Many experts now refer to a condition called complex post-traumatic stress disorder (CPTSD) to describe a set of symptoms for which there was previously not a satisfactory diagnosis. The condition can express itself in a similar way to borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) but is sufficiently distinct from these to warrant its own name.

Due to the above, it is thought that many individuals have been inaccurately diagnosed with PTSD or BPD when a more accurate diagnosis would have been CPTSD.

Complex post-traumatic stress disorder was not included as a formal diagnosis in ICD 10 but is likely to be included in ICD 11. (ICD stands for International Classification of Diseases)

Causes of complex post-traumatic stress disorder:

Research shows that those abused in childhood, and over an extended period of time, by their parents or primary caregivers, and by older siblings, are at high risk of developing the condition compared to those who were fortunate enough to experience a relatively stable childhood.

Also, children who suffered long- term neglect (physical and/or emotional), were poorly nurtured or abandoned are at much higher than average risk of developing CPTSD.

CPTSD can also be viewed as a set of responses learned in childhood (as survival mechanisms) and as a failure, caused by dysfunctional caregiving, to complete all of the normal phases of child and adolescent development. Indeed, another name for CPTSD is developmental trauma disorder.

Symptoms of CPTSD:

1) Emotional flashbacks – unlike ordinary flashbacks, emotional flashbacks frequently occur without any visual content. Instead, they can be seen as regressions to the experience of intense psychological pain associated with being an abused, neglected or abandoned child.

Often, such flashbacks will entail the experiencing of extreme fear, resulting in hyperarousal of the sympathetic nervous system and triggering of the ‘fight or flight’ response. 

Other emotions which may accompany such flashbacks include a feeling of utter powerlessness, hopelessness, helplessness, shame and despair.

2) A deep sense of shame/guilt- some dysfunctional primary caregivers/parents are prone to frequently treating their children with contempt. Such treatment is known to be particularly psychologically damaging and can lead to what has been called a sense of toxic shame. Individuals suffering from this tend to see themselves as despicable, contemptible, repellant human beings and in some profound, yet inexpressible, way, irredeemably morally flawed.

Feeling like this can prevent the individual from seeking help – instead, the person may isolate him/herself and ‘hide him/herself away’ due to the FALSE belief that s/he does not ‘deserve’ help, but instead ‘deserves’ to suffer. S/he may, too, believe s/he will be negatively judged by any potential therapist, or even actively disliked by such a therapist.

Certainly, at my worst, I became paranoid about seeing any type of therapist, believing, at the time, they would undermine me as much as they could.

3) Learned helplessness a person with CPTSD will very frequently feel that, during their prolonged period of suffering trauma, there was NO ESCAPE or WAY OUT (whether this belief was real or imagined; it is the perceiving of it to be true which is crucial). This is because such an experience can lead to a syndrome known as learned helplessness’. 


4) Great difficulty controlling own emotions 

5) Biological effectse.g .increased propensity to develop physical illnesses 

6) Difficulties forming and sustaining relationships 

7) Proneness to outbursts of extreme rage. 

8) Difficulty controlling impulses.

9) Cognitive problemsthese may include delayed language development, poor judgement, difficulty making decisions and impaired ability to concentrate.

10) Compulsive sexuality or extremely inhibited sexuality.

11) Memory problems – these can include the forgetting of extremely traumatic events ( in my own case, whole chunks of my childhood are ‘missing’ from my memory) as an unconscious form of self-protection; psychologists refer to this as PSYCHOGENIC AMNESIA.

Alternatively, the individual with CPTSD may think obsessively about his/her painful childhood; psychologists refer to this as ‘obsessive rumination’ and it is thought it may be an attempt by the brain to process and make sense of what happened. Sometimes, the CPTSD sufferer may fixate, and become preoccupied with, his/her relationship with the person responsible for the trauma; counter-intuitively and paradoxically, this can sometimes actually entail idealizing the perpetrator. 

12) Dissociation – a person who dissociates is, essentially, ‘cutting off from reality’, either deliberately by means such as drugs and alcohol, or due to a subconscious defence mechanism. 


David Hosier BSc Hons; MSc; PGDE(FAHE).