The short answer: complex trauma comes from repeated or prolonged trauma, often in childhood. Common signs include strong emotions that are hard to manage, feeling constantly on edge, nightmares, a negative or unstable sense of self, and difficult relationship patterns. It’s treatable, and therapy usually works not only with what happened, but with what those experiences taught you about yourself.
What is complex trauma?
Complex trauma usually develops after trauma that was repeated or went on for a long time, such as ongoing abuse or neglect in childhood, family violence, or long periods of feeling unsafe. When it meets diagnostic criteria, it’s called complex PTSD (CPTSD).
Alongside the usual symptoms of PTSD, complex PTSD involves difficulties with emotional regulation, a negative sense of self, and problems in relationships. Research supports CPTSD as distinct from PTSD (Cloitre et al., 2013).
Common signs of complex trauma
These are the patterns I see most often in people living with complex trauma:
Memory and perception changes
Gaps in memory, or memories and perceptions that feel distorted or hard to trust.
Difficulty regulating emotions
Feelings that are intense, sudden or hard to settle, or feeling numb and shut down.
High levels of arousal and distress
Feeling wired, tense or overwhelmed much of the time.
Hypervigilance
Always scanning for danger, being easily startled or finding it hard to relax.
Nightmares and disturbed sleep
Distressing dreams, waking often, or dreading going to sleep.
Coping strategies that don’t really help
Ways of getting through that made sense at the time but now keep you stuck.
A distorted or poor sense of self
Feeling worthless, defective, ashamed or responsible for what happened.
Difficult relationship patterns
Struggling with trust, closeness or boundaries, or repeating painful dynamics.
If several of these sound familiar, it doesn’t mean something is “wrong” with you. Many of them are understandable responses to experiences that were never okay.
How complex trauma differs from single-incident trauma
My approach differs depending on whether we’re working with a single traumatic event or complex, repeated trauma.
With single-incident trauma, treatment can often focus more directly on processing the traumatic memory, reducing the associated emotional and physiological distress, and helping the nervous system recognise that the threat has passed.
Complex trauma, particularly CPTSD, often requires a broader approach. Research shows that prolonged trauma, especially during childhood, can affect brain development, emotional regulation, attachment, and a person’s sense of identity (Teicher et al., 2016; Cloitre et al., 2013).
This means we’re not necessarily just working with what happened to someone, but also with what those experiences taught them about themselves.
For example, someone who experiences a single traumatic incident might develop the belief that the world is unsafe. Someone who experiences repeated childhood abuse or neglect might develop the much deeper belief that they are fundamentally unsafe, unworthy, defective, or responsible for what happened to them. These beliefs can become deeply embedded in how a person experiences themselves and their relationships (Putica & Agathos, 2024).
How I work with complex trauma
Clinically, I adapt my approach accordingly. I integrate EMDR-informed techniques, clinical hypnotherapy, counselling, and other evidence-informed approaches depending on the person’s presentation, capacity for emotional regulation, and therapeutic goals.
With complex trauma, this may involve working on emotional regulation, developing a sense of safety, addressing negative self-beliefs, understanding protective responses, and processing traumatic memories. Importantly, these aren’t necessarily separate stages, and treatment is tailored to the individual rather than following a rigid sequence.
My goal isn’t simply to reduce someone’s trauma symptoms. It’s also to help them change the way they relate to themselves, their emotions, and the people around them.
The distinction is that with single-incident trauma, we may primarily be working to change the impact of what happened. With complex trauma, we’re often also working to change what the person came to believe about who they are because of what happened.
You don’t need to tell your story in detail for this work to help, and we go at a pace that feels safe. Learn more about trauma and PTSD counselling at Bloom.
When to reach out
If these patterns are affecting your relationships, work, sleep or how you feel about yourself, it’s worth talking to someone. If you’re in crisis or having thoughts of suicide, call Lifeline on 13 11 14 (24/7), or 000 if life is in danger.
Frequently asked questions
What are the signs of complex trauma in adults?
Common signs include difficulty managing emotions, feeling constantly on edge or hypervigilant, nightmares, memory gaps or distorted perceptions, a negative sense of self, coping strategies that keep you stuck, and difficult relationship patterns.
What is the difference between PTSD and complex PTSD?
Complex PTSD includes the core symptoms of PTSD plus ongoing difficulties with emotional regulation, a negative sense of self, and relationships. It usually follows repeated or prolonged trauma, often in childhood.
Can complex trauma be treated?
Yes. Treatment usually works on safety, emotional regulation, negative self-beliefs and processing traumatic memories, tailored to the person rather than following a rigid sequence.
Do I need to remember everything that happened?
No. You don’t need complete memories or to share every detail for therapy to help. We work with how those experiences affect you now.
Can I have therapy for complex trauma online?
Yes. Sessions are available online anywhere in Australia, as well as in person in Yarrabilba, near Logan.
Getting started
Sessions are available in person in Yarrabilba, near Logan, Jimboomba and Beenleigh, or online anywhere in Australia. No referral is needed. Book a session or call 0451 119 353.
References
- Cloitre, M., et al. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. European Journal of Psychotraumatology, 4.
- Putica, A., & Agathos, J. (2024). Reconceptualizing complex posttraumatic stress disorder: A predictive processing framework for mechanisms and intervention. Neuroscience & Biobehavioral Reviews, 105836.
- Teicher, M. H., Samson, J. A., Anderson, C. M., & Ohashi, K. (2016). The effects of childhood maltreatment on brain structure, function and connectivity. Nature Reviews Neuroscience, 17, 652–666.
