Complex PTSD
03 of 08When survival has shaped how you live, connect and see yourself.
Complex PTSD often follows prolonged or repeated trauma, particularly when escape was difficult or impossible. This can include childhood abuse, family violence, coercive control and repeated emotional or psychological abuse. The harm does not have to be physical or visible to have a profound impact.
Sudden or traumatic deaths and repeated losses can also form part of someone’s experience, overwhelming their capacity to cope or bringing earlier trauma to the surface. What happened, the circumstances around it and the support available all matter. You do not need to compare your suffering with someone else’s for it to deserve care.
Recognised in the World Health Organization’s ICD-11, complex PTSD includes the core features of PTSD alongside persistent difficulties regulating emotions, a deeply negative sense of self and difficulties with relationships. Repeated adversity or loss does not automatically become complex PTSD, but its effects deserve to be understood and taken seriously.
It can reach into ordinary life
You might find closeness difficult even when you want it. Carry shame that does not belong to you. Feel overwhelmed by emotion, then feel nothing. Struggle to trust your own judgement or believe you deserve care.
For some people, dissociation and shutdown are especially disruptive. You may keep appointments, answer messages and care for your children while feeling almost entirely disconnected. At other times, even those basic tasks become impossible. Outward functioning can hide enormous internal effort.
Complex does not mean hopeless
Complex PTSD is not simply “more severe PTSD”, and shutdown is not exclusive to it. It describes an additional pattern of difficulties that deserves to be understood and treated in its own right.
Support may need to address safety, relationships, dissociation and daily functioning alongside traumatic memories. A treatment plan should reflect your needs and capacity, rather than asking you to push through overwhelming distress.
Your mind and body can feel out of step
You may understand your history and still be unable to change the response. Insight can help, but it does not always bring immediate relief. Recovery can involve learning, gradually and with support, how to feel present, recognise choices and reconnect with people and activities that matter.
You are more than the adaptations that helped you survive. Those patterns can change, even when they have been with you for a long time.
