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What is Complex Trauma & Complex PTSD?


Complex Post Traumatic Stress Disorder, is Post Traumatic Stress Disorder symptoms with added symptoms caused due to prolonged severe interpersonal trauma within a captivity or entrapped situation. As opposed to PTSD, which can be caused by a one-time trauma, like a car crash, or bank hold up.


Complex PTSD is a proposed disorder, with most therapists, psychologists, psychiatrists and mental health professionals experienced in trauma, treating complex trauma survivors with Complex PTSD accordingly. 


The term 'Complex PTSD' was introduced by Judith Herman M.D, in her book 'Trauma & Recovery - The Aftermath of Violence from Domestic Abuse to Political Terror' and subsequent paper. See link here.


I have read this book and I highly recommend it. It explains the affects of complex trauma in detail and I felt as though I was reading about myself through much of it.


In the UK, they use the ICD for diagnosis of psychiatric disorders, and their 'Disorder of Extreme Stress Not Otherwise Specified', does more accurately reflect Complex PTSD, as opposed to simply PTSD.




Trauma types that can cause Complex PTSD


This is prolonged, repeated or multiple trauma within an environment where it is perceived there is no viable escape. The trauma can be multiple types.


Examples of complex trauma are;


Prolonged child abuse - e.g. sexual, physical, psychological, neglect.

Prolonged severe domestic violence relationships

Prisoner Of War


Forced prostitution

Sexual slavery

Sex trafficking

Long term exposure to crisis conditions

Living in a war zone.



The trauma type that cause Complex PTSD, are different to PTSD.


PTSD can be caused be a one-time trauma, such as a car crash, one off sexual attack, bank hold up etc.






Emotion Regulation Problems


This includes having difficulty managing emotions, such as severe depression, suicidal thoughts, anger, impulsive behaviour.


One's System of Meanings


May include a loss of sustaining faith or a sense of hopelessness and despair.



Cognitive Distortions


This includes 'all or nothing' thinking, catastrophizing, minimizing, jumping to conclusion, emotional reasoning and other forms of cognitive distortions. See link for more info on this Here



Changes in Consciousness


This includes repressed memories, flashbacks and dissociation.



Personal Relationship Difficulties


The Complex PTSD sufferer will often have issues with trust and negative affects within relationships, trust being one of the biggest issues I have seen talked about with complex trauma survivors.



How The Person Views Themselves


This includes feelings of shame, guilt, self blame, helplessness, hopelessness,  feeling different to other people.



How the Victim Views the Perpetrator/Abuser


Someone with Complex PTSD oftens feels like the perpetrator has total control over them and feels helpless. The complex PTSD sufferer may also have continual thoughts about perpetrator/abuser.



How The World Is Viewed


Victims exposed to prolonged, repeated trauma and abuse often view the world as dangerous and lack hope for the future to be positive. Feelings of hopelessness and feeling totally alone - something I term - terminal aloneness.



Loss of Faith


Often a victims spirituality is affected and faith in God can be altered and a loss of faith is common.

Links to great articles on Complex Trauma & Complex PTSD

How a Diagnosis of Complex PTSD Differs From PTSD - Matthew Tull Ph.D

Healing Complex Trauma, Part I: The Path to Self-Awareness - Good Therapy

Healing Complex Trauma, Part II: The Path To Integration - Good Therapy

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