The majority of us have heard about PTSD (Post-Traumatic Stress Disorder), the condition that can occur when someone is exposed to a situation over which they had little or no control and from which there was little or no hope of escape. It is often associated with members of the military who have witnessed the horrors of battle, or with people who have endured an extreme physical or emotional trauma. PTSD can occur after experiencing even just one threatening situation, such as being involved in a car accident. But, what about those who have gone through long-term exposure to a continuing, intense level of stress?

Recently, mental health experts have begun to realize there are more layers to the emotional suffering experienced by people who have been through long-lasting stressors like childhood sexual abuse, for example, or years of domestic violence. In cases like these, a PTSD diagnosis partly addresses their condition, but doesn’t adequately define the severe psychological harm that has resulted from the trauma. Therefore, some mental health professionals now believe there should be a new category added to the PTSD diagnosis – one that will encompass this emotional scarring from long-term, chronic trauma: Complex PTSD (C-PTSD).

Even with this new classification, it is important to note that the victims of chronic trauma can have both PTSD and Complex PTSD simultaneously. Here is an easy way to see the differences between the two conditions:

  • A child witnessing the death of a friend in an accident may show some symptoms of PTSD
  • A child who has lived with years of sexual or physical abuse may have symptoms of C-PTSD in addition to PTSD.

CPTSD Symptoms

People who have gone through a long-standing, extremely traumatic situation may exhibit both physical and emotional symptoms related to their ordeal.

Emotional symptoms may include:

  • Rage displayed through violence, destruction of property, or theft
  • Depression, denial, fear of abandonment, thoughts of suicide, anger issues
  • Low self-esteem, panic attacks, self-loathing
  • Perfectionism, blaming others instead of dealing with a situation, selective memory
  • Loss of faith in humanity, distrust, isolation, inability to form close personal relationships
  • Shame, guilt, focusing on wanting revenge
  • Flashbacks, memory repression, dissociation

Victims of C-PTSD may also have physical symptoms, such as:

  • Eating disorders, substance abuse, alcoholism, promiscuity
  • Chronic pain
  • Cardiovascular problems
  • Gastrointestinal problems.
  • Migraines

Help for Complex PTSD

With Complex PTSD, healing cannot happen on its own because the survivor keeps reliving the trauma through flashbacks and dreams. People who suffer from C-PTSD may go for years before making the connection between their symptoms and the chronic stress and trauma they have been trying to cope with. Once they do, healing can begin and many people have been able to overcome their past to find a more meaningful and healthy present.

Cognitive Behavioral Therapy (CBT) has been shown to be highly effective in treating both PTSD and Complex PTSD. This therapy works to change unhelpful thinking and behaviors. It challenges deep-seated patterns and beliefs. CBT therapy helps replace “errors in thinking” (for example: magnifying negatives, minimizing positives, and overthinking) with more realistic and effective thoughts. This serves to decrease both emotional distress and self-defeating behaviors.

EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder/CPTSD. It has been shown to help trauma survivors heal faster than through traditional therapy. In fact, EMDR can be successful in as few as 3-12 treatment sessions. This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time.

We Can Help

Complex PTSD can be debilitating. Those who suffer from CPTSD may be at greater risk of substance abuse or of deliberate self-harm in order to cope with their emotional pain. We can help! To learn more, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.






Dr. Andrew Rosen PHD, ABPP, FAACP is a Board-Certified Psychologist and the Founder and Director of The Center for Treatment of Anxiety and Mood Disorders, as well as, the Founder of The Children’s Center for Psychiatry Psychology and Related Services.

29 Responses

  1. Even though I can’t find help for my C-PTSD, I truly cried when I read this article. Thank you. I have lived through so many traumas and have been in therapy for years without improvement (cognitive and EMDR). I also just returned from a private six hour appointment with Dr. Jon Connelly and he performed light hypnosis using his world renowned Rapid Resolution Therapy. Not one peep of improvement. I am also getting zero benefits from my plethora of anti psychotic medications. Now, my wife has PTSD symptoms from living with my illness and the daily rages with unbridled anger. I am BEGGING for support and help.

    1. Hi Elizabeth, I hope you’re doing better. There are books I’m reading now which you may find useful, like Complex PTSD – From Surviving to Thriving by Pete Walker and The Body Keeps the Score Brain, Mind, and Body in the Healing of Trauma by Bessel Kolk.

    2. Holy crap! That’s horrible. You’ve had it so hard and you are still out there looking for help, trying to get better. You must have a great strength inside you. My heart goes out to you and I wish for you to find some peace, even if only a few minutes.

  2. Anywhere in California that can help ? Recently left my husband after 7 years of physical mental emotional abuse. I gym, have individual and group counseling yet i cannot cope. I need help.

  3. I think that it is irresponsible to promote CBT and EMDR for CPTSDas the realty is that the complexity and chronic nature of developmental trauma in children who have been abused does not respond to these treatments. The evidence does not support the assumptions and limitations of cognitive therapies. EMDR is designed for DISCRETE episodes of trauma and is not appropriate for the chronic relational trauma associated with emotional abuse in childhood.

    1. Amanda,
      Can you share any research or books you may have come upon that effectively addresses chronic trauma? From my own personal experience, I agree with everything you wrote and believe it to be true.

      1. Pete Walker’s book “CPTSD: from surviving to thriving”. He has CPTSD and is a therapist so knows what he’s talking about. YouTube has lots of stuff.

