How A Complex PTSD Therapist (UK) Can Help With Healing

According to PTSD UK, between 50–70% of people worldwide will experience a traumatic event in their lifetime. A single traumatic event or series of events can affect a person on a deep emotional level, sometimes causing a condition like post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (C-PTSD) to develop in traumatised individuals. Keep reading to explore causes and symptoms of C-PTSD, common therapy approaches used to support clients navigating PTSD or C-PTSD, and other treatment options for adults in the UK who have experienced trauma. With patience and proper support, it is possible for individuals to process, heal, and move forward toward a more positive future after experiencing trauma.

What is complex post-traumatic stress disorder (C-PTSD)?

Due to repeated or prolonged exposure to complex trauma, C-PTSD often causes even deeper emotional, psychological, and relational challenges than standard PTSD. Research also suggests that people with C-PTSD have an earlier onset of trauma than people with PTSD, which may be one reason it typically involves more severe symptoms and requires a nuanced and comprehensive trauma treatment approach. For adults with C-PTSD, treatment may involve a combination of psychological treatments, such as trauma-focused cognitive behavioral therapy and other forms of counselling, as well as medication.

Causes of C-PTSD

C-PTSD can be caused by sustained exposure to traumatic events—especially those that occur in environments where a person feels powerless or unable to leave. Potential causes include:

• Childhood neglect or abuse: C-PTSD is perhaps most often associated with interpersonal trauma during childhood. Since these experiences occur when the individual is still developing emotionally and cognitively, they can have a larger impact.
• Domestic violence: prolonged exposure to an abusive relationship where feelings of safety are compromised
• Captivity or exploitation: situations such as being held hostage, being a survivor of human trafficking, or living in a war zone
• Repeated trauma at work or in caregiving roles: First responders, medical professionals, or caregivers in high-stress environments are at risk of C-PTSD due to repeated exposure to secondary trauma.

C-PTSD is likelier to develop when the individual has no opportunity to process or escape these situations, leaving their nervous system in a constant state of hypervigilance.

Symptoms

Research suggests that people with C-PTSD report lower levels of psychological well-being than people with PTSD. Although symptoms of PTSD can be severe and highly disruptive to daily life, those associated with C-PTSD may be even more so. 

Some symptoms of C-PTSD include:

• Emotional dysregulation: Depending on the cause of the trauma, this effect can lead to excessive fear, worry, shame, or guilt, along with other negative emotions. 
• Interpersonal difficulties: Forming and maintaining close relationships may become more difficult. For example, someone with C-PTSD may distrust new friends and partners if they’ve experienced abuse in a past relationship.
• Negative self-perception: persistent negative feelings toward oneself due to a traumatic experience
• Dissociation: feeling detached from one’s body, emotions, and surroundings
• Physical symptoms: Chronic pain and fatigue are especially common in people with PTSD, especially if they experienced trauma through a physical injury.
• Re-experiencing trauma: flashbacks, nightmares, or intrusive memories of the traumatic events
• Hypervigilance: being constantly on edge and feeling unsafe even in non-threatening situations

C-PTSD vs. post-traumatic stress disorder (PTSD)

C-PTSD and PTSD share many similarities. However, key differences lie in the cause and severity of symptoms. 

PTSD often develops as the result of a single, isolated traumatic event. Some examples include a car accident, a natural disaster, or an experience of assault. Symptoms tend to revolve around reliving that specific incident, avoiding reminders of it, and experiencing heightened anxiety as a result of it.

C-PTSD is slightly different since it develops as a result of prolonged exposure to trauma over multiple occasions. This distinction can have significant implications for treatment, as C-PTSD often requires a more holistic approach that addresses deep-seated emotional and relational wounds.

Severity of symptoms

While PTSD can result in severe symptoms, such as flashbacks and hypervigilance, C-PTSD is often more complex, also involving chronic feelings of shame, significant difficulties with trust, and a fragmented sense of identity. This fact can make C-PTSD more challenging to address, often resulting in a longer duration of treatment. 

Also note that researchers have identified various risk factors as well as perfect protective factors that may impact whether the person develops a trauma-related illness and the severity of their symptoms if so. Examples of such factors include whether the person already has a diagnosed mental illness, whether they have social support, and whether they've experienced trauma before. 

Type of trauma

PTSD is typically associated with a specific, single, identifiable event. In contrast, C-PTSD usually stems from sustained trauma, such as years of emotional abuse or neglect.

Age of onset

C-PTSD is more commonly associated with trauma experienced in childhood or adolescence. This type can be referred to as developmental trauma, since these years are formative for emotional and psychological development. On the other hand, PTSD can develop at any age.

Treatment options

While C-PTSD can feel overwhelming, there are effective treatments that help many people address symptoms. Remember that symptoms of a trauma-related mental illness typically will not resolve without treatment, so seeking professional support via a therapist as soon as possible is generally recommended. 

Medication

Medication is sometimes prescribed for individuals living with PTSD or C-PTSD,  usually in combination with some form of talk therapy. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may help reduce symptoms of anxiety and depression, while other medications may be prescribed to regulate sleep or stabilize mood. More research on the efficacy of medications is needed for C-PTSD, but studies suggest that SSRIs may be effective in helping reduce PTSD symptoms. Remember not to start, stop, or change any medication without consulting your doctor. 

