Severe and complex PTSD

Why it is not the same as PTSD

PTSD typically follows one bounded event. Complex PTSD develops when what happened continued over time — neglect, violence, abuse, sustained fear — and often early in life, while the personality was still forming.

Three things appear that are not part of ordinary PTSD:

• Emotion regulation. Swinging between overwhelm and numbness, often both in the same week.
• Sense of self. A deep, settled conviction of being wrong, shameful or damaged — experienced not as a thought but as a fact.
• Relationships. Closeness feels dangerous. You seek it and flee it, often within the same relationship.

And with them, dissociation: going blank, losing time, watching yourself from outside. This is one reason standard trauma treatment often cannot be completed — the patient leaves the room without moving.

Why treatment often stalls

Complex PTSD is where therapy most often gets stuck. Either you move too fast and the system shuts down, or you move so carefully that you never reach the material, and the work becomes supportive conversation for years.

What decides it is timing and regulation — seeing when anxiety is about to tip and adjusting before it does. That is a technical skill, and it is the one we have spent years training.

How we work

1. We map your defences and your anxiety channel before touching content.
2. We build capacity — being able to feel something without disappearing or exploding.
3. Only then do we work with the trauma material, in doses you can carry.
4. Finally with what sits on top: the shame, the self-image, the relationships.

If therapy has not worked before

This is very common in this group, and it is rarely because someone is "treatment resistant". Usually the treatment did not reach where the trauma lives — or reached it too quickly. If you have had several courses of therapy behind you, bring that to the first session. It says something important about what needs to be done differently.