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Category What Is CPTSD? not found

Simple Explainer

C-PTSD, or Complex Post Traumatic Stress Disorder*, is a mental disorder caused by repeated exposure to traumatic events*. These events can include, but are not limited to, physical, psychological* or #Sexual abuse or neglect; domestic violence; bullying; chronic illness; torture; imprisonment; or poverty. Symptoms of this disorder can cause a feeling of unreality*, sudden bursts of unexplained, inappropriate or uncontrollable emotions*, self-sabotage*, feelings of hopelessness*, and even a loss of a sense of self*. Fortunately there are now numerous treatment modalities and many of those afflicted can come to a place where they no longer suffer from the symptoms of CPTSD. How CPTSD develops

Types of trauma






Emotional Flashbacks

Toxic Inner Critic

Why do I feel like I won’t get better?


The 4F Response is a model of human stress responses put forward by Pete Walker in From Surviving to Thriving. Most people are familiar with the idea of the ‘fight or flight’ response, whereby organisms respond to threatening situations by either fighting or running away.

To fight and flight, 4F adds #Freeze and #Fawn. They are inbuilt neurological responses that are activated when a basic need is not met. That might be the need for safety, sustenance, love, or anything else that is necessary for survival.

In the context of CPTSD, Pete Walker focuses on 4F responses in children, the reasons they are triggered, and the effects of being in a 4F response for an extended period of time. An individual will tend to rely on one or two out of the four, and many symptoms of CPTSD are rooted in the stress responses to which one gravitates.

Details on fight, flight, freeze and fawn are given below.






  • Illness Stories
  • Co-occuring Conditions
  • Neurodevelopmental Disorders
  • Physical Illnesses
  • Addiction
  • Personality Disorders


C-PTSD is a mental disorder developed after long periods of prolonged stress or trauma. Although C-PTSD is not currently recognized by the DSM V (Diagnostic and Statistical Manual of Mental Disorders)*, it is recognized by the WHO’s ISCD-11 (Word Health Organization’s International Statistical Classification of Diseases)* and many other countries’ health services. C-PTSD was originally proposed to the American Psychiatric Association, (the body which controls what disorders and illnesses are represented in the DSM,) as DES-NOS (Disorder of Extreme Stress Not Otherwise Specified) to be added into the DSM IV. It was rejected due to insufficient validity research***

Later, supporters of DES-NOS tried again in 2013 to propose DTD, (Developmental Trauma Disorder), as a new entry into the DSM-V. DTD focused primarily on traumatic childhoods and the long-term effects. DTD was also denied due to insufficient validity research*** Today, one of the biggest arguments offered towards adding C-PTSD to the DSM-VI* has been that the existing system of diagnosing suspected C-PTSD has been to code the diagnosis as PTSD and tack on any existing “comorbid” disorders*, which are commonly present in C-PTSD but not PTSD*. Advocates for C-PTSD’s addition to the DSM argue that a single, broad disorder provides a better and more simplified diagnosis than the current system*. The American Psychiatric Association does not officially recognize C-PTSD as a valid diagnosis, but many clinicians have been unofficially treating it by coding it under PTSD*. Some have argued that, because of the similarities between C-PTSD and PTSD that this is beneficial to the patient, while others have argued that [the dsm v is the bible of psychology and the hippocratic oath is an oath to existing research]. As far as recent research has concluded, there is no set path that the majority of medical professionals can agree on in order to treat C-PTSD. [Trauma informed therapists are important though]. As of 2017, though, the American Psychological Association PTSD Clinical Practice Guideline strongly recommends treatment that involves the following therapies**. Though these treatments are recommended, the research regarding the efficacy of their treatment in PTSD and C-PTSD is still incomplete and ongoing.

Cognitive Behavioral Therapy (CBT)* and trauma informed CBT* Cognitive processing therapy (CPT)* Prolonged Exposure Therapy (PE)* Brief Eclectic Psychotherapy (BEP)* Eye Movement Desensitization and Reprocessing (EMDR)* Narrative Exposure Therapy (NET)*

Curated Links

Key point People who suffer from C-PTSD frequently experience emotional flashbacks, which can be best described as an overwhelming emotional experience where they feel as hopeless, helpless, and scared as they did when the original trauma(s) occurred. This often causes survivors to doubt their own reality*. Symptoms of C-PTSD are well-documented within the ISCD-11*. A person afflicted with C-PTSD has an increased likelihood of developing comorbidities such as depression, anxiety, and other mental illnesses. Symptoms of C-PTSD include hyperarousal*, hypervigilance*, increased emotional sensation*, emotional dysregulation*, intrusive thoughts*, low self-esteem*, interpersonal difficulties*, difficulty paying attention*, anxiety*, depression*, somatization*, dissociation* C-PTSD can be developed at any age, but has especially high rates of comorbidities if developed at a younger age. Children are susceptible to developmental delays under periods of long-term stress, which can contribute to development of life-changing disorders like personality disorders* and dissociative disorders*. Treatment options are available. A mental healthcare professional can point patients toward the treatment that is right for them, as not every form of treatment is right for everyone. Currently existing treatment methods include psychotherapy* and psychiatric medications* to manage symptoms.

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Action Box

Action Step: Reflect on if CPTSD Might Apply to Me

Ask myself - have I been exposed to:

Repeated relational trauma? Trauma depends on the experiencer: Where the relational events overwhelming in a negative way? Did I feel powerless to stop the experience?

Do I have a toxic inner critic?

Do I experience harsh self-judgments on a fairly regular basis? Is my identity affected negatively? Shame Worthlessness

Do I experience emotional flashbacks?

A complex mixture of intense and confusing reliving of past trauma from childhood. It is like living a nightmare while you are awake, with overwhelming sorrow, toxic shame, and a sense of inadequacy.

Do I have difficulty feeling close to others?

Am I uncomfortable in relationships? Is isolation a more comfortable alternative sometimes?

If the above seems to fit for you, you might want to continue your exploration of CPTSD and CPTSD Recovery.