Speaking with a complex PTSD therapist: Therapy for trauma

Therapy is typically a key component of complex PTSD treatment, offering individuals a safe space to process their trauma and develop healthy coping mechanisms with the help of a therapist. Here are some common types of talk therapy used in the UK for the treatment of C-PTSD:

• Trauma-focused cognitive behavioral therapy (TF-CBT): This form of therapy gives adolescents and children, in particular, the tools to question and alter existing thoughts and feelings. Research suggests that it can effectively treat grief, anxiety, and depressive symptoms in young people.
• Eye movement desensitization and reprocessing (EMDR): This form of talk therapy involves engaging in rapid eye movements, which mirror the patterns that occur in the REM sleep cycle while verbally recalling trauma. EMDR may help people consciously process traumatic memories and emotions.
• Somatic therapy: This body-centered approach focuses on reconnecting with bodily sensations and using movement or breathwork to release trauma.
• Dialectical behavior therapy (DBT): DBT may be beneficial for people experiencing emotional dysregulation as a result of trauma. It may help an individual better manage emotions, interpersonal relationships, and overall mood. As with many of these treatments, DBT can also be used to treat other mental health conditions such as obsessive-compulsive disorder (OCD), depression, and anxiety.

How therapists assess and begin treatment for complex PTSD

When individuals seek support for complex PTSD, therapists may use a range of clinical assessment tools to evaluate their symptoms. One of the most common assessment tools for complex PTSD is the International Trauma Questionnaire (ITQ; 5), which assesses clients for both ICD-11 PTSD and CPTSD. 

Based on this assessment, the severity of symptoms, and other factors, various treatment options may be recommended, as different individuals may benefit from different approaches. These approaches may include watchful waiting, which involves monitoring your symptoms to see if they improve without treatment; certain medications; and various forms of psychotherapy. 

Evidence-based therapies for complex PTSD

As mentioned earlier, psychotherapy (also called talk therapy) is often a core component of treatment for complex PTSD. Depending on an individual’s symptoms and any other comorbid conditions, therapists may utilize various psychological treatments and counselling techniques, but in many cases, evidence-based therapies for complex PTSD are often recommended. These include trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR). 

Body-based and experiential approaches 

There are also a range of other approaches that some individuals with complex PTSD may be interested in exploring, depending on their symptoms and personal preferences. These include body-based and experiential approaches, such as somatic experiencing, mindfulness-based therapies, and focusing-oriented therapy. These approaches aim to help individuals release trauma stored in the body, such as by helping them practice mindfulness skills to observe thoughts and bodily sensations without judgment. 

Group therapy options

In addition to these individual therapy approaches, some individuals may also benefit from group therapy options. Group therapy allows individuals with complex PTSD to connect with and learn from others in a safe and supportive environment, with group supervision led by a qualified therapist. For individuals working in high-stress, trauma-prone fields, such as members of the military or frontline healthcare professionals, there may be group therapy options available for supporting professionals working in your particular field, which may offer an added level of connection and tailored support.

Working with a complex PTSD specialist 

When seeking treatment for complex PTSD, it can be important to find a psychologist or other mental health professional who has the appropriate clinical training, knowledge, and experience to provide effective, compassionate care. You can find qualified professionals who work as part of a broader organization, operate their own independent practice, or offer therapy online through a reputable platform; but in any case, it can be important to consider their specific credentials, qualifications, training, and background to ensure they are the right fit for your needs.

Training, skills, and professional development for trauma therapists

There is a wide range of additional training and professional development options available for mental health professionals working in the trauma space. In the UK, trauma therapists may pursue specialized diplomas, certificates, courses, and clinical supervision to help them develop and practice key skills necessary for supporting individuals with PTSD and complex PTSD. 

Complex PTSD therapist: UK options

There are several different ways for an individual in the UK who is experiencing the effects of past trauma to receive therapeutic support. First, mental health therapy through the National Health Service (NHS) is free for eligible citizens and residents. You can self-refer online or get a referral for a therapist through your GP.

Outside of the NHS, independent providers may treat trauma, though payment for their services is typically required. Some independent providers offer sliding-scale fees to help make their therapy sessions more widely available. In addition, universities, some employers, and mental health charities may also offer support in finding and/or paying for mental health care.

Another option is online therapy sessions through a therapist platform that serves the UK, such as BetterHelp. This type of service can match you with a professional therapist according to your needs and preferences, as outlined in a simple onboarding questionnaire. Since feeling comfortable with your therapist can be paramount for effective C-PTSD treatment, BetterHelp also allows you to switch providers at any time for no extra cost. This platform offers subscriptions as low as £65, billed every four weeks, which can be affordable for those wanting to seek out mental health treatment with a therapist.

How online therapy can benefit adults navigating PTSD

Online therapy has become more popular in recent years, and various studies have examined its effectiveness. In general, research suggests that online treatment can often be as effective as in-person care for symptoms of PTSD. For some traumatised individuals, symptoms of PTSD may make it difficult to leave home or travel to appointments, and the ability to have therapy sessions from the comfort of home can be a key benefit of online therapy. With online therapy, clients can receive compassionate, professional support that helps them make positive change, without even having to leave the house.