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What is Complex PTSD?

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Rebeckah Atkinson

Written by Rebeckah Atkinson, BS

Rebeckah is currently an intern and under the supervision of Kayce Bragg, LPCS (# 8061), LAC #369

Rebeckah Atkinson, BS  is a resident of West Columbia, South Carolina. She received her B.S. in Psychology from Coastal Carolina University in Conway, South Carolina in December 2018, and she is currently completing her M.A. in Clinical Mental Health Counseling at Webster University (Columbia, SC). She is on track to graduate in the Spring of 2024. 

Rebeckah believes that coming to therapy is a powerful step in the healing process. She aspires to create an open, empathetic, culturally sensitive environment in which clients can express their mental health or life concerns in a judgement free environment. She employs an integrative, trauma-informed approach to counseling that includes person-centered, cognitive-behavioral, and family systems therapy techniques. Rebeckah works with individuals, children, couples, and families.

What is Complex PTSD?

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When people hear the term PTSD, often times they associate it with military combat or a major devastating event in someone’s life. However, what people are not always aware of is that PTSD, or post-traumatic stress disorder, can affect anyone who has experienced any form of trauma that leads to things such as anxiety, flashbacks, nightmares, and many other unwanted psychological conditions. Moreover, there are many various scenarios that could lead to PTSD, such as witnessing a car accident, being in a car accident, any form of abuse, terrorist attacks, and many other events that cause stress and have lasting effects. Occasionally, it may even be something like losing a pet or a seemingly small event in your life that just affects you deeply. 

Complex PTSD: A Deeper Dive


In 2019, The World Health Organization coined the term Complex PTSD as a diagnosis. Although the American Psychological Association has yet to recognize Complex PTSD as its own diagnosable condition, they have a subcategory in the diagnostic manual (DSM-5) that is termed as dissociative PTSD which is somewhat comparable to Complex PTSD with similar symptoms. Complex Post Traumatic Stress Disorder is defined as a mental health condition that develops if someone is exposed to long-term experiences of trauma. The symptoms of Complex PTSD (CPTSD) as very similar to those of PTSD. Some examples are the following:

  • anxiety,
  • flashbacks,
  • nightmares,
  • avoiding anything that may relate to the traumatic events, and many others.

Understanding Complex PTSD: Challenges, Prevalence, and Diagnosis


If you have ever been in an abusive relationship, such as one involving intimate partner violence, childhood physical or sexual abuse, combat, or even frequent community violence, you may have CPTSD. CPTSD is typically associated with long-term trauma during childhood, but it has also become more prevalent in adults as well. Some experts believe that CPTSD, PTSD, and other mental health conditions may exist on a spectrum of trauma-related mental health disorders, varying in the level of severity.

For individuals who may have CPTSD, it is common for them to experience issues with emotional regulation, identity issues, struggling with their sense of self, and commonly have trouble maintaining healthy relationships. Despite being a developing topic in the mental health world, CPTSD is believed to effect 1% to 8% of the world’s population. However, as it continues to be studied, there is no test to diagnosis it. A counselor or mental health professional may determine you have CPTSD after reviewing your symptoms, medical history, mental health history, and any exposure to trauma you may have had.

Treating and Managing Complex PTSD


Fortunately, even though CPTSD isn’t officially recognized, there are various ways to handle it. The primary treatment is talk therapy, mainly Cognitive Behavioral Therapy (CBT). In sessions, you’ll get support, discuss trauma, learn about CPTSD, manage it between sessions, and get guidance on healthier coping strategies. Additionally, loved ones can also learn how to support you in your healing journey.

Moreover, when dealing with any form of trauma, you mental health professional will be using trauma-focused CBT. In trauma-focused CBT, you will learn about how you and your body respond to trauma and stress in your life, how to manage your symptoms, how to identify and reframe problematic thinking patterns, and often times, counselors will use exposure therapy once you are further along in your therapy treatment. 

Coping Strategies and Support


Getting treatment is crucial for those individuals who have experienced any form of trauma in their life. Moreover, it is common for those individuals to avoid anything that they associate with their trauma. Consequently, avoiding these triggers impedes the opportunity to learn how to effectively handle the associated fear and emotions.

Some examples of strategies:


  1. Exposure Therapy: Facing Triggers Head-On. Using exposure therapy gives the counselor the ability to slowly encourage clients to put themselves in triggering situations and teach they how to cope with those emotions that they experience, therefore, lessening the effects that the situation has on the client.
  2. Grounding Techniques: Regulating Emotions Beyond Sessions. Outside of sessions, it is important that you continue to do the work to help ground yourself in situations you find yourself triggered. There are many ways that you are able to do this. One example would be to use coping strategies, such as meditation, breathing exercises, or anything that elevates your mood.
  3. Setting Realistic Goals and Building a Support System. It is important to set realistic goals for yourself on this healing journey and to spend time with those you trust. While spending time with your trusted circle, it is important to educate them about your experience and explain to them what often triggers you and teach them how they may be able to help you in those situations. Often times, they will be able to help you ground yourself or assist you in focusing on your breathing and other things that are a distraction from the trauma and bring you back to the present.
  4. Finding Your Safe Space: A Sanctuary for Healing. Another important thing is to identify your safe spaces. When you have had a triggering day, it is important that you have a place that you feel safe and at peace. This gives your body and mind time to let your defenses down and be at peace.
  5. Support Groups: Sharing and Healing Together. There are also support groups that may be available and individuals who have experienced trauma often find it very helpful to be surrounded by others who have experienced similar issues, and they also are able to share things that have helped them with their healing journey that you may benefit from hearing. 

The Healing Journey: Show Yourself Grace


In coping with trauma, it’s essential to show yourself grace. Remember, healing doesn’t happen overnight, and it’s not your fault. Take time to process and learn to manage symptoms. Additionally, be patient, try new things, and use coping skills when triggered. Healing takes time; there’s no deadline to “feel better.” Trauma is unique, so the healing process is unique. Don’t be discouraged if things don’t improve right away.

Moreover, for those using prescription meds to manage symptoms, it’s important to recognize that there is no shame in doing so. Trauma can mess with the brain, but it can be rewired over time. You’re not alone; loved ones and counselors are here to help. If you’re struggling, reach out—no judgment. Remember that seeking help is a sign of strength; everyone needs it at times. You’re strong and will overcome this battle.

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If you, or know of someone who could use some online counseling to feel heard and learn ways to cope, please connect with one of our therapists today for a free consultation.


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