Post-traumatic stress disorder (PTSD) is a mental health disorder that can develop following exposure to an extremely threatening or horrific event or series of events (e.g., sexual assault, witnessing a death, car accidents). PTSD involves four types of symptoms:

· Re-experiencing the event(s) in the present (e.g., nightmares, intrusive memories)

· Avoidance (e.g., avoiding remembering the event, avoiding places that remind one of the event[s])

· Changes in thinking and mood (e.g., loss of previous beliefs about one’s safety, a persistent negative mood)

· Changes in reactivity and arousal (e.g., difficulty sleeping, hypervigilance, difficulty concentrating, being easily startled).

Complex Post-Traumatic Stress Disorder (CPTSD), on the other hand, can also develop from exposure to an extremely threatening or horrific event or series of events but tends to develop from prolonged or repetitive events from which escape is difficult or impossible (e.g., repeated childhood physical and sexual abuse, torture, prolonged exposure to domestic violence). Furthermore, in addition to core PTSD symptoms, CPTSD involves disturbances in self-organisation, meaning that the trauma has a more fundamental impact on how the person relates to themselves and others and manages their emotional life:

· Chronic difficulties with emotional regulation (e.g., emotional numbing, dissociation, anger outbursts, intense emotional reactivity, self-destructive behaviour).

· Persistent negative self-concept (e.g., deep shame, feelings of worthlessness, or a sense of being damaged, defeated, or diminished).

· Difficulties in feeling close to others and forming/maintaining interpersonal relationships (e.g., feeling unsafe with closeness, withdrawing from others, or finding that relationships become intense and short-lived).

Treatment for CPTSD is often less linear than treatment for PTSD. While exposure-based therapies can be very effective in reducing core PTSD symptoms, many people find that the difficulties with self-organisation are the most painful and disruptive. For this reason, therapy for CPTSD is typically longer-term and progresses at a pace that prioritises emotional safety and stability.

In my clinical experience, as people gradually develop greater emotional regulation, a more authentic relationship with themselves, and a stronger sense of internal stability, they are often better able to approach and process traumatic memories.

I have extensive experience working with individuals affected by PTSD and CPTSD arising from a range of traumatic experiences, including childhood physical and sexual abuse, prolonged domestic violence, and military-related trauma. While the work can be challenging, people can and do make meaningful recovery in therapy for CPTSD.

For many, the hardest part is the act of starting therapy, as well as continuing to engage in the long term, even when the process feels painful or confronting. If you have been diagnosed with CPTSD, suspect you may have CPTSD, or feel the time is right to process traumas you have experienced in your life, please do not hesitate to contact me for an initial phone call to discuss your concerns and ask any questions you may have about engaging in therapy.