Complex PTSD occurs in situations where the victim has experienced chronic trauma over many months. The most common sources of complex PTSD in America today are children victimized by prolonged periods of physical or sexual abuse and domestic violence by perpetrators who exert high levels of control for extended periods of time.

Unlike victims of simple PTSD whose symptoms result from short lived traumas such as car accidents, natural disaster, or criminal victimization, victims of complex PTSD often experience profound changes in their self concepts and their ability to cope with stressful events.

Symptoms of complex PTSD include:

• Inability to regulate emotions: explosive or overly inhibited anger, persistent sadness, etc.
  
  
• Changed awareness: forgetting or intense reliving of traumatic events, extreme detachment from one's self or one's physical experience, self injury without feeling pain.
  
  
• Changed sense of self: pervasive feelings of helplessness, shame, guilt, and a sense of being completely apart from others.
  
  
• Altered relationships: self isolation, inability to achieve intimacy, tendency to enter into chaotic relationships where further victimization can happen.
  
  
• "Hitting the wall." Prolonged inability to function following a relatively minor crisis after feeling successful coping with major traumas and crises.
  
  

Treatment for complex PTSD has several phases. It is often essential for the client to learn to moderate intense emotions and to control impulsive behavior before working on developing a healthy awareness and sense of self. A secure and stable relationship with a skilled psychotherapist is essential as the client moves from phase to phase of treatment. Many individuals with complex PTSD find that antidepressant medications are important to facilitate healing.

---