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I have Complex PTSD [Cptsd] and wrote this book from the perspective of someone who has experienced a great reduction of symptoms over the years. I also wrote it from the viewpoint of someone who has discovered many silver linings in the long, windy, bumpy road of recovering from Cptsd.
I felt encouraged to write this book because of thousands of e-mail responses to the a
Published December 18th 2013 by Azure Coyote Publishing (first published December 13th 2013)
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AbbyThe book is intended for those with CPTSD from childhood trauma. PTSD typically occurs due to one-time trauma, like a particularly scarring event of…moreThe book is intended for those with CPTSD from childhood trauma. PTSD typically occurs due to one-time trauma, like a particularly scarring event of sexual assault, violence, etc. CPTSD occurs due to ongoing trauma in which there is no perceived chance of escape; it's most commonly seen in survivors of childhood abuse and neglect of all sorts, but also occurs sometimes in prisoners of war, etc.
Whether you have a formal diagnosis of CPTSD or not, if you have a childhood that was at all troubled or traumatic in any way, it's definitely a book worth reading. It does primarily focus on healing from childhood trauma, however, so if you're suffering from PTSD resulting from events in adulthood, it may not be as helpful to you (unless you're also suffering from the effects of childhood trauma in addition).(less)
Пламен ДойковIt deals with all kinds of child abuse - physical, sexual, verbal, emotional, neglect.
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Rating details

Nov 30, 2016lov2laf rated it it was amazing
Shelves: nonfiction-self-help, nonfiction-ptsd, nonfiction-psychology, 350-400-pages, own, nonfiction, nonfiction-trauma-recovery, favorites
Complex PTSD is one of the best books I’ve read on childhood trauma recovery.
Despite the long title, the book itself is not complex nor is it written in psycho-babble ra-ra. The author is grounded in that he himself has struggled with trauma recovery and it’s palpable that he wishes to impart the strategies and wisdom he has found to work for himself and others.
There are many elements that make this self-recovery book stand above others for me.
*The author speaks from experience as both a surviv
Nov 21, 2014Marsmannix rated it it was amazing
There are less than 20 books i can think of that actually changed my life, and this is one of them.
Pete Walker outlines in clear understandable language what contributes to C-PTSD. This is definitely a layman's book and thank god, it's free from the endless anecdotes that infest most popular 'self help' or psychology books that populate the ranks of Amazon best sellers.
Dr. Walker uses examples from his own life with humility and insight---a refreshing change from the hectoring and condescending
Feb 01, 2014Gemma rated it it was amazing
Shelves: zacquired-2014-kindle, z2014, z2014-read-kindle, recommended-nonfiction-and-selfhelp, kindle
Absolutely excellent. Anyone who had an abusive/neglectful childhood should read this book, whether you have a formal diagnosis of CPTSD or not. Practical advice on learning to be free from toxic shame and the inner critic.
Apr 10, 2016Kerry rated it really liked it · review of another edition
We all are familiar with PTSD. Most often in the news concerning returning veterans. Walker's books is about Complex PTSD (cPTSD.) The added 'c' essentially extends many of the ideas of trauma recovery to childhood developmental traumas. Most specifically childhood traumas arising from poor parenting and troubled home environments.
It is delineated by common features: emotional flashbacks (unlike PTSD there is not usually visual component), toxic shame (directly drawing from the work of John Bra
I would highly recommend this book. It is written by someone who suffers from CPTSD. At times, the text might feel superfluous, but in fact, it is good for explaining the points the author is making.
WARNING: It can be a very triggering read. I found that I could only read it in small bits. And, at times, triggering is healing. You have to be ready to look at yourself and be willing to accept truths as you read them.
The books is well written. The insight very helpful. Add this to other modes of h
Nov 17, 2016Travel Writing rated it it was amazing
Recommends it for: Every single person in the world
Shelves: right-in-the-feeeeels, awesome-sauce, grief, holy-shit-amazing-stuff, self-help
'..become an unflinching source of kindness and self-compassion for yourself.'
Excellent read on how an abusive childhood has had a profound impact on you. And not just a broken-bones-CPS-got-involved-kind of childhood, but a childhood with parents who had minimal attunement, who were sharp tongued more often than not, who had addictions, even if those addictions were seemingly under control- they weren't. The book also speaks clearly on specific ways to walk yourself to healing, to a life that

