Complex Trauma (C-PTSD)

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When trauma shapes who you believe you are.

Beyond a single traumatic event.

Complex Post-Traumatic Stress Disorder develops in response to prolonged, repeated or chronic trauma — particularly trauma that occurs in contexts where escape is difficult or impossible. This includes childhood abuse or neglect, domestic violence, prolonged emotional abuse, captivity, war or growing up in an environment of chronic instability and unpredictability.

Unlike PTSD which typically develops in response to a single traumatic event, C-PTSD results from trauma that is sustained over time — often during formative developmental periods. This shapes not just how a person responds to threat but how they see themselves, others and the world. The effects are pervasive and deeply embedded in identity, relationships and the nervous system.

C-PTSD is not a character flaw or a sign of weakness. It is the understandable result of extraordinary circumstances. With the right support meaningful recovery is possible — not just managing symptoms but genuinely healing.

SYMPTOMS

Does this sound familiar?

Trauma Responses

▪ Flashbacks, intrusive memories or nightmares

▪ Hypervigilance — feeling constantly on alert for danger

▪ Emotional flashbacks — sudden overwhelming feelings from the past

▪ Avoidance of people, places or situations that trigger memories

▪ Physical responses to trauma triggers — racing heart, panic, freeze

Emotional Regulation

▪ Difficulty managing intense emotions

▪ Persistent feelings of shame, guilt or worthlessness

▪ Chronic emptiness or numbness

▪ Explosive anger or complete emotional shutdown

▪ Feeling permanently damaged or different from others

Identity & Relationships

▪ A deeply negative or unstable sense of self

▪ Difficulty trusting others even when you want to

▪ Patterns of chaotic, volatile or painful relationships

▪ Feeling detached from yourself or the world around you

▪ Difficulty feeling safe in relationships — even close ones

▪ A persistent sense that you are fundamentally broken or unlovable

C-PTSD and PTSD

Both involve trauma — but they are distinct conditions that require different approaches to treatment.

PTSD:

Typically develops following a single traumatic event or a discrete period of trauma. Core symptoms include intrusive memories, avoidance, negative changes in mood and cognition, and hyperarousal. PTSD responds well to trauma-focused therapies including Prolonged Exposure and CBT.

C-PTSD:

Develops following prolonged, repeated trauma — particularly in childhood or in contexts of captivity or control. In addition to PTSD symptoms C-PTSD involves significant disturbances in self-perception, emotional regulation and relational patterns. Treatment requires a phased, longer term approach that addresses both trauma and its impact on identity and attachment.

Treatment

Healing is possible. It takes time — and the right support.

Treatment for C-PTSD at Karasick Psychology is phased, collaborative and paced entirely to you. We do not rush trauma processing — safety, stabilization and trust come first. Only when a strong therapeutic foundation is in place do we move toward processing traumatic material.

We draw from evidence-based approaches including Cognitive Behavioural Therapy adapted for complex trauma and Prolonged Exposure Therapy where appropriate. Biofeedback is integrated to support nervous system regulation — building the physiological capacity to tolerate and process difficult material without becoming overwhelmed.

Treatment for C-PTSD is longer term than many other presentations. Progress is real and meaningful — but it unfolds at its own pace. Many clients describe therapy for complex trauma as some of the most profound and transformative work of their lives.

Treatment begins with a thorough intake to understand your history, your symptoms and what you need most. From there therapy is collaborative and paced entirely to you — your safety and comfort guide every step of the process.

A note on safety

If you are currently in an unsafe situation — including domestic violence or abuse — please know that support is available. Therapy for complex trauma works best when you are in a position of relative safety. If you are unsure whether therapy is right for you right now please reach out and we can discuss what support looks like at this stage.

You are not alone

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Reaching out for therapy is hard, but struggling alone is harder. Contact us to learn how we can support your path toward healing, development, and lasting improvement.