What Is CPTSD? Understanding Complex Trauma | Squamish Trauma Therapy
Have you ever felt like your reactions are bigger than the moment calls for, and you don't fully know why?
Maybe it's a wave of shame that shows up out of nowhere, or a flood of anxiety triggered by something small, or a nervous system that never quite settles, even when nothing is actually wrong right now. Or perhaps a moment of intense rage that comes up out of nowhere followed by a period where you completely blacked out and forgot it even happened. For a lot of people, these patterns trace back to something with a name: Complex PTSD, or CPTSD.
Right now, CPTSD isn't officially listed in the DSM, the diagnostic manual used in the United States. It is, however, recognized by the World Health Organization in the ICD-11, used across much of the rest of the world. So while there's debate about where it belongs on paper, there's a lot less debate about what's actually happening underneath it.
Here's what most trauma researchers agree on: the relationship between an infant and their caregiver plays a profound role in shaping that infant's developing nervous system. When that early attachment is unpredictable, frightening, or neglectful, it creates an overwhelming amount of stress for a nervous system that doesn't yet have the tools to manage it.
An infant can't reason their way to safety or talk themselves down. What they can do, because it's built into all of us, is dissociate. It's one of the oldest survival tools we have. Over time, in an environment that keeps calling for it, that response can become automatic, wired in early and carried forward quietly into adulthood.
C-PTSD develops out of insecure attachment relationships. Research shows that individuals who score high on Adverse Childhood Experiences (ACEs) are significantly more likely to show traits of C-PTSD and dissociation. C-PTSD is complex because it doesn't present as straightforwardly as PTSD does, which is rooted primarily in a hyperaroused nervous system response, the familiar fight or flight. Instead, C-PTSD tends to move between two extremes.
There are moments of that same fight or flight activation, a nervous system stuck "on," bracing for danger that isn't there. And then there are moments of the opposite: going numb, shutting down, feeling far away from your own body or your own life. This second response has a name of its own. It's called dissociation.
Dissociation is one of the oldest tools the nervous system has. When a threat can't be fought off or escaped, especially for a child with nowhere to go, the mind finds another way through. It creates distance, from the moment, from the pain, sometimes even from yourself. This is part of what makes C-PTSD so complex. It isn't one steady state to treat. It's a system that learned to swing between bracing for danger and disappearing from it, sometimes within the same day, sometimes within the same conversation.
Where CPTSD Comes From
CPTSD develops from trauma that is repeated or prolonged, and that often happens when there's no real way to escape it. This can look like growing up in a home marked by neglect, unpredictability, or abuse, but it can also come from long-term domestic violence, captivity, or ongoing exploitation at any age.
Because the trauma isn't one clear event but a repeated pattern stretched across months or years, it tends to shape a person broadly. It doesn't just affect how someone responds to reminders of danger. It shapes how they see themselves, how safe they feel in relationships, and how steady their emotional world feels day to day.
When trauma keeps repeating, especially before a person has had the chance to form a stable, settled sense of who they are, the mind often finds a way to keep going anyway. One part learns to function: to show up, get through the day, keep everything moving. Another part ends up quietly carrying what never got the chance to be felt or processed. Over time, this can start to feel less like one continuous "you," and more like several different versions of yourself, depending on the day, the situation, or who you're with.
This is part of why CPTSD can be so easy to live with quietly for years without a name for it. It doesn't always look like a single wound. More often, it looks like a whole way of moving through the world, sometimes several ways at once, each one taking its turn.
What CPTSD Can Look Like
Because CPTSD affects so many areas of life, it doesn't always look like what people expect trauma to look like. It can show up as:
Emotional flooding. Feelings that seem to arrive too fast, too strong, and too overwhelming, and take a long time to settle once they start.
A harsh inner voice. A persistent sense of being flawed, unlovable, or somehow to blame, even when there's no clear reason for that belief.