From Surviving To Thriving Book

After reading this book and becoming more aware of PTSD and C-PTSD and all the (initially) pretentiously sounding terms like emotional flashbacks and bibliotherapy (but later on revealing elusive emotional processes that are very little written about even in the world of psychology); I can honestly say that I have come to regard Pete Walker as nothing less than a brilliant practitioner of psychotherapy specializing in C-PTSD, which is grossly under-diagnosed throughout the world, currently, but..more
Dec 09, 2016Dani rated it it was amazing
Shelves: books_that_changed_my_life, non-fiction, narcissism, psychology, narcissistic-abuse-syndrome, psychopathy, cptsd
This book changed my life.
Highly, highly recommended for everybody with any kind of childhood trauma - and that includes
the devastating effects of the invisible, intangible emotional neglect by chronically stressed, distracted and otherwise occupied parents.
Another brilliant (and quite unique) aspect of the book is the deep insight Pete Walker has in the traumatic origin of pathological narcissism and sociopathy.
The way he shows in his empathetic, wise and deeply insightful style that both narc
May 08, 2017Vesna rated it it was amazing
10 stars
This is the best and most helpful book I've ever read and reading it was the most encouraging thing I've done in years.
Finally someone understands me. Finally I don't feel like a lost case, a weird psycho, the only one in the universe suffering from an array of psychological problems that sometimes show for no obvious reason.
This book gave me hope which I lacked for years. There's a very long and difficult journey in front of me, but I don't mind. After reading this book, I know there's
Walker is amazing for breaking down so many thought processes and physical sensations in a repeated, clear, descriptive way. I didn't always jive with his perspective on traumatizing parents because he has a very black and white 'people who caused these problems are terrible and never had anything good to offer' and it's often so much more complicated. He also has some gender essentializing language and perspectives. But for the most part the tools in this book are incredibly helpful for working..more
Sep 16, 2015Steve Woods rated it it was amazing
Shelves: ptsd, recovery, psychology-psychotherapy
This is an outstanding piece of work. Probably the best treatment of Complex PTSD I have read, written in language that anyone can understand and full of material that can be brought into use to effect. Much of what he outlines here comes from his own personal experience and accords with my own. Many of the approaches he outlines I have had to work out for myself through trial and error and they've worked for me. the great benefit was the additional clarity he could offer and some new insights t..more
This is by far the BEST book I have ever read on Complex PTSD , which is very different from PTSD.
As a therapist and a survivor of C- PTSD myself , I have found that the often prescribed CBT type of therapy does not work for those of us with C-PTSD. My experience and my own journey as a survivor of childhood trauma has led me on a quest to find the most effective therapy methods for healing. I have found these clients need more than what traditional therapists frequently offer. For one, the the
Mar 19, 2017Mary rated it it was amazing · review of another edition
I've read a lot of self-help books that I thought would help me address various problems connected with my early life, and this is far and away the most helpful. Pete Walker seems to be a compassionate man, and his words and viewpoint really resonated for me. The book wasn't always an easy read because it brought up some painful feelings and realizations, but it was so well worth it. It provides an overview of the various dimensions (cognitive, emotional, physical) involved in healing from child..more
This book is so good! But why did the author have to bring 'god' into the mix? Argh..
