Signs of Complex PTSD: Understanding Trauma That Develops Over Time
If you've experienced prolonged trauma—whether through childhood neglect, an abusive relationship, or ongoing difficult circumstances—you might be dealing with Complex PTSD (C-PTSD) without even realizing it. Unlike the PTSD that develops from a single traumatic event, Complex PTSD stems from repeated, long-term trauma, often in situations where escape felt impossible.
Many people with C-PTSD have spent years thinking something is fundamentally wrong with them, not understanding that their struggles are actually normal responses to abnormal circumstances. Healing from complex PTSD begins with recognizing these patterns for what they are.
What Is Complex PTSD?
Complex PTSD is a condition that develops when someone experiences trauma repeatedly over months or years, particularly during childhood or in situations where they felt trapped. This might include:
Childhood emotional, physical, or sexual abuse
Ongoing emotional neglect or inconsistency from caregivers
Long-term domestic violence or emotional abuse
Being held captive or trafficked
Chronic invalidation in important relationships
Relational trauma within families or partnerships
While traditional PTSD involves symptoms like flashbacks and hypervigilance following a specific traumatic event, C-PTSD includes these symptoms plus deeper challenges with identity, relationships, and emotional regulation. Complex PTSD often involves relational trauma—wounds that developed within unsafe or unpredictable relationships, especially with caregivers or partners.
Common Signs of Complex PTSD
Emotional Dysregulation
You might experience intense emotions that feel overwhelming and difficult to control. This can look like sudden anger, deep shame, or feeling emotionally numb. Many people describe feeling like they're "too much" or "too sensitive," when really, their nervous system is responding to past overwhelm. Your body may keep reacting as if the danger is still happening, even when you're physically safe.
Negative Self-Perception and Shame
C-PTSD often creates a deep sense of worthlessness or shame. You might have a persistent inner critic that tells you you're broken, unlovable, or fundamentally flawed. You may constantly second-guess yourself or feel "not enough." This isn't about low self-esteem—it's about how trauma reshaped your view of yourself.
Relationship Difficulties and Trust Issues
If you struggle with trust, fear abandonment, or find yourself in repeated unhealthy relationship patterns, this may be related to C-PTSD. You might push people away when they get close, or become overly dependent on others for validation. Many people with complex trauma long for connection but feel unsafe when relationships get close. You might notice yourself falling into patterns of people-pleasing or fawning to keep the peace.
Difficulty with Boundaries
You might have trouble saying no, feel responsible for others' emotions, or struggle to identify what you actually want and need. Conversely, you might have rigid boundaries that keep everyone at arm's length.
Dissociation and Disconnection
Many people with C-PTSD experience feeling disconnected from their body, emotions, or surroundings. You might "zone out" frequently, feel like you're watching your life from the outside, or have difficulty remembering parts of your day. This shutting down emotionally or going numb is a protective strategy your nervous system developed.
Hypervigilance and Anxiety
You might feel a constant sense of dread or hypervigilance, like you're always waiting for the other shoe to drop. Your nervous system stays on guard, scanning for danger even in safe situations. This can be exhausting and make it difficult to relax or feel at ease.
Physical Symptoms
C-PTSD often shows up in the body as chronic pain, fatigue, digestive issues, headaches, stomach pain, or a sense of being constantly on edge. These physical symptoms are often tied to stress and a dysregulated nervous system that remains in a state of alert.
Reactivity to Conflict
You might notice yourself "overreacting" to conflict or avoiding it at all costs. Small disagreements can feel threatening, and your body's response may feel disproportionate to the situation.
Loss of Core Beliefs
Trauma can shatter your sense of meaning, hope, or faith. You might feel hopeless about the future or struggle to find purpose and direction in life.
Why Complex PTSD Develops
When trauma happens repeatedly, especially in childhood or in relationships where we depend on the person harming us, our nervous system adapts to survive. Complex PTSD develops through repeated or ongoing experiences of emotional neglect, inconsistency, or unsafe environments. It's not always one major event—it's often a series of moments that taught your nervous system to stay on guard.
The coping mechanisms that once protected you—numbing out, people-pleasing, hypervigilance, perfectionism—can become patterns that persist long after the danger has passed. These aren't character flaws or personal failings. They're intelligent survival strategies that made sense given what you experienced.
The Connection Between Relational Trauma and Complex PTSD
Relational trauma happens when important relationships, especially with caregivers or partners, are unsafe, invalidating, or emotionally unpredictable. These early wounds shape the way you see yourself and others. They may leave you questioning your worth, struggling to trust, or feeling like closeness always comes with risk.
While not the same, relational trauma and complex PTSD are closely connected. Both involve the long-term impact of unsafe relationships, and both require care that goes beyond coping skills to truly address the root causes.
How Trauma Therapy Can Help with Complex PTSD
The good news is that healing from complex PTSD is possible. Trauma-informed therapies like EMDR (Eye Movement Desensitization and Reprocessing) and Internal Family Systems (IFS) are particularly effective because they work with both the mind and body to process stored trauma and help your nervous system recalibrate.
Healing from complex PTSD takes more than just talking about the past. It requires working with your mind, body, and nervous system in an integrative way.
In trauma therapy in San Diego, you'll learn to:
Understand how your past experiences connect to your current struggles
Reprocess memories and sensations without having to relive them
Build compassion for the protective parts of yourself that have been working so hard
Develop tools to regulate your emotions and nervous system
Reconnect with your body and help your nervous system find calm
Build healthier relationship patterns and rebuild trust
Release shame and self-criticism
Create a greater sense of safety and grounding in your body
You're Not Broken—Your Symptoms Make Sense
If you recognize yourself in these signs, please know: there is nothing fundamentally wrong with you. Your symptoms are not who you are—they're responses to what you've been through. These are not personal flaws but protective strategies your nervous system developed to help you survive.
With the right support, healing from complex PTSD is possible. You can move from survival to stability, from shame to self-compassion, and from disconnection to deeper connection—with yourself and with others.
Ready to Begin Healing from Complex PTSD?
If you're tired of feeling stuck in patterns that no longer serve you, I'm here to help. You don't have to carry this alone. Contact now to learn more about how trauma therapy can support your healing journey.
About the Author
Aleah Maas is a Licensed Clinical Social Worker and trauma therapist based in San Diego, CA. She is the founder of Holistic Flow Therapy, where she specializes in helping adults heal from Complex PTSD, relational trauma, and attachment wounds. Using EMDR, Internal Family Systems (IFS), and nervous system-based approaches, Aleah supports clients in processing what's been stuck, releasing shame, and building healthier patterns in relationships and within themselves. She offers therapy online across California and in person in La Jolla.
Learn more about working with Aleah | Book a free 15-minute consultation
