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Complex PTSD

Living with Complex PTSD symptomsComplex PTSD

Sometimes people are referred for psychotherapy to treat symptoms they describe as relating to anxiety or obsessional issues.

Often it transpires that there is an underlying condition of complex PTSD that has not been diagnosed.

A client I will call Ryan, spoke about his experience of childhood bereavement:

‘When it happened I could not look away, everybody else did. I was left alone with it.  I knew that the worst possible thing that could happen, had happened.  There was no going back.  Everything was lost’.

Complex PTSD and traumatic childhood bereavement

Ryan’s father died in what the coroner described as an accidental death.  Ryan explains that it wasn’t just his father’s death, but the way his family weren’t prepared to talk about what had happened that crushed the life out of him.

‘My family couldn’t process it, reflexively they all looked away. Said nothing.  Until the events were swallowed up in silence.  It became too painful to think or talk about, but at the same time everywhere I looked I was reminded of it.  It was hell.’

‘Very quickly my family started telling stories that covered the whole thing up. If I tried to bring it up I was told off for going on about it.  My grief became mixed up with guilt and shame.  I fell further and further into myself.

‘I started to fall apart.  My education disintegrated pretty quickly.  I could no longer concentrate, slept badly, had terrible nightmares I was good for nothing, I could hardly even count.’

Ryan described how scared he became of everything, and of how bullies at school noticed his fears and picked on him.  Ryan was caught in a negative spiral.

Complex PTSD can be difficult to diagnose

Complex PTSD can develop over many years and during that time people are often given incorrect diagnosis, sometimes of anxiety disorders or depression. It is not uncommon to be put on medication, perhaps antidepressants without the underlying condition being picked up.

Ryan was in a very vulnerable position.  He had to endure unhelpful responses and never got offered helpful or appropriate treatment.

‘School went from worse to worse, nobody intervened, I got into petty theft, drugs, expulsion, a criminal record followed, I became kind of delinquent’.

Complex PTSD symptoms often relate to traumatic events

Events that have been experienced repeatedly such as;

  • bullying at school at home or at work
  • domestic violence
  • childhood disturbances
  • combat experience
  • repeated exposure to emergency accident scenes

In Ryan’s case no one saw the fact of his failings at school as a sign that he needed help, they left him to it and punished him for getting into trouble.

‘It was the way everybody turned away.  They just did not know how to speak about grief, felt too guilty I guess.  They preferred trying to cover the whole thing up. But I just couldn’t think about anything else.  I thought I must have gone mad.’

Complex PTSD and dissociation

A consequence of suffering complex PTSD symptoms is that when the traumatic events happened, part of the individual’s sense of themselves becomes cut off from awareness, this is referred to as dissociation.

In his twenties Ryan found a way into psychotherapy.

‘Something good must have endured in me from before the trauma, maybe something to do with the way I remembered life before my dad died’.

Something remained healthy in Ryan and waited for when he could find help. ‘It was like some cell of me that that kept on living, in a different cut off part of me.’

Gradually, through working in psychotherapy, Ryan began to realize that he was suffering from complex PTSD.

For Ryan, his families repeated unwillingness to speak about his father’s death tortured him over and over again.

‘I could live with the loss but not with the silence. I could not find a way to think about it, and I could not think about anything else’.

Working with complex PTSD symptoms in psychotherapy

It turned out that Ryan was able to think and reflect to a great depth on what his complex PTSD was like.  He just needed a safe place in which to do so.

Being able to think about what had happened provided him with a platform from which he could move forward more constructively.

A person who has gone through complex PTSD is likely to have cut themselves off from the impact and severity of the original experiences in an attempt to survive them.

Until we find a way to talk about the underlying experiences, until we find a way to link up our distressing feelings with the facts of what we have been through, we are likely to keep going round a traumatic loop.




Complex PTSD

Toby Ingham

Toby Ingham is a psychoanalytic psychotherapist and supervisor based in High Wycombe in England. Toby works on both a short and long-term basis with people who are trying to work through a variety of situations. Sometimes these relate to a specific event such as CPTSD, bereavement, divorce or redundancy, sometimes relating to a more general problem or behavior. He blogs on a wide range of psychological themes.

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APA Reference
, . (2018). Complex PTSD. Psych Central. Retrieved on March 24, 2019, from


Last updated: 17 Mar 2018
Last reviewed: By John M. Grohol, Psy.D. on 17 Mar 2018
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