    2. I totally agree. I’m beginning to despair at the lack of understanding about CPTSD and having the right treatment etc. I can’t see how CBT would help at all. I had EMDR but my trauma was day in day out..not really specific incidents…they were part of the ongoing terrorizing and so more diffused than, say, a car accident. We need totally different treatment!!

  4. I have ptsd and it’s hard for me to talk to people or go out and get a job idk what to do it’s so crippling for me, I practically always get anxiety when I’m by myself and having to do outside activities.

  5. At last I can begin to understand what happened to me. I do not want pitty. I want to get better. My years of torture finally have a name.

  6. I’ve long been aware of PTSD & Complex PTSD: their causes, symptoms, differences, etc. Most articles I’ve read highly recommend Cognitive Behavioral Therapy as an effective approach to lifting the dark, oppressive clouds in which PTSD or C-PTSD sufferers live. But 99% of those articles do NOT explain: what distinguishes a therapist who practices CBT from a general therapist, what training, licensing, type of practice, years of experience, how to identify which therapists as good or poor fits for you. One of the well-known publications on psychology runs photos of therapists & lists therapies they practice. Most lists identify CBT as just one of 10 or more therapies they do. Very few list CBT as their specialty. Research has shown it takes 10+ years to develop expertise in one specialty. So, please, what are the attributes of expert CBTs? Who is a CBT among those saying, “I do everything!” Which therapist treats mostly PTSD or C-PTSD?

  7. CBT and EMDR for C-PTSD?! God help us! I agree with Sam’s book recommendations (Bessel van der Kolk and Pete Walker). Both books are excellent resources. C-PTSD is definitely a process to treat and it would be irresponsible for any therapist to make a prediction of how long it will last. I suspect that the younger the age of the trauma, the less support you had at the time, the longer it lasted, the more traumas you’ve had over your lifetime, and even the relationship you had with your abuser (e.g. relative, caregiver) will likely require more comprehensive treatment (not a single modality) over a longer period of time than single event PTSD. If you had preverbal trauma, traditional talk therapies aren’t going to cut it. Look into Internal Family Systems, Sensorimotor Psychotherapy, Somatic Experiencing, neurofeedback, and Instinctual Trauma Response. Also check out Polyvagal theory. This is not an exhaustive list. These therapies don’t get much attention because there’s a lack of funding that goes to research for them. It’s all very political and an incredible disservice to those whose suffer from C-PTSD.

    1. Hooray. So glad to find a couple of people here who know whats needed for CPTSD not PTSD. Was beginning to despair that nobody else knew. Sick of being lumped in with PTSD. CPTSD is much worse than PTSD. Has different causes and symptoms and effects.

  8. Hi. I have strong c ptsd from 22 years of emotional abuse and sometimes physical from my family. I have gone to different doctors and therapists and gone through different medicines and thank God I am on natural medicines now. I need someone who understands this and will take my insurance. I cut my family off so that I could heal and cut off everyone connected to them and am facing homelessness. I just want to know a doctor who actually understands c ptsd and who will take my insurance. Please help

    1. So sorry you are struggling so much. I can’t help with your question but I wish you the very best and that you get what you need. Hang in there kid.

  9. There’s a lack of help where I live. This article though helped me to understand myself more. I’m now 40 and things that happened as a child through my early 29s are still affecting me. It’s to the point it’s affecting my employment and I’m losing hope.

  10. I don’t even know how to have any hope of recovery. My father sexually abused from the time I was 4 until the night before he died when I was 11. My grandmother was a textbook narcissist and very talented at mind games. She was also aware of what my father was doing to me. Needless to say as soon as I hit my teens I ended up in relationship after relationship with narcissist and horribly abusive men. I gone through countless years of therapy and so many different head meds. Last year I rented a place for teenage son and I and every thing looked like it was getting easier. I saw a light at the end of a 45 year long darkness when the landlord decided he turn my life into a living hell. Sexual harassment and physical threats along with demanding I do what he wanted or we would be out on the street. I lost the job I worked really hard to get because I couldn’t focus or remember deadlines or even how to do the reports I had doing for months. I was calling out all the time and my boss had to finally let me go. My care got repossessed and the bills went to collections and he ended up filling for an eviction anyway. I was lucky and caught wind of a great lawyer who made sure the eviction was dismissed and I my son and I found another home.
    But… now? I am so screwed up more than I have ever been. I’m on disability because of my anxiety and CPTSD. I trying so hard to overcome all of this. Because my son needs me to be ok. I am feeling pretty hopeless though. I feel like all the work I have done just went poof and I am back at square one. How is someone supposed to get better when there are so many sickos in this world lurking around every dam corner? I also have dyslexia, so I probably made a ton of typos. What ever, I hope this post made sense.

  11. Mindfulness helps enhance a person’s ability to respond positively even to difficult circumstances, instead of behaving in a negative way.

    Being mindful is about taking the time to concentrate and think about your actions.
    This allows you to think more clearly, and to discover the best ways to behave in more positive ways.

  12. I need help. The Normalization of pedophilia is affecting me horribly. 16 psychologists in Denton and Dallas Texas have ignored my pleas for appointments. I am a survivor of sociopath who locked me in closets, beaten, tied to beams, starved, sexual, abused and trafficked. For 7 years of my life, I endured this, and the told to act like nothing happened. Please help my find help. Online meetings, locAl group therapy actually Told me I was overplaying it for attention. I’m not in crisis, but very near it. Panicking, withdrawal from life and with medication that I need to live. Literally easily withdrawn….I consider it stopping it. Please, I’m begging for real help.

Comments are closed.