Trouble trusting closeness. Wanting connection deeply, while also feeling unsafe in it, sometimes pulling away from the very people who are kind and consistent.
Feeling disconnected from yourself. Moments of numbness, spacing out, or feeling like you're watching your own life from a slight distance.
A nervous system stuck "on." Chronic tension, difficulty relaxing, or a baseline sense that something bad is about to happen, even in ordinary, safe moments.
Difficulty feeling emotions, pleasure, and fun. A steady sense of flatness, where good and positive moments don't quite reach you the way they should. It's not sadness exactly. It's more like joy has to push through fog to land.
Trouble focusing or sitting still. A mind that drifts, loses the thread of conversations, or jumps from task to task, not from a lack of ability, but because part of your attention is always scanning for what might go wrong. It's often mistaken for ADHD, and sometimes shows up alongside it.
If several of these sound familiar, it doesn't mean something is wrong with you. It means your mind adapted to circumstances that asked a lot of it, for a long time. What you're noticing are survival strategies, and they were adaptive at the time. They were the best options available to you back then. They kept you connected and they kept you safe.
Why Prolonged Trauma Leaves a Different Mark
When something overwhelming happens once, the mind can often process it over time, even if that takes support and effort. But when overwhelming things happen again and again, especially while you're still growing and forming your sense of who you are, there often isn't a break in between to recover. The nervous system doesn't get the chance to reset before the next difficult moment arrives.
Over time, this can lead the mind to organize itself around survival rather than around growth. Parts of you may have learned to stay small, to please, to fight, or to disappear inward, because at the time, that's what kept you safest. Those same strategies, so useful once, can end up feeling more like a cage later in life, long after the original danger has passed.
This is also why CPTSD often isn't just about memories. It's about entire ways of coping and relating that got built early, and quietly carried forward.
There Is a Way Through
CPTSD can feel like a heavy word to sit with, but understanding it is often the first real relief many people feel. It replaces the question "what's wrong with me?" with a more accurate one: "what happened to me, and how did I adapt?"
With the right support, the nervous system can learn that it's safe to soften. The inner critic can be understood rather than obeyed. And the parts of you that learned to survive can be met with curiosity instead of judgment, which is often where real healing begins.
Effective Clinical Modalities for CPTSD
EMDR
Parts Work (Ego State, TIST, IFS)
Attachment-Focused Therapy
AEDP
Somatic Therapy (Sensorimotor Psychotherapy)
A Small Thing to Try This Week
You don't need to do any deep processing to start. This week, notice one moment when your reaction to something small feels bigger than the situation calls for. Instead of judging yourself for it, get curious. You might ask silently:
"Does this feeling belong only to right now, or does some of it come from somewhere older?"
You don't need an answer right away. Simply noticing the difference is often the first step toward feeling steadier.
"Perfectionism is the unparalleled defense for emotionally abandoned children." — Complex PTSD: From Surviving to Thriving
Further Reading
If you'd like to learn more about complex trauma, these are a good place to start:
Complex PTSD: From Surviving to Thriving by Pete Walker
What My Bones Know by Stephanie Foo
Adult Children of Emotionally Immature Parents - Dr. Lindsay Gibson
The Boy that was Raised by Dogs - Bruce Perry
You can find all of these titles, along with more books I recommend to clients, on my Amazon storefront HERE
Katharina Bleinis is a Registered Clinical Counsellor based in Squamish, BC, holding a Master's in Counselling Psychology. Her practice is trauma-informed, drawing on Parts-Informed therapy, Sensorimotor Psychotherapy, and the structural dissociation theory to help clients understand and work with the parts of themselves shaped by difficult experiences. Katharina works with clients navigating complex trauma, dissociation, and the lasting effects of adverse childhood experiences, with a warm, collaborative approach grounded in both research and lived clinical experience
CPTSD can feel like a heavy and confusing word to carry alone, but it doesn't have to stay that way.Understanding what happened to you is often the first step toward feeling like yourself again.