Feb 03, 2018Jocelyn Beecher rated it it was amazing · review of another edition
Can’t recommend this one enough. It’s taken me about a month to work through for two reasons.
1) I wanted to really absorb all the information so I forced myself to only read in short bursts. This was sometimes not hard to do because my mind would constantly explode as I read and I’d need to collect myself.
2) At about 50 pages in I started over so I could write notes as I went and I continued to copy down important bits of information up until almost the last page.
For me this has been an invalua
Feb 10, 2017Allison rated it it was amazing
I read this thinking- 'yeah right, its going to be a lot of comparisons to people with this disorder who are nothing like me, nothing ever relates to my situation, this is so stupid' and I was wrong. I laid in bed reading and I kept thinking WOW this is me! This is why I do this! Now I know how to cope with emotions or how to understand them better the next time I react to something. It was extremely educational and helpful and I really enjoyed it. This was also a very pleasant read, easy to abs..more
This is the single greatest therapeutic resource I have ever read and I wish it was more widely available. I don't know if it's easily accessible to people without a background in therapy or mindfulness, but it will send you a long way to being able to self-soothe, and to understand and reduce your trauma reactions. I have used the flashback management tips several times, and they have mostly been successful.
Jun 05, 2016Betty Mars rated it it was amazing · review of another edition
This is truly the only book--the only anything--I have ever read that accurately describes my internal experience. If you or someone you love has CPTSD, this is an invaluable resource that not only offers insight on how it plays out but actionable guidance on how to navigate it as well. Must read.
This is an excellent book. I found his writing and how he explained PTSD to be very compassionate. That is something very important when trying to understand yourself and make changes in your behavior. I really am very grateful Walker wrote this book. Thank you.
Essential read for anyone who grew up with abusive or unavailable parents.
A very accessible, validating read with many practical suggestions on ways to process and integrate trauma.
Feb 04, 2019Charlie Hailey rated it it was amazing
There were issues with this book that make this 5-star review maybe not ENTIRELY justified- namely the very stigmatizing and outdated discussions about borderline (especially disappointing considering the body of evidence suggesting that borderline and cptsd may be synonymous). The author also advocated for some therapies that I feel edge a little too close to pseudoscience to be suggesting to vulnerable abuse survivors.
That being said, I’m very liberal with my 5 star reviews and this book reall
This was a *very* good book on the topic of how to find your way out of the automatic emotional reactions that grew as a reaction to neglect or abuse in childhood.
The author knows what he is talking about from his own experience, and can explain very clearly why and how the various intense emotions (fear, shame, self-accusations) can come up again and again. This recognition is already wonderful, but it is even better that he shows how to navigate out from that inner turmoil. It is a very hopefu
Dec 31, 2018Tracie Griffith rated it it was amazing
Jun 11, 2018Moth rated it it was amazing
The most comforting book I've ever read. I'm so thankful to the author.
The most helpful and illuminating self-help book I have ever read. I highly recommend this read for anyone who has had a difficult childhood, difficult relationship with their parents, been shamed by organized religion, or who has been abused in a relationship. Honestly I think everyone should read it as there is something for everyone and the coping strategies are wonderful.
Apr 07, 2018Nina rated it it was amazing
Shelves: usa, toxic-relationships, owned-digital, cptsd, non-fiction, psychology

