The basics
What is complex PTSD?
Complex post-traumatic stress disorder (CPTSD) is a condition related to PTSD. In the ICD-11, it includes the core features of PTSD together with persistent difficulties in emotion regulation, self-concept, and relationships. These additional areas are often called disturbances in self-organization.
CPTSD is more often associated with prolonged or repeated trauma, but a particular kind of event does not determine a diagnosis. People respond to traumatic experiences differently, and not everyone who experiences trauma develops PTSD or CPTSD.
Diagnostic systems also differ: ICD-11 lists CPTSD separately, while the DSM-5 does not have a separate CPTSD diagnosis. A qualified mental health professional can help make sense of symptoms within the system used in your region.
A framework, not a checklist
Patterns a clinician may explore
In ICD-11, CPTSD includes the main PTSD symptom areas and three broader areas of difficulty. Only a clinician can assess whether these patterns fit a person's experience.
Core PTSD features
- Reliving traumatic events as if they are happening now
- Avoiding reminders of the events
- A persistent sense of current threat or being on guard
Disturbances in self-organization
- Difficulty regulating strong emotions or feeling emotionally numb
- Persistent beliefs of being worthless or diminished
- Difficulty feeling close to, or maintaining relationships with, others
Finding support
Support can be shaped around you.
A mental health professional can discuss your concerns, explain available options, and work with you on a plan that reflects your needs and preferences. Treatments used for PTSD may also help people with CPTSD. Research is still developing on whether phase-based approaches work better than trauma-focused treatment alone, so this is a useful question to discuss with a clinician.
You might ask a prospective provider how they work with trauma, what choices you have about pace and methods, and what you can do if a session feels overwhelming. You do not need to share every detail of what happened before asking for help.
Questions you can take to an appointment
- What treatment options are available for my concerns?
- How will we decide on the pace and goals together?
- What can I do if I feel overwhelmed between appointments?
The NICE guideline covers recognition, assessment, and treatment of PTSD for adults, children, and young people. Treatment choices should be discussed with a qualified professional.
Optional practice
A brief orientation to the present
Grounding does not work the same way for everyone. If it feels comfortable, try this gentle check-in; skip any step that does not feel right.
- STEP 01
Look around and name a few neutral things you can see.
- STEP 02
Notice what is supporting your body, such as a chair or the floor.
- STEP 03
Remind yourself where you are and name one small thing you need now.
If focusing on the room increases distress, stop and choose another way to feel supported. A clinician can help you find strategies that suit you.
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Further reading
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