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What Is Complex PTSD (CPTSD)?

By Hila Teller, LCSW · Licensed Clinical Social Worker · Los Altos, CA

Most people have heard of PTSD — post-traumatic stress disorder — often associated with veterans or survivors of a single traumatic event. But what happens when trauma isn't a single incident, but a pattern that stretched across months or years? That's where Complex PTSD, or CPTSD, comes in.

As a trauma therapist in Los Altos, CA, I work with many clients who come in wondering why they feel so different from descriptions of "typical" PTSD — and often, CPTSD is the missing piece of the puzzle.

PTSD vs. CPTSD: What's the Difference?

PTSD can develop after a single traumatic event — a car accident, assault, or natural disaster. CPTSD typically develops from prolonged or repeated trauma, such as:

• Childhood abuse or neglect
• Domestic violence
• Emotional or sexual abuse over a long period
• Growing up in a home marked by addiction or instability
• Surviving captivity, trafficking, or war

Both conditions share symptoms like flashbacks, nightmares, and hypervigilance — but CPTSD adds a layer of difficulty with emotional regulation, self-perception, and relationships.

Signs of Complex PTSD

• Intense, hard-to-manage emotions — rage, shame, despair
• A deeply negative view of yourself ("I am broken," "I am worthless")
• Difficulty trusting others or feeling safe in relationships
• Feeling detached from yourself or the world (dissociation)
• A sense of hopelessness about the future
• Chronic guilt and shame, even when it's not your fault
• Difficulty feeling pleasure or joy

How Therapy Helps With CPTSD

Healing from CPTSD is possible, but it takes time and the right therapeutic relationship. Psychodynamic therapy is especially well-suited for CPTSD because it goes beyond surface symptoms to explore the deeper patterns that formed in response to ongoing trauma.

In our work together, we build a safe, consistent relationship — often the first truly safe relationship some clients have experienced. Over time, this becomes the foundation for understanding old wounds, developing self-compassion, and creating new ways of being in the world.