Complex Ptsd From Surviving To Thriving Pdf Downloads

This book is a masterpiece. Pete Walker excels at describing his own experience with CPTSD and he conveys it in a format that can be understood by all. The information in this book will help you heal, read it slowly because it's highly triggering, but it's worthy. Your well being is worth. You matter.
CPTSD (Complex Post-Traumatic Stress Disorder) develops as a result of being raised in a abusive/neglectful environment, in which the primary caregivers (parents, grandparents, step-parents, other
Nov 16, 2015Tom Britz rated it it was amazing · review of another edition
This book goes a long way to explaining what Complex PTSD is, how it comes about and some of the ways to help deal with it. Complex PTSD is a debilitating condition and it is invisible to others. The only symptoms are how it affects the person with it. For a few years now, I thought I was suffering from the king of writer's block, but then someone told me to check into PTSD. My eyes grew large almost from the first page, as I found myself being described on, not every page, but enough to convinc..more
Mar 06, 2017Hungry Changeling rated it really liked it

From Surviving To Thriving

Lots of practical tips and a very friendly approach
Jul 26, 2015Molly McCarty rated it it was amazing
Despite its hideous cover, this is one of the best books on C-PTSD I have ever read. Walker writes with deep compassion and the wisdom of navigating his on condition, as well as many years working as a counselor. This book is packed with information and useful tools for people struggling trauma-related mental illnesses. I highly recommend this book to anyone diagnosed with C-PTSD, PTSD, BPD, or a history of emotional, verbal, sexual, or physical abuse. Read it with highlighter in hand.
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Pete Walker is a 'general practitioner' who has a private practice in Berkeley, California, in the serene Claremont Hotel neighborhood. He has been working as a counselor, lecturer, writer and group leader for thirty-five years, and as a trainer, supervisor and consultant of other therapists for 20 years.
Pete Walker is a 'general practitioner' who has a private practice in the Rockridge neighborho
“Reparenting Affirmations I am so glad you were born. You are a good person. I love who you are and am doing my best to always be on your side. You can come to me whenever you’re feeling hurt or bad. You do not have to be perfect to get my love and protection. All of your feelings are okay with me. I am always glad to see you. It is okay for you to be angry and I won’t let you hurt yourself or others when you are. You can make mistakes - they are your teachers. You can know what you need and ask for help. You can have your own preferences and tastes. You are a delight to my eyes. You can choose your own values. You can pick your own friends, and you don’t have to like everyone. You can sometimes feel confused and ambivalent, and not know all the answers. I am very proud of you.” — 9 likes
“There is often a close relationship between emotion and physical sensation. Physical sensations in the body often co-occur with feelings. Moreover, sensations of tightness and tension can develop as a defense against feelings. As unexpressed feelings accumulate, a greater degree of muscular tension is necessary to keep them under wraps. A child who is repeatedly punished for emoting learns to be afraid of inner emotional experience and tightens [armors] the musculature of her body in an effort to hold feelings in and to banish them from awareness. Holding your breath is a further manifestation of armoring. It is an especially common way of keeping feelings at bay, as breathing naturally brings your awareness down to the level of feeling.” — 8 likes
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Complex post-traumatic stress disorder

Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder)[1] is a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma in a context in which the individual has little or no chance of escape[2]. C-PTSD relates to the trauma model of mental disorders and is associated with chronic sexual, psychological and physical abuse and neglect, chronic intimate partner violence, victims of kidnapping and hostage situations, indentured servants, victims of slavery and human trafficking, sweatshop workers, prisoners of war, concentration camp survivors, residential school survivors, and defectors of cults or cult-like organizations.[3] Situations involving captivity/entrapment (a situation lacking a viable escape route for the victim or a perception of such) can lead to C-PTSD-like symptoms, which can include prolonged feelings of terror, worthlessness, helplessness, and deformation of one's identity and sense of self.[4] C-PTSD has also been referred to as DESNOS or Disorders of Extreme Stress Not Otherwise Specified.[5]

Researchers concluded that C-PTSD is distinct from, but similar to, PTSD, somatization disorder, dissociative identity disorder, and borderline personality disorder.[6] Its main distinctions are a distortion of the person's core identity and significant emotional dysregulation.[7] It was first described in 1992 by Judith Herman in her book Trauma & Recovery and in an accompanying article.[6][8] The disorder is included in the World Health Organization's (WHO) International Statistical Classification of Diseases and Related Health Problems, 11th Edition (ICD-11); this category of PTSD is not yet adopted by the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

C-PTSD is a learned set of responses, and a failure to complete numerous important developmental tasks. It is environmentally, not genetically, caused. Unlike most of the diagnoses it is confused with, it is neither inborn nor characterological, not DNA based, it is a disorder caused by lack of nurture.[9]

  • 1Symptoms
  • 2Diagnostics
    • 2.1Differential diagnosis
  • 3Treatment


Children and adolescents[edit]

The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war.[10] However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver.[11] In many cases, it is the child's caregiver who caused the trauma.[10] The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development.[10]

The term developmental trauma disorder (DTD) has also been suggested.[11] This developmental form of trauma places children at risk for developing psychiatric and medical disorders.[11] Bessel van der Kolk explains DTD as numerous encounters with interpersonal trauma such as physical assault, sexual assault, violence or death. It can also be brought on by subjective events such as betrayal, defeat or shame.[12]

Repeated traumatization during childhood leads to symptoms that differ from those described for PTSD.[12] Cook and others describe symptoms and behavioural characteristics in seven domains:[13][14]

  • Attachment – 'problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to others' emotional states'
  • Biology – 'sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems'
  • Affect or emotional regulation – 'poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes'
  • Dissociation – 'amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events'
  • Behavioural control – 'problems with impulse control, aggression, pathological self-soothing, and sleep problems'
  • Cognition – 'difficulty regulating attention, problems with a variety of 'executive functions' such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with 'cause-effect' thinking, and language developmental problems such as a gap between receptive and expressive communication abilities.'
  • Self-concept – 'fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self'.


