What Is Complex PTSD?

A phase-based therapy approach may be ideal for treating this disorder

Teenage girl (14-15) sitting sad in armchair
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Some mental health professionals make the distinction between the diagnosis of post-traumatic stress disorder (PTSD) and Complex PTSD.

Complex PTSD vs. PTSD

The symptoms of PTSD apply well to people who have experienced a discrete or short-lived traumatic event, like a motor vehicle accident, natural disaster, or rape. But, they do not always apply well to people who have experienced chronic, repeated, or long-lasting traumatic events, such as childhood sexual and/or physical abuse, domestic violence, or captivity (for example, being in a prisoner of war camp or a concentration camp).

In these instances, the symptoms of PTSD do not really seem to completely describe the psychological harm, emotional problems, and changes in how people view themselves and the world following chronic traumatic exposure.

Therefore, some mental health professionals believe that we should distinguish between the type of PTSD that develops from chronic, long-lasting traumatic events, and the type of PTSD that results from short-lived events.

With that, the diagnosis of "Complex PTSD" refers to the set of symptoms that commonly follow exposure to a chronic traumatic event.

Events Connected to Complex PTSD

The traumatic events connected to Complex PTSD are long-lasting and generally involve some form of physical or emotional captivity, such as childhood sexual and/or physical abuse or domestic violence. In these types of events, a victim is under the control of another person and does not have the ability to easily escape.

Symptoms of Complex PTSD

The following symptoms stem from exposure to a chronic traumatic event where a person felt captive:

  • Emotion Regulation Problems
    People with Complex PTSD experience difficulties managing their emotions. They may experience severe depression, thoughts of suicide, or have difficulties controlling their anger.
  • Changes in Consciousness
    Following exposure to a chronic traumatic event, a person may repress memories of the traumatic event, experience flashbacks, or experience dissociation.
  • Changes in How a Person Views Themselves
    Symptoms in this category include feelings of helplessness, shame, guilt, or feeling detached and different from others.
  • Changes in How the Victim Views the Perpetrator
    A person with Complex PTSD may feel like he has no power over a perpetrator (the perpetrator has complete power in a relationship). In Complex PTSD, people might also become preoccupied with their relationship with a perpetrator (for example, constant thoughts of wanting revenge).
  • Changes in Personal Relationships
    These symptoms include problems with relationships, such as isolating oneself or being distrusting of others. Note that this is unique from borderline personality disorder (BPD), in that a person with Complex PTSD often alienates themselves, as opposed to people with BPD who engage in unstable relationships that can be dramatic and volatile.
  • Changes in How One Views the World
    People exposed to chronic or repeated traumatic events may also lose faith in humanity or have a sense of hopelessness about the future.

    Finding Help for Complex PTSD

    Treatments for PTSD and other disorders (for example, Dialectical Behavior Therapy for borderline personality disorder) may also be helpful for a person with Complex PTSD.

    That being said, as experts continue to study Complex PTSD, there is scientific research that supports a unique phase-based treatment approach. This treatment approach entails three phases:

    • improving self-management skills
    • processing and reviewing traumatic memories
    • promoting engagement back into community life

    Complex PTSD can be a debilitating condition, but there are effective therapies available to address the chronicity and complexity of a person's past trauma.


    If you have been exposed to a chronic traumatic event, it is important to seek out help. You can learn more about Complex PTSD from the National Center for PTSD.


    Cloitre M., et al.  (November 2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults.

    Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysisEur J Psychotraumatol. 2014 Sep 15;5.

    United States Department of Veteran Affairs. PTSD: National Center for PTSD: Complex PTSD.