Understanding C-PTSD: Symptoms, Triggers, and Healing for Survivors

What Is Complex Post-Traumatic Stress Disorder? Could I have C-PTSD?

Trauma isn’t always about a single, life-altering event like a car crash, natural disaster, or combat. For many, trauma happens repeatedly over time—this is known as chronic trauma. It can take many forms, such as childhood abuse, long-term emotional neglect, or domestic violence. While PTSD is typically linked to a single shocking event, complex PTSD (C-PTSD) develops from prolonged exposure to trauma, particularly in relationships. Over time, it can affect self-worth, emotional regulation, and the way you connect with others.

A lot of people don’t even realize their experiences count as trauma or that they’re still dealing with the effects. You survived—so everything should be fine now, right? But when trauma shapes who you are, it can be tricky to recognize its impact. Unlike PTSD, which can have more obvious signs like flashbacks or nightmares, C-PTSD tends to show up in more subtle but powerful ways:

• People-pleasing behaviors – Constantly prioritizing others' needs over your own.

• Struggles with boundaries – Finding it difficult to say no or recognizing toxic relationships.

• Negative self-talk – Chronic feelings of unworthiness or self-doubt.

• Repeated patterns in relationships – Seeking out or tolerating unhealthy dynamics.

A lot of people with childhood trauma don’t seek help because they don’t want to dig up painful memories. But the truth is, trauma doesn’t always stay in the past—it can pop up at major life moments, like breakups, marriage, or having kids. Major life transitions can be the catalyst that pushes you into recognizing or facing the impact that the past is having on your present. This is the first step towards healing.

PTSD shapes how you react to the world around you; C-PTSD shapes how you see yourself.

The concept of C-PTSD emerged thanks to the groundbreaking work of Dr. Judith Herman, a psychiatrist and trauma researcher. In her 1992 book Trauma and Recovery, she argued that the existing definition of PTSD didn’t fully capture the experiences of individuals who had endured long-term, inescapable trauma—especially trauma that occurred in relationships, such as childhood abuse or domestic violence. Unlike PTSD, which is often rooted in a fear of reliving a single event, C-PTSD profoundly affects a person’s sense of identity, emotional regulation, and relationships.

PTSD vs. C-PTSD: What’s the Difference?

While both PTSD and C-PTSD stem from trauma, C-PTSD is more deeply tied to prolonged, repeated exposure rather than a single traumatic event. Here’s how they differ:

PTSD

• Caused by a single traumatic event (e.g., an accident, natural disaster, or assault).

• Main symptom clusters are :

  • Intrusive memories - include flashbacks, nightmares, unwanted reminders.

  • Avoidance - avoiding people, places or things that may cause an intrusive memory.

  • Hypervigilance - being watchful, on guard, jumpy or easily startled.

  • Negative changes in Mood and Thinking - blaming yourself, sadness, can often look like depression

C-PTSD

• Caused by long-term trauma (e.g., childhood neglect, domestic abuse, repeated emotional abuse).

• Symptoms include all PTSD symptoms plus emotional dysregulation, interpersonal difficulties, and negative self-concept. This can vary between individuals, but may look like :

  • Dysregulation – intense mood swings, overwhelming emotions, or feeling numb.

  • Distorted Self-Perception – chronic shame, guilt, or a feeling of being "broken."

  • Interpersonal Struggles – difficulty trusting others, fear of abandonment, or unhealthy relationship patterns.

  • Dissociation & Memory Gaps – feeling detached from yourself or struggling to recall traumatic events.

  • Negative Beliefs About the Self – feeling unworthy of love, safety, or success.

It's important to remember that PTSD and C-PTSD, although classified as mental health disorders, were ultimately your body’s way of trying to protect you. Your brain adapted to help you survive, whether by heightening your awareness, numbing emotions, or avoiding painful memories. These responses at one time may have been necessary for survival, can become disruptive over time. Recognizing that these patterns were once protective mechanisms, not personal failings, is key to shifting toward healing.

How C-PTSD Changes the Brain

Long-term trauma rewires the brain. Dr. Bessel van der Kolk expanded on these ideas in his book The Body Keeps the Score. He emphasized that trauma isn't just stored as a memory—it physically changes the brain and nervous system. This is why survivors of complex trauma often experience hypervigilance, emotional numbness, or difficulties regulating emotions long after escaping the abusive situation.

Studies show that C-PTSD can cause changes in three key areas:

• Amygdala (Fight-or-Flight Center): Becomes hyperactive, making people more prone to fear responses and emotional reactivity.

• Hippocampus (Memory & Learning): Shrinks in size, making it harder to differentiate past from present trauma.

• Prefrontal Cortex (Logical Thinking & Emotional Regulation): Struggles to keep emotions in check, leading to impulsivity and difficulty managing distress.

This is why healing is more than just "thinking positive"—it involves retraining the brain and nervous system to feel safe again.

Healing from C-PTSD: Steps Toward Recovery

C-PTSD can make it feel like your trauma defines you, but that’s not the case. The effects of long-term abuse and neglect are real—but so is your capacity for resilience and growth. By understanding how prolonged trauma affects the brain you can take steps toward reclaiming your sense of safety, self-worth, and autonomy.

Here’s what can help:

1. Recognizing Your Reactions and That They Make Sense

The first, and for many hardest, step towards recovery is recognizing what the problem is. That means getting deeply familiar with your trauma responses and how your experiences have shaped the way you see yourself and others. By recognizing these responses and how they made sense for you, we can build self-compassion. Self-blame only reinforces the shame that abusers instill.

2. Processing Trauma Safely

• Trauma-Informed Therapy – Survivors need spaces where they feel secure enough to explore painful memories and develop healthier coping strategies. Finding that ‘right fit’ therapist and having a strong foundation of trust allows for deeper emotional processing and the ability to rebuild a sense of safety in the world.

• EMDR (Eye Movement Desensitization and Reprocessing) – EMDR helps survivors process traumatic memories by using guided eye movements to reduce the intensity of distressing memories. This therapy helps rewire the brain’s response to trauma, allowing individuals to recall past experiences without being overwhelmed by them.

3. Relearning Trust and Boundaries

Many survivors struggle to identify healthy relationships, often feeling drawn to familiar but toxic dynamics. Building self-awareness helps in distinguishing between safe and unsafe relationships, developing self-trust, and making choices that support emotional well-being. Over time, survivors can learn to trust their instincts, set clear boundaries, and cultivate connections that uplift and support them rather than perpetuate cycles of harm.

4. Self-Compassion as a Daily Practice

Healing from trauma isn’t just about processing the past—it’s about learning to extend kindness to yourself in the present. Many survivors carry deep-seated self-criticism and internalized blame, feeling that they should “just get over it” or that they’re somehow flawed for struggling. Practicing self-compassion means recognizing that you are not stuck in the past—you are continuously growing and developing. Just as trauma shaped your responses, healing can reshape them. When you treat yourself with patience and understanding, you create space for new patterns to emerge.

Healing from C-PTSD is possible. By recognizing trauma responses, seeking support, and practicing self-compassion, you can take back control of your life.

If any of this resonates with you and you would like to explore further, you can book a free consultation here.

You can read more about the work I do with people healing from C-PTSD and trauma from relationships here.