Adults with C-PTSD have sometimes experienced prolonged interpersonal traumatization beginning in childhood, rather than, or as well as, in adulthood. These early injuries interrupt the development of a robust sense of self and of others. Because physical and emotional pain or neglect was often inflicted by attachment figures such as caregivers or older siblings, these individuals may develop a sense that they are fundamentally flawed and that others cannot be relied upon.[8][15] This can become a pervasive way of relating to others in adult life, described as insecure attachment. This symptom is neither included in the diagnosis of dissociative disorder nor in that of PTSD in the current DSM-5 (2013). Individuals with Complex PTSD also demonstrate lasting personality disturbances with a significant risk of revictimization.[16]

Six clusters of symptoms have been suggested for diagnosis of C-PTSD:[17][18]

  • alterations in regulation of affect and impulses;
  • alterations in attention or consciousness;
  • alterations in self-perception;
  • alterations in relations with others;
  • somatization;
  • alterations in systems of meaning.[18]

Experiences in these areas may include:[6][19][20]

  • Changes in emotional regulation, including experiences such as persistent dysphoria, chronic suicidal preoccupation, self injury, explosive or extremely inhibited anger (may alternate), and compulsive or extremely inhibited sexuality (may alternate).
  • Variations in consciousness, such as amnesia or improved recall for traumatic events, episodes of dissociation, depersonalization/derealization, and reliving experiences (either in the form of intrusive PTSD symptoms or in ruminative preoccupation).
  • Changes in self-perception, such as a sense of helplessness or paralysis of initiative, shame, guilt and self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings (may include a sense of specialness, utter aloneness, a belief that no other person can understand, or a feeling of nonhuman identity).
  • Varied changes in perception of the perpetrators, such as a preoccupation with the relationship with a perpetrator (including a preoccupation with revenge), an unrealistic attribution of total power to a perpetrator (though the individual's assessment may be more realistic than the clinician's), idealization or paradoxical gratitude, a sense of a special or supernatural relationship with a perpetrator, and acceptance of a perpetrator's belief system or rationalizations.
  • Alterations in relations with others, such as isolation and withdrawal, disruption in intimate relationships, a repeated search for a rescuer (may alternate with isolation and withdrawal), persistent distrust, and repeated failures of self-protection.
  • Changes in systems of meaning, such as a loss of sustaining faith and a sense of hopelessness and despair.


C-PTSD was under consideration for inclusion in the DSM-IV but was not included when the DSM-IV was published in 1994.[6] Neither was it included in the DSM-5. PTSD continues to be listed as a disorder.[21]

Differential diagnosis[edit]

Post-traumatic stress disorder[edit]

Post-traumatic stress disorder (PTSD) was included in the DSM-III (1980), mainly due to the relatively large numbers of American combat veterans of the Vietnam War who were seeking treatment for the lingering effects of combat stress. In the 1980s, various researchers and clinicians suggested that PTSD might also accurately describe the sequelae of such traumas as child sexual abuse and domestic abuse.[22] However, it was soon suggested that PTSD failed to account for the cluster of symptoms that were often observed in cases of prolonged abuse, particularly that which was perpetrated against children by caregivers during multiple childhood and adolescent developmental stages. Such patients were often extremely difficult to treat with established methods.[22]

PTSD descriptions fail to capture some of the core characteristics of C-PTSD. These elements include captivity, psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized. Most importantly, there is a loss of a coherent sense of self: this loss, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.[19]

