Complex PTSD (CPTSD) – Causes, Symptoms and Treatment

Complex post-traumatic stress disorder (complex PTSD or CPTSD) is a mental health condition that can develop in people who have experienced repeated and sustained traumatic events. These events may include physical, sexual or emotional abuse, neglect, domestic violence, war or torture. Complex PTSD can be very debilitating and can affect every area of a person’s life.

CPTSD is particularly prevalent in adults who experienced prolonged and repeated abuse as children. This may be due to the fact that childhood abuse can interrupt the development of a healthy sense of self, leading to problems with regulating emotions and behaviour later in life.

In fact adult children of narcissists (ACoNs) often struggle with CPTSD due to the constant ambient abuse they grew up in. Their lives as children were blighted by the manipulative tactics of their narcissistic parent. These include gaslighting, triangulation, abuse by proxy and a myriad other narcissistic abuse tactics from the narcissist’s toolkit.

However, it is not only related to childhood abuse. Complex post-traumatic stress disorder is also common in people who experienced domestic violence, war or torture.

What causes CPTSD?

CPTSD develops when an individual has been exposed to prolonged and repeated trauma, often over the course of months or years. This can include but is not limited to physical, psychological, verbal or sexual abuse. Other situations such as bullying or war-related combat can also be factors in the development of CPTSD.

The effects of this kind of trauma are far-reaching and can take an emotional toll on the individual that is severe enough to cause lasting psychological damage. Symptoms may manifest in various ways, including avoidance behaviour, changes in mood and dramatic shifts in self-esteem.

It is essential that CPTSD is recognized early so intervention and treatment can begin quickly before the impact becomes entrenched and it develops into a more serious mental health issue.

Symptoms of CPTSD

People with CPTSD often find it difficult to trust others and may isolate themselves from friends and family. They experience trauma triggers and have problems regulating their emotions and behaviour. They are also hypervigilant and on edge, as if they are in danger, which leads them to be excessively irritable or aggressive. This makes it very difficult for them to maintain relationships and jobs.

People with complex PTSD often have intrusive memories or flashbacks of the traumatic events. They often struggle with nightmares and panic attacks. There is a very strong link between CPTSD and other mental health conditions, such as depression, anxiety disorders, eating disorders and substance abuse.

The most Common Signs and Symptoms of CPTSD

Troubled Relationships

People who have complex post-traumatic stress disorder often struggle to maintain healthy, supportive relationships. They may feel overwhelmed in social situations and mistrustful of others, leading to a sense of isolation. This can cause issues in interpersonal relationships and make it difficult to create and sustain close connections with other people. The emotional dysregulation and difficulty regulating behaviour associated with CPTSD can also contribute to trouble in relationships.

Intense Emotional Reactions

People with CPTSD often experience intense emotional reactions. These reactions can be unpredictable and can range from feelings of fear and anxiety to unexpected outbursts of anger, irritability, and rage.

In some cases, the intensity of their emotions can lead to self-destructive behaviours such as self-harm or substance abuse in an attempt to numb their feelings. Fortunately, these reactions can be managed with proper diagnosis and treatment.


CPTSD patients are often in a state of constant hypervigilance. This means they may be constantly searching their environment for potential danger, assessing and evaluating their surroundings, and feeling an increased need to take action to protect themselves from perceived threats. This can lead to feelings of being overwhelmed or isolated, and even potentially dangerous behaviours such as lashing out defensively at others.

Hypervigilance is commonplace among CPTSD sufferers and is usually addressed through psychotherapy and medication as part of an overall treatment plan.

Difficulty Controlling Thoughts

People with CPTSD often find it difficult to control their thoughts. This is because of the lingering effects of trauma, which can lead to intrusive flashbacks, nightmares, and thoughts that become stuck in the mind.

These intrusive thoughts can be overwhelming and can cause difficulty concentrating on normal tasks. They may also lead to feelings of guilt, shame, and helplessness. With the help of a trained therapist, CPTSD sufferers can work to address these intrusive thoughts and eventually gain better control over them.

Feeling Detached From Your Body

Trauma has a lasting effect on the way we experience sensations and emotions, making it difficult for CPTSD sufferers to make sense of how they are feeling in any given moment.

This disconnection can also lead to difficulty sleeping, eating, and staying in touch with basic needs. By working with a trained therapist, CPTSD sufferers can learn new ways to connect with their body and address feelings of disconnection.

Disassociation or Dissociative Amnesia

This is a common symptom of CPTSD. It involves a detachment from your conscious awareness and can lead to feelings of numbness, confusion and disconnection. It can also cause amnesia, where a person may be unable to remember significant moments or events that occurred during the period of disassociation.

Nightmares or Flashbacks

CPTSD nightmares are usually re-enactments of past traumatic events and can be very vivid and distressing. They can cause intense fear, panic, or even physical sensations that seem real. Nightmares associated with CPTSD may also involve themes of helplessness, danger, or despair and in some cases, people may even act out their nightmares through physical movements.

