What is complex PTSD? Plus, 9 tips to help you heal

Mental Health

May 27

Written By Calm Editorial Team

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

Complex PTSD can impact how we feel, trust, and relate. Discover what C-PTSD really looks like and how to support yourself (or a loved one) through healing.

Complex post-traumatic stress disorder, or C-PTSD, is a clinical term for a condition that can impact every area of a person’s life. It often shows up as ongoing self-doubt, relationship struggles, or a feeling of being on edge. And many people living with this condition don’t even know it has a name — they just know something is wrong.

Complex PTSD is caused by the impact of long-term trauma that’s often rooted in childhood, toxic relationships, or other situations where someone felt powerless for an extended period of time. Unfortunately, because the symptoms of C-PTSD are similar to generalized anxiety disorder, it's often misdiagnosed and is also underdiagnosed.

Let’s break down what complex PTSD is, how it’s different from PTSD, the signs to watch for, and simple ways to begin healing. Whether you’re navigating this yourself or trying to support someone you love, you deserve clarity, compassion, and tools that meet you where you are.

What is complex PTSD (C-PTSD)?

Complex PTSD is the result of ongoing trauma impacting someone over an extended period of time, as opposed to a singular traumatic event. Common causes of C-PTSD include childhood neglect or abuse, domestic violence, ongoing emotional manipulation, or living in a high-control environment (like cults or captivity). The common thread is a loss of control over one’s own safety, often at the hands of someone who was supposed to provide protection.

People with C-PTSD often walk through life carrying the unspoken belief that they’re not safe, not worthy, or not good enough. And while they may seem high-functioning on the outside, it’s a different story on the inside — filled with anxiety, distrust, and shame that doesn’t easily go away.

Learning more about complex PTSD can help you make sense of your pain and know that healing, while not easy, is absolutely possible.

C-PTSD vs PTSD

Complex PTSD and PTSD both come from trauma, but the type of trauma and how it affects a person over time can look different.

PTSD usually develops after a single traumatic event that’s sudden, shocking, and overwhelming. Although the person survives the event, their nervous system stays stuck in survival mode. They might experience flashbacks, nightmares, hypervigilance, or avoid situations that remind them of what happened.

Complex PTSD forms in response to repeated or prolonged trauma, especially trauma that happens in relationships or environments where a person feels trapped, such as childhood emotional neglect, long-term abuse, human trafficking, domestic violence, or growing up in a home where love was conditional and safety was inconsistent.

Here’s what that can look like in real life:

Someone with PTSD might avoid driving after a serious crash.
Someone with C-PTSD might feel unsafe in relationships, struggle with ongoing self-blame, and be unable to trust even the people closest to them.

PTSD tends to revolve around specific memories or triggers. C-PTSD shows up everywhere: In how someone sees themselves, how they relate to others, how they handle stress, and how they manage emotion.

6 symptoms of complex PTSD

Complex PTSD isn’t always as obvious as other diagnoses may be. It can show up as patterns and feelings that become so normalized, people assume it’s just who they are. Thoughts like, “I’m just too sensitive,” “I have trust issues,” or, “I’m bad at relationships” are common.

If any of these resonate, just know that you’re not broken. Your nervous system is doing its best to survive what you were never meant to endure alone.

Here are six common symptoms of C-PTSD:

1. Emotional flashbacks: These aren’t visual replays of trauma, but intense emotional reactions like shame, panic, or helplessness that come on suddenly and feel overwhelming. Your body reacts like it’s in danger, even if you can’t pinpoint why.

2. Chronic shame and guilt: C-PTSD often leaves you with a deep sense of unworthiness. You might apologize constantly, overanalyze everything you say, or feel like a burden to others.

3. Difficulty with relationships: Trust can feel risky, and boundaries might feel impossible to set or maintain. You might get close too fast, stay too long, or keep everyone at a distance. Relationships feel more like survival than safety.

4. Emotional numbness or volatility: You might swing between feeling nothing at all and feeling way too much. Some days you’re checked out, and other days, every little thing hits hard.

5. Negative self-image: If you grew up with constant criticism or neglect, it’s easy to believe you’re broken, unlovable, or failing. These thoughts are rooted in survival, not truth.

6. Hypervigilance and dissociation: Your system stays on edge, scanning for danger. You might feel constantly anxious, have trouble sleeping, or react strongly to small triggers. Other times, you may go numb, detach, or mentally check out to cope.

How to treat C-PTSD: 9 tips to help you heal

Healing from complex PTSD is not about erasing the past but about rewriting your relationship to it. It’s about slowly and gently re-learning how to feel safe in your body, relationships, and the world.

Here are nine practical tips to help you move forward at your own pace.

1. Find a trauma-informed therapist

Not every therapist understands complex trauma. Look for someone trained in types of therapy like eye movement desensitization and reprocessing (EMDR), somatic experiencing, internal family systems (IFS), or sensorimotor psychotherapy. These therapies work with the body, not just the mind, and that’s essential for trauma that lives in your nervous system.

2. Learn the signs of emotional flashbacks

Emotional flashbacks are sudden waves of shame, fear, or helplessness that seem out of proportion, and it can be helpful to spot them when they happen. Instead of spiraling, you might be able to talk yourself through the reality of the past versus what’s happening now.

What helps: Use grounding techniques like touching a textured object, naming five things you see, or placing your feet flat on the floor. Anything that connects you to the present moment helps interrupt the spiral. (Here are 18 grounding exercises to try.)

3. Practice body-based grounding every day

Your body remembers trauma even when your mind doesn’t. That’s why daily grounding is essential to calm the nervous system and reinforce a felt sense of safety.