C-PTSD is also characterized by attachment disorder, particularly the pervasive insecure, or disorganized-type attachment.[23]DSM-IV (1994) dissociative disorders and PTSD do not include insecure attachment in their criteria. As a consequence of this aspect of C-PTSD, when some adults with C-PTSD become parents and confront their own children's attachment needs, they may have particular difficulty in responding sensitively especially to their infants' and young children's routine distress—such as during routine separations, despite these parents' best intentions and efforts.[24] Although the great majority of survivors do not abuse others,[25] this difficulty in parenting may have adverse repercussions for their children's social and emotional development if parents with this condition and their children do not receive appropriate treatment.[26][27]

Thus, a differentiation between the diagnostic category of C-PTSD and that of PTSD has been suggested. C-PTSD better describes the pervasive negative impact of chronic repetitive trauma than does PTSD alone.[20] PTSD can exist alongside C-PTSD, however a sole diagnosis of PTSD often does not sufficiently encapsulate the breadth of symptoms experienced by those who have experienced prolonged traumatic experience, and therefore C-PTSD extends beyond the PTSD parameters.[8]

C-PTSD also differs from continuous traumatic stress disorder (CTSD), which was introduced into the trauma literature by Gill Straker (1987).[28] It was originally used by South African clinicians to describe the effects of exposure to frequent, high levels of violence usually associated with civil conflict and political repression. The term is also applicable to the effects of exposure to contexts in which gang violence and crime are endemic as well as to the effects of ongoing exposure to life threats in high-risk occupations such as police, fire and emergency services.

Traumatic grief[edit]

Traumatic grief[29][30][31][32] or complicated mourning[33] are conditions[34] where both trauma and grief coincide. There are conceptual links between trauma and bereavement since loss of a loved one is inherently traumatic.[35] If a traumatic event was life-threatening, but did not result in a death, then it is more likely that the survivor will experience post-traumatic stress symptoms. If a person dies, and the survivor was close to the person who died, then it is more likely that symptoms of grief will also develop. When the death is of a loved one, and was sudden or violent, then both symptoms often coincide. This is likely in children exposed to community violence.[36][37]

For C-PTSD to manifest traumatic grief, the violence would occur under conditions of captivity, loss of control and disempowerment, coinciding with the death of a friend or loved one in life-threatening circumstances. This again is most likely for children and stepchildren who experience prolonged domestic or chronic community violence that ultimately results in the death of friends and loved ones. The phenomenon of the increased risk of violence and death of stepchildren is referred to as the Cinderella effect.

Attachment theory and borderline personality disorder[edit]

C-PTSD may share some symptoms with both PTSD and borderline personality disorder.[38]


Treatment is usually tailored to the individual.[39]


The utility of PTSD derived psychotherapies for assisting children with C-PTSD is uncertain. This area of diagnosis and treatment calls for caution in use of the category C-PTSD. Ford and van der Kolk have suggested that C-PTSD may not be as useful a category for diagnosis and treatment of children as a proposed category of developmental trauma disorder (DTD).[40] For DTD to be diagnosed it requires a

'history of exposure to early life developmentally adverse interpersonal trauma such as sexual abuse, physical abuse, violence, traumatic losses of other significant disruption or betrayal of the child's relationships with primary caregivers, which has been postulated as an etiological basis for complex traumatic stress disorders. Diagnosis, treatment planning and outcome are always relational.'[41]

Since C-PTSD or DTD in children is often caused by chronic maltreatment, neglect or abuse in a care-giving relationship the first element of the biopsychosocial system to address is that relationship. This invariably involves some sort of child protection agency. This both widens the range of support that can be given to the child but also the complexity of the situation, since the agency's statutory legal obligations may then need to be enforced.

A number of practical, therapeutic and ethical principles for assessment and intervention have been developed and explored in the field:[42]

  • Identifying and addressing threats to the child's or family's safety and stability are the first priority.
  • A relational bridge must be developed to engage, retain and maximize the benefit for the child and caregiver.
  • Diagnosis, treatment planning and outcome monitoring are always relational (and) strengths based.
  • All phases of treatment should aim to enhance self-regulation competencies.
  • Determining with whom, when and how to address traumatic memories.
  • Preventing and managing relational discontinuities and psychosocial crises.


