Complex PTSD: What is it?

Complex PTSD (C-PTSD) is a psychological condition that can be experienced as a result of prolonged and repeated exposure to traumatic events. For example, various forms of abuse, particularly during earlier years or in the context of ongoing interpersonal relationships.  


C-PTSD symptoms can be similar to those of post-traumatic stress disorder (PTSD), but there are additional features. In addition to the classic symptoms of PTSD such as flashbacks, nightmares, and avoidance behaviours, people suffering from C-PTSD may also experience difficulty with controlling emotions, have a sense of loss of control over one's life, and disturbances in their self-concept and interpersonal relationships.

Some common symptoms of C-PTSD include:

  • Difficulty with managing emotions, including intense anger, sadness, or anxiety, and sometimes engaging in impulsive or self-destructive behaviour.
  • Negative ideas about the self, including feelings of shame, guilt, or worthlessness, a pervasive sense of failure, and a distorted self-image.
  • Difficulties with relationships: including difficulty with trusting people, fear of intimacy or abandonment, and difficulty with establishing healthy boundaries.
  • Hypervigilance, which is feeling constantly on edge or alert to danger, also difficulty with sleeping, and a heightened startle response: ‘anything makes you jump out of your skin’.

Treatment for C-PTSD typically involves a combination of therapies, including cognitive-behavioural therapy (CBT), trauma-focused therapy, and medication. 

In the past, this condition has sometimes been misdiagnosed as a personality disorder but in many cases, it has been identified for what it is: the result of a series of distressing experiences.

The way that I work with clients to manage C-PTSD is to progress through how the symptoms affect the person, at their own pace, addressing the troubling feelings and their associated thoughts in sessions that build on each of the previous ones. Very often a new reality can be discovered and the world around the client, and themselves in it, can be seen in a different way.

The way that I work with clients who are suffering from complex PTSD follows my style of practice for all the therapies that I use: we share a number of sessions together at the client’s pace so that there is no rush or timetable to be kept to. Working on such issues can be unsettling but the aim is to put a set of memories and associated feelings where they belong, in the past.

Nothing like hypnosis is involved, the two of us talk together about the issues when the client feels ready to, so sometimes there will be a period of establishing a professional relationship so that conversation is relaxed enough while we speak in a safe, confidential environment. The number of sessions that we share together is ultimately controlled by the client. There is no contract and sessions can end whenever the person wishes.

The change from being unhappy, scared and perhaps ashamed because of things that have happened in the past can be replaced gradually by the realisation of a different reality which finds the person seeing themselves and the world around them in a very different way, perhaps the way it always was but without the negative influences of what has had to be endured within the person’s thoughts and feelings about the past. 

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Wrexham, Clwyd, LL13 8BT
Written by Martin Clegg, BSc (Hons) Psych, Accredited Member MBACP, MSc
Wrexham, Clwyd, LL13 8BT

Martin Clegg is an accredited member of the British Association for Counselling and Psychotherapy and has been practicing in Wrexham and Chester since 2011.
His practice is based on an integrative counselling approach and makes extensive use of cognitive behavioural therapy and mindfulness.

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