Abnormal Startle Response

This manifests as an extreme fear reaction when startled or exposed to a sudden loud noise. It may include physical symptoms such as increased heart rate, trembling, sweating and even shock. This type of reaction is usually linked with flashbacks from past trauma and can be very distressing for those affected by CPTSD.

Changes In Self-Perception

Trauma impacts how sufferers view themselves and the world around them. It can lead to feelings of worthlessness, guilt and shame, as well as difficulty trusting others or feeling connected to situations that remind the sufferer of their traumatic experience.

With the help of a trained therapist, CPTSD sufferers can begin to work through these issues and gain greater self-awareness and understanding of how their experience is impacting their life.

Treating CPTSD

There is no one-size-fits-all approach to the treatment of CPTSD. However, there are some treatment options that you might want to consider. It is important that any treatment plan is tailored to the individual, taking into consideration their particular circumstances and needs.

CPTSD Treatment – Individual Therapy

Working with a qualified therapist in individual therapy is an effective way of treating Complex Post-Traumatic Stress Disorder (CPTSD). Through this method of treatment, sufferers can access the necessary support and guidance to work through their triggers.

This approach allows for deeper exploration and understanding of their emotions, thoughts, and needs, which promotes healthier behavior patterns that ultimately lead to improved mental health.

With the right guidance and support, CPTSD sufferers can gain insight into how to effectively manage symptoms while developing a more positive outlook on life.

CPTSD Treatment – Group Therapy

Group therapy is another effective way to help those with Complex Post-Traumatic Stress Disorder. It allows the participant to receive social support from others who may have similar experiences, while providing a safe environment that encourages personal growth.

Group therapy sessions provide an opportunity for CPTSD sufferers to discuss their thoughts and feelings and gain valuable insight into how to manage their symptoms.

CPTSD Treatment – Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is an evidence-based form of talk therapy that helps CPTSD sufferers recognize the links between their thoughts, feelings, and behaviors. This approach provides individuals with the tools to make positive changes in order to cope with the symptoms associated with CPTSD.

CBT sessions involve working with a qualified therapist to identify unhelpful thinking patterns and gradually work towards developing healthier thought processes.

With this type of therapy, CPTSD sufferers can learn how to better manage their emotions while gaining insight into ways they can take proactive steps towards improving their mental health.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a specialized psychotherapy technique that helps process traumatic memories more effectively by using guided eye movements, tones or tactile stimulation while focusing on the trauma memory or associated thoughts and beliefs.

EMDR helps CPTSD sufferers work through their distressing memories by targeting underlying emotions related to the traumatic event, ultimately leading to improved mental health.

By using this type of therapy, individuals can gain insight into how to better cope with difficult emotions and build confidence in their ability to manage their symptoms.

CPTSD Treatment – Medication

Medication may be prescribed for CPTSD sufferers to help manage symptoms like depression and anxiety. These medications typically include antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers.

While medication can help alleviate some of the symptoms associated with CPTSD, it is important to note that it should only be taken in combination with other therapies like CBT or EMDR. This combination helps create a more holistic approach to managing the condition and its associated symptoms.

The Importance of Self-Care

Additionally, it’s also important for individuals to practice self-care to cope more effectively with their condition. Self-care enables suffering from CPTSD to manage symptoms and provide a sense of stability and control.

Get Adequate Rest: Ensuring you are getting enough sleep is essential to managing your CPTSD symptoms and overall wellbeing. Try to keep to a consistent sleep schedule, and make sure that the environment you’re sleeping in is comfortable and peaceful.

Exercise: Regular exercise can help reduce stress, anxiety, and depression associated with Complex post-traumatic stress disorder. Aim for at least 30 minutes of moderate physical activity each day if possible.

Mindfulness Meditation: Practices such as deep breathing and guided meditation can help to reduce stress, rumination thoughts, intrusive memories, and other CPTSD symptoms.

Connect With Supportive People: Spending time with supportive family members or friends can help improve mood and provide a sense of security during difficult times when coping with CPTSD symptoms.

Eat Healthily: Eating healthily can help improve energy levels, mental clarity, and overall wellbeing which are all important aspects when managing CPTSD symptoms.

Engage in Meaningful Leisure Activities: Whether it’s going for a walk in nature or picking up a hobby you enjoy, engaging in leisure activities serves as an important outlet when dealing with CPTSD symptoms like depression or anxiety.

Journaling: Writing down your thoughts can be an effective way to process negative emotions as well as recognize positive ones associated with recovery from CPTSD symptoms.


CPTSD is a complex set of symptoms that can be difficult to manage. But with support, determination and self-compassion, healing from this condition is possible. With the right resources and guidance, those who suffer from Complex post-traumatic stress disorder can learn to live more meaningfully and create healthier relationships with themselves and others.

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