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What's The Difference Between Complex Trauma and PTSD?

PTSD develops from a single traumatic event, like a car accident or natural disaster. Complex trauma arises from ongoing physical, mental, or emotional abuse, neglect, violence, or loss over months or years, especially during early development. This constant exposure and lack of safety causes deeper issues with self-worth, relationships, and managing emotions.

  • With complex trauma, you may struggle with emotional regulation, dissociation, and impaired memory. Sudden noises or touches can trigger intense reactions as your body remains in a state of hyperarousal.

  • Problems with attachment and trust are common, as your primary caregivers may have failed to provide safety and nurturing. This can make relationships challenging and lead to feelings of isolation or neediness.

  • A negative self-image is typical, seeing yourself as worthless or defective. You may engage in self-harm or struggle with low self-esteem, guilt, and shame.

  • Physical symptoms are frequently present, such as digestive issues, chronic pain, or sleep disturbances. Substance abuse is also common as a way to self-medicate and numb painful emotions.

How it Impacts the Brain

Repeated trauma at a young age actually alters the way your brain develops. Connections that regulate emotions, memory, and the stress response can become disrupted. This makes complex trauma survivors prone to difficulties with:

•Emotional regulation: Struggling to manage emotional reactions and outbursts. Feeling emotions intensely but having trouble identifying them.

•Memory: Having trouble accessing memories or dissociating from them. Memories may feel fragmented or hazy.

•Stress response: Difficulty calming down after becoming upset or anxious. Feeling constantly on guard or like threats are looming.

•Self-image: Developing a poor sense of self-worth and identity. Having trouble maintaining healthy relationships as a result.

•Physical health: Facing a higher risk of health issues like fibromyalgia, chronic pain, digestive issues, and insomnia. Trauma impacts both the body and the mind.

Complex Trauma Has Widespread Effects

Complex trauma can affect your sense of safety, self-worth, and ability to regulate emotions. It often leads to issues like:

  • Difficulty trusting others or establishing healthy relationships

  • Trouble managing intense emotions like anger, fear, and shame

  • Feeling helpless, hopeless or overly responsible for the trauma

  • Struggling with boundaries or saying no

  • Engaging in self-harm or unhealthy coping mechanisms

Physiological Effects

Repeated stress and trauma alter your body’s systems. You may struggle with chronic pain, autoimmune disorders, or gastrointestinal issues. Sleep problems, lack of energy, and difficulty regulating emotions are also common.

Relationship Difficulties

If you grew up in an abusive or neglectful environment, you likely didn’t learn healthy relationship skills. You may have trouble trusting others, setting boundaries, or becoming emotionally intimate. This can lead to unhealthy relationships, social isolation, or difficulty parenting. With support, relationship patterns can be unlearned and new skills developed.

Low Self-Esteem

You may see yourself as unlovable, worthless, or defective in some way. Building self-esteem and self-compassion are important parts of the healing process. Speaking to yourself with kindness and encouragement can help reshape your inner dialog.

Difficulty Regulating Emotions

Repeated trauma exposure impacts your nervous system, making emotions feel uncontrollable or overwhelming. You may struggle with irritability, rage, depression, or anxiety. Learning skills like mindfulness, meditation, and deep breathing can help increase your ability to self-soothe and modulate emotional responses. With practice, emotions become less intense and easier to navigate.

Treating Complex Trauma Requires a Specialized Approach

Treating complex trauma requires a specialized approach that addresses its underlying causes and impacts. Traditional talk therapy and medications alone are usually not enough. Here are some of the key things to consider:

A trauma-informed therapist

Seeking help from a therapist or counselor who understands trauma and its effects is critical. They should be trained in trauma-specific therapies like Brainspotting, EMDR, IFS, or somatic experiencing. A trauma-informed therapist will make you feel heard, understood and supported. They will go at your own pace.

Addressing symptoms and coping skills

In addition to processing traumatic memories, therapy will focus on managing symptoms. Learning coping strategies to stay present and grounded can help reduce distressing symptoms. Breathing exercises, mindfulness practices, journaling and yoga are some effective options.

A holistic approach

Treating complex trauma requires a holistic view of wellness. In addition to therapy, it may include lifestyle changes that focus on basic needs. Alternative therapies like massage, acupuncture and equine therapy can also be helpful for some. Building a strong support system of people who understand your experiences is vital.

Recovering from complex trauma is a challenging process that takes time. Be gentle with yourself and celebrate small wins. Don't get discouraged if you face setbacks. With support, the willingness to heal, and a compassionate approach focused on growth and empowerment rather than "getting over it", you can overcome complex trauma. But there are no quick fixes, so patience and self-compassion are must-haves.

The key to recovering from complex trauma is finding what works for you. A combination of the right therapies, coping strategies, self-care and social support can help you move from surviving to thriving. But go slowly, be kind to yourself along the way, and remember that healing is a journey, not a destination.

Finding the Right Therapist for Complex Trauma

Finding the right therapist for complex trauma can be challenging. Many therapists are not properly trained to treat complex trauma, so you’ll want to do your research to find someone with experience helping clients work through chronic trauma, abandonment, or attachment issues. Some things to consider:

Level of Experience

Look for a therapist with specific experience treating complex trauma. Ask about their training, certifications, and years of experience during your initial consultation. A therapist should be well-versed in treatments like Brainspotting, EMDR, somatic therapy, and/or parts work.

Treatment Approach

An effective therapist will focus on the underlying issues, not just managing symptoms. Treatments should be tailored to your unique experiences and needs. The most effective approaches for complex trauma are experiential, body-based methods.

Your Connection

The therapeutic relationship is one of the most important factors in healing from complex trauma. Look for a therapist you feel comfortable opening up to and who shows compassion and understanding. During your initial session, notice how you feel in their presence. Do you feel heard, accepted and supported? Trust your instincts—if something feels off, keep looking.

The healing journey from complex trauma is challenging but finding an experienced, compassionate therapist you connect with and trust can make all the difference. While it may take time, finding the right fit will help you feel empowered and supported to work through trauma in a way that resonates for you.


Schalinski, I. Elbert, T. & Schauer, M. (2021). The neurobiology of complex PTSD and its clinical consequences. European Journal of Psychotraumatology, 12(1), 1856532. https://doi. rg/10. 080/20008198. 020. 856532

Ford, J. D. Spinazzola, J. van der Kolk, B. & Grasso, D. (2021). Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children and Adolescents Exposed to Complex Trauma. American Journal of Psychiatry, 178(2), 133-143. https://doi. rg/10. 176/appi. jp. 020. 7121397

Eckhardt, C. I. Samper, R. E. & Jacob, S. (2022). Complex trauma: A systematic review of measurement instruments. Trauma, Violence, & Abuse, 23(1), 126-142. https://doi. rg/10. 177%2F1524838020915641

Lindert, J. Ehrenstein, O. S. Priebe, S. Mielck, A. & Brähler, E. (2023). Complex trauma and mental health in the general population–An epidemiological study. Plos one, 18(1), e0262592. https://doi. rg/10. 371/journal. one. 262592

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