Understanding Complex PTSD: A Deep Dive into Healing
- Scarlet Plus LLC
- Aug 18
- 4 min read
Updated: Oct 21
When people hear the term “PTSD,” they often think of military veterans or survivors of single traumatic events like car accidents or natural disasters. However, trauma isn’t always a single, isolated incident. For many, trauma occurs repeatedly and over long periods of time—during childhood, in abusive relationships, or in unsafe environments. This is known as Complex PTSD (C-PTSD), a condition that is less widely understood but deeply impactful.
At Forbs Behavioral Health Services, LLC, serving both Maryland and Washington, D.C., we often work with individuals struggling with the lingering effects of complex trauma. Understanding what C-PTSD is, how it differs from traditional PTSD, and the symptoms to watch for can help people finally put words to their experiences and begin the journey toward recovery.
Page Contents
What Is Complex PTSD?
PTSD vs. Complex PTSD: What’s the Difference?
Symptoms of Complex PTSD
Causes and Risk Factors
The Mind-Body Connection in C-PTSD
How C-PTSD Impacts Daily Life
Pathways to Healing
How Forbs Behavioral Health Services Can Help
Conclusion
What Is Complex PTSD?
Complex PTSD develops after prolonged or repeated exposure to trauma, often in situations where escape feels impossible. Unlike PTSD, which can result from a single event, C-PTSD is associated with chronic trauma.
Examples of Chronic Trauma
Chronic trauma that may lead to C-PTSD includes:
Childhood physical, emotional, or sexual abuse
Growing up in a neglectful or unstable household
Living with domestic violence
Long-term captivity, trafficking, or imprisonment
Repeated exposure to war or displacement
C-PTSD isn’t officially listed in the DSM-5 as a separate diagnosis, but the World Health Organization’s ICD-11 recognizes it. Many clinicians treat it as distinct because of the additional symptoms beyond PTSD.
PTSD vs. Complex PTSD: What’s the Difference?
Both PTSD and C-PTSD share core symptoms:
Re-experiencing (flashbacks, nightmares, intrusive memories)
Avoidance of reminders of the trauma
Hyperarousal (being constantly “on edge,” startled easily)
However, C-PTSD adds layers of emotional and relational difficulties:
Emotional Dysregulation
Intense anger, sadness, or fear that feels uncontrollable
Numbness or emotional shutdown
Negative Self-Perception
Deep feelings of guilt, shame, or worthlessness
Believing one is “damaged” or unlovable
Relationship Challenges
Difficulty trusting others
Avoidance of closeness or, conversely, desperate need for approval
Fear of abandonment
Dissociation
Feeling detached from reality or disconnected from one’s body
Memory gaps related to trauma
Chronic Health Symptoms
Headaches, digestive issues, sleep disturbances, or chronic pain often accompany C-PTSD.
Symptoms of Complex PTSD
People with C-PTSD often describe feeling like their trauma defines their entire identity, not just their past. Common symptoms include:
Emotional flashbacks: Unlike visual flashbacks, these are sudden waves of overwhelming emotion with no clear trigger.
Self-blame: Believing the trauma was their fault.
Hopelessness: Feeling the future holds no possibility of change.
Difficulty with authority or control: Because trauma often involved powerlessness, survivors may struggle in workplaces or relationships where they feel controlled.
Isolation: Avoiding social connections out of fear of being hurt again.
Causes and Risk Factors
Not everyone who experiences repeated trauma develops C-PTSD. Factors that increase vulnerability include:
Trauma starting at an early age (childhood trauma is especially impactful).
Lack of supportive caregivers or community.
Multiple forms of abuse (emotional, physical, sexual, neglect).
Long-term exposure without escape or intervention.
Protective factors—like having even one supportive adult in childhood—can sometimes reduce the long-term effects.
The Mind-Body Connection in C-PTSD
Just like traditional PTSD, complex trauma doesn’t just affect the brain—it alters the entire stress response system. Survivors often experience:
Overactive nervous system, keeping them in constant fight-or-flight mode.
Cortisol imbalance, contributing to fatigue, inflammation, and immune issues.
Digestive problems like IBS, often tied to stress and anxiety.
At Forbs Behavioral Health Services, we take these physical symptoms seriously because treating trauma isn’t just about emotions—it’s about the whole person.
How C-PTSD Impacts Daily Life
Living with complex trauma can make ordinary tasks overwhelming. Survivors may:
Struggle to keep jobs due to triggers, concentration problems, or interpersonal conflict.
Withdraw from relationships or experience cycles of unhealthy ones.
Avoid medical care because it feels invasive or triggering.
Experience burnout from constantly trying to “hold it all together.”
These struggles often lead to secondary conditions, like depression, substance use, or eating disorders.
Pathways to Healing
Recovery from C-PTSD is absolutely possible, but it requires patience and an approach tailored to the survivor’s unique experiences. At Forbs Behavioral Health Services in Maryland and Washington, D.C., we use a combination of evidence-based therapies and holistic care.
1. Trauma-Focused Therapy
EMDR (Eye Movement Desensitization and Reprocessing): Helps reprocess trauma memories so they no longer trigger overwhelming reactions.
Cognitive Processing Therapy (CPT): Addresses negative beliefs about the self that often come from trauma.
Somatic Therapy: Focuses on how trauma is stored in the body and teaches techniques to release physical tension.
2. Building Safety and Trust
Since many survivors experienced betrayal, therapy emphasizes creating a safe, trusting relationship first before deep trauma work begins.
3. Emotional Regulation Skills
Learning grounding techniques, mindfulness, and self-soothing strategies can help manage overwhelming emotions.
4. Medication Management
While therapy addresses root causes, medications may help with depression, anxiety, or sleep disturbances.
5. Group Support
Connecting with others who share similar experiences can reduce isolation and create a sense of belonging.
How Forbs Behavioral Health Services Can Help
Our clinics in Maryland and Washington, D.C. provide:
Psychiatric care for symptom management
Group therapy programs for trauma recovery
Telehealth for convenient, private access
A compassionate team that validates the survivor’s experiences
We believe survivors of complex trauma deserve care that acknowledges the depth of their pain but also their capacity to heal.
Conclusion
Complex PTSD is more than just “severe PTSD.” It is the result of long-term, repeated trauma that changes how survivors view themselves, their relationships, and the world. The symptoms can feel overwhelming, but healing is possible.
At Forbs Behavioral Health Services, LLC, we help survivors rebuild their sense of safety, reclaim their identity, and move toward a healthier future. Trauma may shape a person’s past, but it doesn’t have to define their future.
References
Herman, J. (1992). Trauma and Recovery.
World Health Organization. ICD-11: Complex PTSD.
National Center for PTSD. Complex PTSD Factsheet.
American Psychiatric Association. Trauma and Stressor-Related Disorders.