Try this:

Place one hand on your heart and one on your belly.
Breathe in for four counts, hold for two, and exhale for six.
Whisper a mantra like, “I am safe right now,” or, “This is not that.”

💙 Try the 5, 4, 3, 2, 1 grounding meditation led by Tamara Levitt to relax into your body and calm your nervous system.

4. Build a routine, even if it isn’t perfect

Because trauma thrives in chaos, daily routines can help you feel more stable (these 10 tips are a good place to start). Try waking up around the same time every morning, eating regular meals, or taking a walk after work to help regulate your nervous system. Explore 10 more ideas to help you build your routine.

5. Reclaim your body through movement that feels good to you

Trauma often disconnects us from our bodies, but movement can help rebuild that bridge. Focus on movement that feels good to you.

Try these mindful movement ideas:

Stretching to your favorite playlist
A walk while naming everything you see
Gentle yoga, qigong, or tai chi
Dancing in your kitchen while dinner simmers on the stove

💙 Make time for mindful movement every day with help from Mel Mah’s Daily Move sessions.

6. Name and honor your boundaries

Boundaries aren’t walls. Instead, they can be seen as windows. They let in what nourishes you and keep out what doesn’t. If you grew up with boundary violations, setting them now may feel terrifying or selfish. But it’s not. It’s survival.

Start here:

“I’m not available for that conversation right now.”
“I need a break from this dynamic.”
“I’m learning to take care of myself, even when others don’t understand.”

7. Connect with safe people (and detach from unsafe ones)

Trauma often teaches us that connection equals danger, but healing can happen in safe relationships. Not perfect ones. Safe ones. If safe people are hard to find in your life right now, you can seek out safe connections in support groups (in person or online), trauma-informed communities, or even trauma-aware creators on social media can provide meaningful validation.

8. Get real about your inner critic

C-PTSD loves to dress up as self-doubt. The inner critic that says you’re too much, too needy, or too broken is a survival strategy that once tried to protect you from pain or rejection. But now it just keeps you small.

Reframe the voice:

Name it: Hey, these thoughts aren’t actually helpful today.
Counter it with a new voice: I’m allowed to take up space.
Affirm yourself: Keep a running list of affirming truths and speak them aloud.

9. Celebrate even the smallest progress

Healing from complex trauma is like learning to walk after years of crawling. It takes time. You’ll have setbacks. You’ll lose steam. But every time you notice your pattern, make a new choice, or simply survive a hard day is progress.

Track your wins:

“I didn’t text them back out of guilt.”
“I grounded myself during a flashback.”
“I cried and let it happen.”

Complex PTSD FAQs

How long does therapy take for childhood trauma?

There’s no one-size-fits-all answer here, and anyone who gives you a neat timeline probably hasn’t lived it. Healing from childhood trauma—especially the kind that leads to C-PTSD—is usually a long-term process.

That’s not because you’re too damaged or slow to heal, but because this trauma happened over time, often during the years your identity was forming. Therapy might begin to bring clarity and relief within a few months, but deeper healing can take years. The goal is to feel more regulated, more resourced, and more you as you move through life.

How is complex PTSD different from regular PTSD?

While both PTSD and C-PTSD are trauma responses, their roots and symptoms are different. PTSD usually develops after a single traumatic event, like an accident, assault, or natural disaster. The trauma is specific, and the symptoms tend to focus on re-experiencing that event, like flashbacks, nightmares, or avoidance.

Complex PTSD, on the other hand, develops from repeated or prolonged trauma. That might mean emotional neglect, abuse, captivity, or abandonment. C-PTSD doesn’t just impact how you remember the past, but it reshapes your sense of safety, your emotional regulation, and even your identity.

What are emotional flashbacks in C-PTSD?

Emotional flashbacks are sudden, intense emotional states that flood your body and often come with feelings like shame, fear, panic, or helplessness. You might not see a mental image or remember a specific event. Instead, your whole system reacts as if it’s back in a threatening situation, even if you’re physically safe.

These flashbacks can be especially confusing because they feel irrational, but they’re very real. Your brain is responding to a perceived threat based on past experiences, not present reality. Learning to recognize emotional flashbacks and ground yourself in the current moment is a huge part of C-PTSD recovery. (These 15 grounding ideas are a great place to start.)

Can C-PTSD be mistaken for BPD or anxiety?

Yes, because C-PTSD isn’t always well-known or well-trained for, many people get diagnosed with borderline personality disorder (BPD), generalized anxiety, depression, or even bipolar disorder before anyone considers complex trauma.

There’s definitely symptom overlap, such as mood swings, fear of abandonment, emotional intensity, self-harm, and dissociation. But the origin matters. Where BPD is considered a personality disorder, C-PTSD is a trauma response. Treating C-PTSD like BPD can lead to frustration and missed healing opportunities.

If you feel your diagnosis doesn’t fully explain your experience—and especially if you have a history of long-term trauma—it’s worth exploring C-PTSD with a trauma-informed provider.

How can I help someone I love with C-PTSD?

Supporting someone with complex PTSD isn’t about fixing them. It’s about being a steady, safe presence while they find their way. That means being patient when their reactions seem disproportionate, validating their feelings without trying to rationalize them away, and respecting their boundaries, even if you don’t always understand them.

Avoid pushing them to talk about their trauma unless they want to. Instead, focus on offering consistency, emotional safety, and the message that they aren’t too much for you. Encouraging professional help is great, but pressuring them into it isn’t. Healing from C-PTSD is deeply relational, and your empathy can be part of that process, even in small, quiet ways.

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Calm Editorial Team