PTSD is a familiar diagnosis. Yet for many, it doesn’t fully explain the lingering effects of trauma — especially when harm was ongoing or came from people who were supposed to provide safety. That’s where Complex PTSD (CPTSD) comes in.
CPTSD is not about labelling someone as “damaged.” It is about recognizing a pattern that makes sense of overwhelming experiences. For many, having a name for what they live with brings relief, reduces shame, and opens the door to more appropriate care.
What CPTSD Means (and why you may not see it in every textbook)
The World Health Organization’s ICD-11 recognizes CPTSD as a distinct condition. It includes the core features of PTSD — re-experiencing, avoidance, and a sense of ongoing threat — plus three additional areas called disturbances in self-organization:
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Emotion regulation difficulties — emotions that arrive like tidal waves, or stretches of feeling flat and numb
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Negative self-concept — chronic guilt, shame, or beliefs like “I’m broken”
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Relational struggles — difficulties with trust, closeness, or feeling safe with others
In contrast, the DSM-5-TR, more commonly used in Canada and the U.S., does not include CPTSD as its own diagnosis. Instead, people may be diagnosed with PTSD, another trauma-related disorder, a personality disorder, or a group of other labels. This gap can cause confusion. But even if the label isn’t always used, the experiences it describes are real — and increasingly acknowledged by clinicians and researchers.
How CPTSD Shows Up Day to Day
CPTSD affects more than memory or mood. It shapes the rhythms of daily life. Survivors often describe carrying an invisible weight that others can’t see, but which colours every interaction.
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Emotions: feeling “too much” — anger, grief, fear — or “nothing at all” through emotional shutdown
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Inner world: parts of us may carry critical or shaming messages like “I’m broken” or “No one will ever love me.” These voices developed to protect us from being hurt again, but over time they can reinforce deep feelings of worthlessness.
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Relationships: longing for closeness while fearing betrayal or rejection; withdrawing even when desiring connection
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Awareness and attention: dissociation, memory lapses, losing track of time, or feeling disconnected from the body
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Physical health: tension headaches, stomach distress, disrupted sleep, or chronic pain without clear cause
These are not flaws in character. They are adaptations that once made survival possible — but later leave life feeling harder than it needs to or could be.
Roots of CPTSD: Chronic, Interpersonal, and Developmental Trauma
CPTSD often arises when trauma is repeated and relational — for example, childhood abuse, neglect, or family violence. These experiences are often grouped together as Adverse Childhood Experiences (ACEs). CPTSD can also develop in adulthood through situations like interpersonal violence. The common thread is threat that persists over time, often in relationships where trust was expected.
Research on ACEs helps explain how early adversity increases vulnerability:
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In Alberta, over half of adults report at least one ACE, and 12% report four or more. (Note: this is a pre-COVID statistic so it may be higher now.)
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Experiencing one ACE raises the likelihood of experiencing others by 84%.
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Nearly half of poor adult health outcomes in Alberta can be linked to ACEs.
This doesn’t mean trauma defines who someone is. Many people with high ACE scores never develop CPTSD. It does show how deeply early environments shape later health and relationships — and why CPTSD is more than a collection of symptoms.
Big Questions People Ask
Is CPTSD a serious condition?
Yes. CPTSD can have significant effects on health, emotions, and relationships. But “serious” is not the same as hopeless. Many survivors discover healing pathways that allow them to feel more grounded, connected, and whole.
Can CPTSD be cured? Will it ever go away?
Brains and bodies can change. While trauma leaves traces, healing approaches help the nervous system learn new patterns of safety. For most people, recovery doesn’t mean erasing the past — it means experiencing more freedom, less overwhelm, and greater choice.
Is CPTSD recognized in Canada?
The ICD-11 officially includes CPTSD, but the DSM-5-TR — used most often in Canada — does not. This can affect what shows up in medical files or insurance paperwork. Still, many clinicians are aware of CPTSD and use its framework to guide treatment.
Is CPTSD a disability?
Sometimes. If symptoms significantly limit daily life, CPTSD may qualify as a disability. Access depends on the guidelines for each program.
Can CPTSD overlap with other conditions?
Yes. CPTSD can resemble or co-occur with other experiences, including depression, anxiety, neurodivergence, and personality disorders. There is debate about these overlaps, but the most balanced view is that both trauma, personality disorder and neurodivergence exist — sometimes together, sometimes separately. Careful, trauma-informed and neurodiversity-aware assessment is key. If you are querying one or the other (or all three), try to find a clinician who is trained to assess across these areas to ensure an accurate diagnosis.
Why Diagnosis Confusion Happens
Because CPTSD isn’t listed in the DSM, people often receive other diagnoses instead. Sometimes these labels fit, and other times they don’t.
So for people who struggle with the diagnosis they received, it helps to recognize the limits of the current diagnostic systems. Diagnosis can be important — it influences access to resources and treatment — but a good therapist will also look at you holistically, taking all factors into account regardless of which labels you do or do not receive.
What Helps: First Steps Toward Stability
Recovery from CPTSD begins with creating spaces that feel “safe enough.” That might mean slowing down in therapy, setting boundaries, or simply noticing what situations bring steadiness and what sparks overwhelm.
In Internal Family Systems language, it can also mean getting to know the parts of yourself that carry heavy messages like “I’m broken” or “I’ll never be safe.” These parts are not enemies — they are protectors, shaped by past experiences, who have been working hard to keep you safe. Learning to meet them with curiosity and compassion allows new possibilities for healing to emerge.
Alongside this inner work, body-based approaches can help restore balance to the nervous system. Protocols like the Safe and Sound Protocol (SSP) or Rest and Restore Protocol (RRP) support the body in learning to relax its guard. In time, survivors often describe feeling less reactive, more connected, and more able to engage with the world around them.
Closing & Looking Ahead
CPTSD offers a framework that validates what many already sense: that life feels heavier, trust feels fragile, and the past shows up in the present. But naming CPTSD is also hopeful — it means these struggles make sense, and that healing is possible.
In Part 3 of this series, I’ll explore why CPTSD is so often confused with other conditions — especially Borderline Personality Disorder and neurodivergence — and how careful, trauma-informed assessment can bring greater clarity and kinder care.
