5 of Your Most Pressing Questions About Complex Trauma Answered

Complex trauma is an often misunderstood condition that deserves its own careful, nuanced consideration. Because complex trauma is not recognized by the DSM-5, the official manual of mental health disorders, many adults and children may be affected by the condition and not even know it. Or, they may receive ineffective treatment that doesn’t address the complexity of the condition.

Symptoms that seem related to PTSD or anxiety to the untrained practitioner may actually be part of a more complex version of trauma. To give you an idea of what complex trauma is and distinguish the condition from other disorders, we’re answering your top 5 questions about the diagnosis.

What is complex trauma?

Complex trauma is a psychological condition that develops from repeated or cumulative trauma, especially in circumstances where a person can’t escape their abuser or situation. Complex trauma may develop after ongoing exposure to situations involving abuse, neglect, violence, or natural disaster.  Most people with complex trauma will develop it when they are young and their traumatic experiences become a part of their developing sense of self.  However, people may develop complex trauma at any age.

Complex trauma is often referred to as complex-PTSD and often presents with symptoms associated with PTSD such as:


  • Intrusions: reliving the traumatic incidents through flashbacks
  • Avoidance: avoiding places and situations that remind you of the trauma
  • Hyperarousal: feeling like you’re in a constant state of high alert


In addition to those traits, complex trauma can also be accompanied by distrust in the world and other people. Physical symptoms may also occur such as difficulty sleeping, trouble concentrating, and dizziness upon recalling certain memories or triggers.

In the bigger picture, deep-seated mistrust and self-esteem issues tend to have a pervasive effect on every aspect of life, from communication to relationships to careers.

Who’s at risk for complex trauma?

Complex trauma affects men, women, and children from all backgrounds. Those who are exposed to traumatizing events such as neglect, abuse, and violence are at the highest risk of developing the condition.

Some of the following factors may be associated with complex trauma:


  • Domestic abuse
  • Sexual, emotional, or physical abuse
  • Ongoing abuse, especially by someone who is trusted
  • Military exposure to violence
  • Human trafficking

How is complex trauma different from anxiety or PTSD?

Complex trauma is often confused with or treated as anxiety or PTSD. While symptoms like anxiety, flashbacks, and hyperarousal may accompany complex-PTSD, they’re often only a small part of a much larger story.

Anxiety tends to occur even when there’s no direct cause. PTSD is often associated with a singular event or experience.  Complex-PTSD develops after repeated exposure to trauma that, over time, become a part of the fabric of one’s identity.

Since complex trauma differs greatly from anxiety and PTSD, the condition also requires a more involved, targeted treatment approach.

What does treatment for complex trauma involve?

Your therapist personalizes treatment for your particular situation and may involve talk therapy, exposure therapy, cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT) to address the complexity of the issue.  Relational work, attachment-based therapy and various other approaches might be used to help you identify and realign with your values, separate from the trauma that you’ve survived.  You may also be encouraged to participate in healthy activities like exercise, meditation, self-care, and socializing.

Some of the goals of treatment are to increase your trust in others, diminish the effects of the trauma, and improve your overall well-being. Your therapists works to help you reprogram counterproductive subconscious patterns and improve your self-perception so you can lead a more fulfilling life.

Treatment for complex trauma may take longer than other treatment for other conditions due to its complicated, far-reaching effects. The condition can affect brain development if the trauma occurred at an early age, and cause ingrained patterns of behavior that affect multiple areas of your life. Your therapist helps you dig into a lifetime-worth of relationship dynamics and coping methods you may have acquired from the trauma.

What should I do if I think I might be experiencing complex trauma?

The best thing you can do if you think you might be affected by complex trauma is to speak with a professional therapist right away even if you haven’t had success with therapy or medication for trauma in the past.  Be sure to seek a therapist with specialized experience working with complex trauma.

You don’t have to try to fix or suffer through the effects of complex trauma by yourself. Left untreated, symptoms can have far-reaching effects and become even more difficult to deal with and treat, which isn’t necessary with the help that’s available.


If you’re in the Boulder area and would like to work toward healing your complex trauma, please call Stepwell Mental Health and Wellness today to find out what provider will be best suited to your individual needs.  Call us at 720-577-5819 or schedule an appointment through our secure client portal today.