Delaying therapy for people with complex PTSD (cPTSD), whether intentionally or not, can exacerbate the condition.[43] Herman proposed that recovery from C-PTSD occurs in three stages:

  1. establishing safety,
  2. remembrance and mourning for what was lost,
  3. reconnecting with community and more broadly, society.

Herman believes recovery can only occur within a healing relationship and only if the survivor is empowered by that relationship. This healing relationship need not be romantic or sexual in the colloquial sense of 'relationship', however, and can also include relationships with friends, co-workers, one's relatives or children, and the therapeutic relationship.[6]

Complex trauma means complex reactions and this leads to complex treatments. Hence, treatment for C-PTSD requires a multi-modal approach.[14] It has been suggested that treatment for C-PTSD should differ from treatment for PTSD by focusing on problems that cause more functional impairment than the PTSD symptoms. These problems include emotional dysregulation, dissociation, and interpersonal problems.[23] Six suggested core components of complex trauma treatment include:[14]

  1. Safety
  2. Self-regulation
  3. Self-reflective information processing
  4. Traumatic experiences integration
  5. Relational engagement
  6. Positive affect enhancement

The above components can be conceptualized as a model with three phases. Every case will not be the same, but one can expect the first phase to consist of teaching adequate coping strategies and addressing safety concerns. The next phase would focus on decreasing avoidance of traumatic stimuli and applying coping skills learned in phase one. The care provider may also begin challenging assumptions about the trauma and introducing alternative narratives about the trauma. The final phase would consist of solidifying what has previously been learned and transferring these strategies to future stressful events.[44]

Multiple treatments have been suggested for C-PTSD. Among these treatments are experiential and emotionally focused therapy, internal family systems therapy, sensorimotor psychotherapy, eye movement desensitization and reprocessing therapy (EMDR), dialectical behavior therapy (DBT), cognitive behavioral therapy, exposure therapy, psychodynamic therapy, family systems therapy and group therapy.[45]

See also[edit]


  1. ^Cook, A., et. al.,(2005) Complex Trauma in Children and Adolescents, Psychiatric Annals, 35:5, pp-398
  2. ^Cortman, Christopher,. Keep pain in the past : getting over trauma, grief and the worst that's ever happened to you. Walden, Joseph,. Coral Gables, FL. ISBN9781633538108. OCLC1056250299.CS1 maint: Multiple names: authors list (link)
  3. ^Stein, Jacob Y.; Wilmot, Dayna V.; Solomon, Zahava (2016), 'Does one size fit all? Nosological, clinical, and scientific implications of variations in ptsd criterion A', Journal of Anxiety Disorders, 43: 106–117, doi:10.1016/j.janxdis.2016.07.001, PMID27449856
  4. ^Lewis Herman, Judith (1992). Trauma and Recovery. Basic Books.
  5. ^Luxenberg, Toni; Spinazzola, Joseph; Van der Kolk, Bessel (November 2001). 'Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part one: Assessment'. Directions in Psychiatry. 21: 22.
  6. ^ abcdeJudith L. Herman (30 May 1997). Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror. Basic Books. ISBN978-0-465-08730-3. Retrieved 29 October 2012.
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Further reading[edit]

  • Walker, Pete (2013-12-13). Complex PTSD: From Surviving to Thriving: A Guide and Map for Recovering from Childhood Trauma. CreateSpace Independent Publishing Platform. ISBN9781492871842.
  • Appleyard, K.; Osofsky, J. D. (2003). 'Parenting after trauma: Supporting parents and caregivers in the treatment of children impacted by violence'(PDF). Infant Mental Health Journal. 24 (2): 111–125. doi:10.1002/imhj.10050.
  • John Briere; Catherine Scott (30 August 2012). Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment. SAGE Publications. ISBN978-1-4129-8143-9. Retrieved 29 October 2012.
  • Ford, J. D. (1999). 'Disorders of extreme stress following war-zone military trauma: Associated features of posttraumatic stress disorder or comorbid but distinct syndromes?'. Journal of Consulting and Clinical Psychology. 67 (1): 3–12. doi:10.1037/0022-006X.67.1.3. PMID10028203.

External links[edit]

  • Post-traumatic stress at Curlie
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