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Trauma stems from an overwhelming and shocking event. When there is exposure to multiple events over a period of time, complex PTSD can develop. Here we look at the condition and how it can be treated.
What is complex PTSD?
Complex post-traumatic stress disorder (C-PTSD) is a form of post-traumatic stress disorder (PTSD) that can develop after experiencing repeated and prolonged traumatic events. It includes symptoms found in PTSD such as reliving traumatic events, avoidance of reminders, and heightened vigilance. There are also problems with self-perception, where symptoms can show up in emotion regulation, negative self-image, and difficulties in relationships.
Complex PTSD can occur in situations such as domestic violence, childhood sexual abuse, war situations or torture. Studies have shown that about 1-8% of the population has the problem. It is a difficult condition that requires prolonged treatment, but it is treatable.
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Is complex PTSD an official diagnosis?
The World Health Organisation (WHO) member states, including the UK, have endorsed a diagnosis of Complex Post Traumatic Stress Disorder (CPTSD) as part of the diagnostic cannon ICD-11. But, the US manual DSM-5 has not yet added it. This does not mean there is no suffering for people who have the symptoms.
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Symptoms of complex PTSD
In complex PTSD, you have the same symptoms as in simple PTSD, but with some additional symptoms mainly relating to your relationship with yourself and others. People suffering from PTSD may experience:
- Reliving the trauma through nightmares or flashbacks.
- Avoidance of feelings, places and situations that remind them of the trauma.
- Impact on thoughts and feelings with numbness, difficulty remembering things, negative feelings such as guilt, shame and anger, as well as impact on self-image and negative thoughts about the world.
- Overexcitement, where there is increased activity in the nervous system, leading to insomnia, irritation, and difficulty concentrating.
Complex PTSD has these additional symptoms:
- More severe problems with self-esteem, self-confidence and a negative self-image. You may feel worthless.
- Problems with interpersonal relationships where you may have difficulty establishing and maintaining healthy relationships. You may feel powerless if you are reminded of traumatic events. There are also often problems with trust, attachment, and social interaction.
- Changes in emotion regulation which may include problems with impulse control, self-harm or substance abuse as a way of coping with difficulties.
Complex PTSD and relationships
In complex PTSD, the impact on relationships is often significant. If you have experienced prolonged and often repeated trauma, your relationships with others may change, you may have difficulty with trust and closeness. You may have been in a violent relationship where there was a threat to leave, and in these situations a lot of support is needed from, for example, women’s shelters and social services.
Children who are exposed are in a dependent position in a different way and here a great deal of support and help is needed from social services and healthy adults in the child’s vicinity. Children, but also adults to some extent, tend to shame and blame themselves and it is important to get the right help in order to improve their self-image and build trust. Safe, supportive relationships are important for people with all forms of complex PTSD. It is possible to regain control of your life and have better relationships.
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Complex PTSD treatment
There is little research on complex PTSD but there are some methods that can be helpful. Judith Herman is an American psychiatrist at Harvard Medical School who has worked extensively with severe trauma and has written the book ‘Trauma and Recovery’. She says that long-term counselilng is important. This is because longer contact may be needed to rebuild trust in relationships.
Trauma-focused cognitive behavioural therapy or other treatments used for PTSD can also be helpful. It is important to get a coherent narrative of your life and to process memories related to difficult events. It is also important that you have a secure relationship with the therapist, get a grounded sense of reality and develop a stable self-image. So this may take a little longer, but it is possible to feel better.
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If you or someone you know is experiencing the symptoms and feelings described, it may be a good idea to talk to a psychologist or therapist. You can easily book an initial session with one of our experienced team today to take the first step towards treatment.
12 frequently asked questions about complex PTSD
What is complex PTSD?
Complex post-traumatic stress disorder (C-PTSD) is a form of post-traumatic stress disorder (PTSD) that develops after experiencing repeated and prolonged traumatic events.
How does complex trauma develop?
Complex PTSD can develop in situations such as domestic violence, childhood sexual abuse, war situations or torture. What these situations have in common is the frequent exposure to severe trauma that often lasts for a long time.
What are the most common symptoms of complex PTSD?
The symptoms of complex PTSD include the symptoms of simple PTSD with reliving experiences, avoidance behaviour, and heightened vigilance. There are also difficulties with self-organisation that manifest as negative self-perception, difficulties with emotion regulation, and problems with interpersonal relationships.
How is complex PTSD diagnosed?
Complex PTSD is not yet an official diagnosis but has been endorsed by the WHO in the ICD-11 diagnostic manual. Until then, you can talk to your therapist or psychologist about your problems and get help to manage your symptoms based on available treatments.
Can complex PTSD be cured?
There is currently little research on treatment for complex PTSD but there are treatments such as trauma-focused cognitive behavioural therapy (CBT), supportive counselling and medication that can help manage symptoms.
How are relationships affected by complex PTSD?
In complex PTSD, the impact on relationships is often significant. If you experience prolonged and often repeated trauma, your relationships with others may change, but you may have difficulty with trust and closeness. You may feel useless and powerless in different situations. It is possible to improve with long-term contact with a therapist or psychologist whom you trust and rely on.
Can personality changes occur after trauma?
If you experience trauma, your thoughts, feelings and behaviours can change so that you act in ways you wouldn’t otherwise. It is possible to get help with this in therapy.
What is the difference between PTSD and complex PTSD?
In complex PTSD you have the symptoms of simple PTSD but you also have additional difficulties with negative self-perception, emotion regulation and interpersonal relating.
Can children have complex PTSD?
Children can suffer from complex PTSD just like adults and it is important to get the right help. This may involve contacting social services if necessary and support from healthy adults close to the child, but also treatment by qualified professionals with extensive experience.
Is complex PTSD related to depression?
Yes, you can have complex PTSD and depression. Many people with complex PTSD also have other mental health problems and may develop problems such as self-harm and substance abuse to cope with their emotions.
Are there many people with untreated complex PTSD?
It is difficult to say how many people have untreated complex PTSD, but about 1-8% of the population have the condition.
How can you seek help?
If you or someone you know is suffering from complex PTSD or trauma, it is important to seek professional help. Book an initial session with one of Lavendla’s psychologists or therapists on our website. We help make the difficult easier.
Can you get rid of complex PTSD?
It is possible to work through severe trauma and complex PTSD, but it takes some time. You often need a lot of support and a therapist or psychologist who is well versed in the problem and whom you trust and rely on. You cannot undo what has happened, but you can work through it so that it no longer affects you as much in everyday life. Through therapy, you can become better at identifying triggers, managing emotions, and improving your self-confidence and self-image. So it is possible to feel better.
More support for complex PTSD
Even if you have experienced things that have led to complex PTSD, it doesn’t mean you can’t live a good life, but you may need more support. Therapy, friends, family, and organisations and associations can be helpful. It is also important to focus on activities that you enjoy and that feel meaningful.
Getting a coherent life story in therapy can also help you to relate to what you have been through in a way that allows you to focus on the future, where your problems will not be as big an obstacle in your life. Although it can feel uncomfortable, or even overwhelming, therapy has many benefits. It gives you a safe place to express and explore your feelings, which can significantly help the recovery process. It takes strength to take the first step towards recovery.
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