired skills, attention and academic ...

What happens when complex PTSD is triggered? ›

Complex PTSD triggers

For example, it could be something you picked up with one of your five senses when the trauma was taking place. Some common triggers include: specific physical sensations or pain. intense emotions like fear, sadness, or anger.

What should you not say to a complex PTSD? ›

10 Things Not To Say To Someone With CPTSD
  • It wasn't that bad, was it?
  • That happened in the past, why are you still upset?
  • Calm down.
  • You're overreacting. It's been years now. Get over it.
  • You're too much right now.
  • What's wrong with you?
  • I don't believe anything you're saying.
  • You are crazy. You are dramatic.

What it's like living with complex PTSD? ›

Living with Complex PTSD can create intense emotional flashbacks that provide challenges in controlling emotions that may provoke severe depression, suicidal thoughts, or difficulty in managing anger. C-PTSD can also create dissociations, which can be a way the mind copes with intense trauma.

What are somatic flashbacks? ›

A somatic flashback causes the person to physically re-experience the trauma. It could be pain or discomfort or sensations. That depends a lot on what kind of experiences you have endured. In the case of sexual trauma, somatic flashbacks can bring back feelings of guilt, shame, and disgust.

Why do clients smile when talking about trauma? ›

Smiling when discussing trauma is a way to minimize the traumatic experience. It communicates the notion that what happened “wasn't so bad.” This is a common strategy that trauma survivors use in an attempt to maintain a connection to caretakers who were their perpetrators.

What happens when trauma is triggered? ›

Initial reactions to trauma can include exhaustion, confusion, sadness, anxiety, agitation, numbness, dissociation, confusion, physical arousal, and blunted affect.

Why do I have symptoms of trauma but no trauma? ›

When Symptoms Occur Without a History of Trauma. It is important to understand that trauma can be inherited independently of difficult family circumstances. A child can develop anxiety, depression, or other stress-related issues such as PTSD as a result of an inherited vulnerability rather than direct trauma.

What medications work for CPTSD? ›

There are 4 SSRIs/SNRIs that are recommended for PTSD:
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Venlafaxine (Effexor)

How long does complex PTSD last? ›

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.

Can you heal from PTSD without therapy? ›

Treatment for PTSD is essential—this is not a condition that will resolve on its own. People with PTSD require professional support, especially therapy, to see improvements.

Do you qualify for disability if you have PTSD? ›

PTSD can be considered a disability by the SSA if the criteria for Listings 12.15 or 112.15 Trauma- and stressor-related disorders are met by the applicant. If your symptoms of PTSD are so severe that you are unable to work, the SSA will consider you disabled and you will be able to get disability with PTSD.

What are the five stages of trauma? ›

There are 5 stages to this process:
  • Denial - this can't be happening.
  • Anger - why did this have to happen?
  • Bargaining - I promise I'll never ask for another thing if only you will
  • Depression - a gloom that comes from having to adjust to so much so quickly.
  • Acceptance.

What does PTSD do to the brain? ›

PTSD causes your brain to get stuck in danger mode. Even after you're no longer in danger, it stays on high alert. Your body continues to send out stress signals, which lead to PTSD symptoms. Studies show that the part of the brain that handles fear and emotion (the amygdala) is more active in people with PTSD.

What do you say to a traumatized person? ›

Listen to them
  • Give them time. Let them talk at their own pace – it's important not to pressure or rush them.
  • Focus on listening. ...
  • Accept their feelings. ...
  • Don't blame them or criticise their reactions. ...
  • Use the same words they use. ...
  • Don't dismiss their experiences. ...
  • Only give advice if you're asked to.

Can you get PTSD from emotional abuse? ›

PTSD is a reaction to psychological trauma which develops in response to actual or threatened extreme danger or personal injury. PTSD can originate from a variety of forms of abuse, ranging from physical abuse to sexual abuse to emotional abuse.

How serious is complex trauma? ›

Complex trauma describes both children'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.

Is complex trauma a mental illness? ›

Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition where you experience some symptoms of PTSD along with some additional symptoms, such as: difficulty controlling your emotions. feeling very angry or distrustful towards the world.

Is complex trauma and PTSD the same thing? ›

The main difference is that PTSD is generally related to a single event or series of events within a short period of time, while complex PTSD is related to a series of events that repeatedly occurred over an extended period of time.

Is PTSD the same as complex trauma? ›

Complex trauma and Complex PTSD

Complex Post Traumatic Stress Disorder, or Complex PTSD, is a formal diagnosis of a mental health disorder. Complex trauma is a series of events and processes, not a diagnosis. Experiencing complex trauma does not mean that an individual will develop Complex PTSD.

What is the best medication for complex PTSD? ›

What are the best medications to treat PTSD?
  • Sertraline (Zoloft) is FDA-approved for treating PTSD, and it's one of the most common medications prescribed for this condition. ...
  • Paroxetine (Paxil) is the only other FDA-approved medication for PTSD. ...
  • Fluoxetine (Prozac) is used off-label for treating PTSD.
6 Jul 2021

Is complex trauma a disability? ›

PTSD can be considered a disability by the SSA if the criteria for Listings 12.15 or 112.15 Trauma- and stressor-related disorders are met by the applicant. If your symptoms of PTSD are so severe that you are unable to work, the SSA will consider you disabled and you will be able to get disability with PTSD.

How do you treat CPTSD? ›

You heal by being present in your current life. Trauma-informed therapy can be an important first step. Therapy is an emotionally corrective relationship which sets the foundation for safety and trust that you will learn to take elsewhere, into other relationships in your life.

What happens when complex PTSD is triggered? ›

Complex PTSD triggers

For example, it could be something you picked up with one of your five senses when the trauma was taking place. Some common triggers include: specific physical sensations or pain. intense emotions like fear, sadness, or anger.

Is Cptsd worse than PTSD? ›

The difference between CPTSD and PTSD is that PTSD usually occurs after a single traumatic event, while CPTSD is associated with repeated trauma. Events that can lead to PTSD include a serious accident, a sexual assault, or a traumatic childbirth experience, such as losing a baby.

What do you do when a complex PTSD pushes you away? ›

It's important to respond with kindness if they continue to push you away. Do your best to do so without judgment. Continue to show them that you do care for them and love them. Allow them to see you want them to know they are not alone and you can see they are struggling right now.

What does a complex PTSD episode look like? ›

Survivors with Complex PTSD have a very difficult time with emotions -- experiencing them, controlling them, and for many, just being able to comprehend or label them accurately. Many have unmanaged or persistent sadness, either explosive or inaccessible anger, and/or suicidal thoughts.

What should you not say to a complex PTSD? ›

10 Things Not To Say To Someone With CPTSD
  • It wasn't that bad, was it?
  • That happened in the past, why are you still upset?
  • Calm down.
  • You're overreacting. It's been years now. Get over it.
  • You're too much right now.
  • What's wrong with you?
  • I don't believe anything you're saying.
  • You are crazy. You are dramatic.

Does complex PTSD ever go away? ›

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.

Videos

1. Childhood Trauma and the Brain | UK Trauma Council
(Anna Freud NCCF)
2. DBT-PTSD – A New Treatment for Complex PTSD
(McLeanHospital)
3. 6 Signs of Complex Post Traumatic Stress cPTSD Diagnosis in the ICD-11
(Doc Snipes)
4. Complex Trauma in Children | Counselor Toolbox Episode 116
(Doc Snipes)
5. Complex PTSD Treatment and Updates from ICD - Marylene Cloitre
(APA Division 56 - Trauma Psychology)
6. Complex Trauma and its Effects on Child Development
(NYU Langone Health)
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