What is CPTSD?
Complex Post-Traumatic Stress Disorder
Many people are unaware of how big of an impact experiences from their upbringing, generational patterns, or racial and systemic adversities have on individuals. These experiences can be categorized as trauma due to the mental, emotional, and physical affects that individuals encounter. Oftentimes, these perpetuating cycles are over a long period of time, causing many significant difficulties and challenges.
When most people think of Post-Traumatic Stress Disorder (PTSD), they think about war veterans or someone surviving a tragic accident. However, these are not the only types of trauma that coincide with a diagnosis of PTSD. The experiences mentioned above also coincide with a diagnosis of PTSD. When the effects of trauma becomes long-lasting to the mind, body, and relationships of a person it can be identified as Complex PTSD.
CPTSD is not officially listed in the DSM-5, but it is recognized in the International Classification of Diseases (ICD-11) as a distinct diagnosis. This post will explain the symptomatology of CPTSD, and how chronic trauma can create a significant impact on someone’s life.
How CPTSD Develops
CPTSD typically develops after long-term exposure to trauma, especially in situations where escape feels impossible. This often includes:
Childhood abuse or neglect
Domestic violence
Human trafficking
Prisoner-of-war experiences
Repeated exposure to community or systemic violence
Generational patterns leading to challenges and difficulties
Unlike single-incident PTSD, complex trauma happens over time. Because it occurs during critical developmental periods or in environments where trust and safety are compromised, it leaves lasting imprints on self-perception, relationships, and emotional regulation.
Symptoms of CPTSD
CPTSD includes the core PTSD symptoms: hypervigilance, avoidance, and re-experiencing, but also expands into additional areas that reflect the complexity of long-term trauma. Researchers often group these into six clusters:
Hypervigilance: Feeling constantly on guard, easily startled, struggling with sleep or irritability.
Avoidance: Steering clear of reminders of trauma, or emotionally shutting down.
Re-Experiencing: Flashbacks, nightmares, or intrusive memories that bring the trauma back vividly.
Affect Dysregulation: Difficulty managing emotions, frequent mood swings, or feeling emotionally numb.
Relationship Difficulties: Struggles with trust, boundaries, or intimacy; patterns of isolation or conflict.
Negative Self-Concept: Deep shame, guilt, or the belief of being “broken” or unworthy.
These clusters don’t exist in isolation, they intertwine, creating cycles of distress that affect nearly every aspect of life.
What CPTSD Feels Like
Living with CPTSD can feel like constantly being pulled between extremes:
Overwhelming emotions vs. emotional numbness
Craving connection vs. fearing intimacy
Wanting safety vs. feeling it’s never possible
Many describe it as carrying the trauma in their body and identity, not just in their memories.
Coping and Survival Mechanisms
People with CPTSD often develop coping strategies that once served as survival tools during trauma but may now create challenges. These can include:
Dissociation or “checking out” mentally
People-pleasing to prevent rejection or conflict
Overachieving or perfectionism to feel worthy
Avoidance through work, substances, or technology
While these strategies offer temporary relief, they can reinforce cycles of distress and disconnection.
Healing from CPTSD
The good news is that recovery is possible. Healing often involves rebuilding safety, trust, and self-compassion over time. Evidence-based approaches include:
Trauma-focused therapies such as EMDR, Brainspotting, Somatic Experiencing, or Trauma-Focused CBT
Skills-based approaches like Dialectical Behavior Therapy (DBT) to manage emotions and relationships
Body-based practices such as yoga, mindfulness, or grounding techniques to reconnect with the present moment
Safe relationships and support networks, which counteract the isolation and mistrust caused by trauma
Healing from CPTSD is not about erasing the past, but about reclaiming a sense of safety, identity, and possibility for the future.
