Understanding Complex PTSD (CPTSD), The Science and How Therapy Can Help

Expansive Therapy

What Is Complex PTSD (CPTSD)?

Complex Post-Traumatic Stress Disorder, or CPTSD, is a mental health condition that results from prolonged or repeated trauma—often occurring in childhood or abusive relationships. Unlike PTSD, which may stem from a single traumatic event, CPTSD is rooted in chronic trauma over time.

Key Symptoms of CPTSD

CPTSD includes all the symptoms of PTSD (such as flashbacks, nightmares, and hypervigilance), but also features:

Emotional dysregulation
Negative self-concept
Difficulty with relationships and trust
Persistent dissociation or detachment

These symptoms make daily functioning, work, and interpersonal relationships more difficult to navigate.

What Does the Research Say About CPTSD?

The term “CPTSD” was officially recognized in the ICD-11 (International Classification of Diseases) by the World Health Organization. Research has shown that CPTSD often develops in individuals exposed to chronic abuse, neglect, or captivity—such as survivors of domestic violence, childhood abuse, prolonged parental neglect, or prolonged combat exposure.

A 2020 study published in The European Journal of Psychotraumatology found that CPTSD has distinct neurological and psychological markers compared to PTSD, suggesting the need for specialized treatment approaches.

How Therapy Can Help: Evidence-Based Approaches to CPTSD

Working through CPTSD requires a trauma-informed approach—one that recognizes the complexity of trauma and supports safety, empowerment, and healing.

1. Phase-Oriented Trauma Therapy

Many therapists use a phased approach:

Stabilization: Focused on building coping skills, emotional regulation, and safety.
Trauma Processing: Using EMDR (Eye Movement Desensitization and Reprocessing) or somatic therapies to process traumatic memories.
Integration: Reinforcing identity, relationships, and a sense of future.

2. EMDR Therapy

EMDR has shown promising results for both PTSD and CPTSD. It helps clients reprocess traumatic memories so they are no longer emotionally triggering. Like with any modality, it's not for everyone.

3. Internal Family Systems (IFS)

IFS helps clients access and heal the wounded “parts” of themselves that developed as survival mechanisms during trauma.

4. Somatic Experiencing & Polyvagal-Informed Therapy

Since trauma lives in the body, body-based modalities help regulate the nervous system and reduce chronic dissociation or shutdown.

What to Expect in CPTSD Therapy

A good therapist will move at your pace. In therapy for CPTSD, you can expect:

A focus on building safety and trust first
Psychoeducation about trauma and the nervous system
Gradual work on difficult memories, not forced exposure
A compassionate, nonjudgmental environment

Recovery Is Possible

Healing from CPTSD is not linear, but significant relief is absolutely possible. With the right therapeutic relationship, evidence-based treatment, and time, many people reclaim their sense of self, rebuild trust, and experience lasting relief from symptoms. The journey starts with a belief that healing is possible.

At Expansive Therapy, we have been trained by the leading trauma experts in the world, including Dr. Bessel Van Der Kolk (author of The Body Keeps the Score) and Dr. Richard Schwartz (founder of IFS). We have immediate openings in California and New York, please text 917-426-1521 or email info@expansivetherapy.com to get started.