Specialist evidence-based therapy to help you understand how prolonged trauma has shaped your emotions, relationships and sense of self, and develop greater safety, connection and choice.
Some traumatic experiences happen suddenly. Others occur repeatedly, over long periods of time or within circumstances where getting away, finding safety or accessing support was difficult.
Complex PTSD (CPTSD) can develop following prolonged or repeated trauma and includes the core difficulties associated with PTSD alongside broader changes in emotional regulation, relationships and the way someone experiences themselves.
For some people, these patterns developed within childhood. For others, they followed abusive or controlling relationships, repeated interpersonal trauma or other prolonged experiences of threat, powerlessness or instability.
When difficult experiences happen repeatedly, we don’t only learn about individual moments of danger. We can begin learning broader lessons about ourselves, other people, emotions, relationships and what we need to do to stay safe.
Therapy helps us understand those patterns in context: not as evidence that something is fundamentally wrong with you, but as adaptations that developed for understandable reasons and may no longer fit the life you are living now.
Understanding Complex PTSD
Complex PTSD shares the core features of PTSD, including re-experiencing traumatic events, avoiding reminders and an ongoing sense of threat. But prolonged or repeated trauma can also influence how someone learns to relate to themselves and other people.
If relationships were unpredictable, closeness may begin to feel dangerous. If expressing emotions led to criticism, rejection or harm, hiding them may have become safer. If your needs were repeatedly ignored, you may have learned not to recognise them at all. Over time, the mind may begin asking:
These patterns aren’t conscious decisions. They can develop gradually through repeated experiences and become increasingly familiar ways of navigating the world.
Someone may become highly attuned to other people’s moods because noticing subtle changes once mattered. People-pleasing may have reduced conflict. Emotional shutdown may have made overwhelming experiences more manageable. Perfectionism may have reduced criticism. Fierce independence may have developed because relying on somebody else repeatedly felt unsafe.
This doesn’t mean every current difficulty should automatically be explained by trauma. Temperament, neurodivergence, culture, relationships, current circumstances and other psychological difficulties can all be relevant too.
The purpose of formulation is to understand what applies to you, rather than fitting your experiences into a predetermined trauma story.
How Complex PTSD Can Affect Everyday Life
Complex PTSD can affect far more than memories of what happened. Its impact may be felt across relationships, work, parenting, identity, emotions, self-worth and everyday decisions. You might notice:
- Trauma memories and reminders, including intrusive memories, nightmares, flashbacks or strong emotional and physical reactions.
- An ongoing sense of threat, feeling on guard, easily startled or unable to fully relax even when there is no obvious danger.
- Avoidance, staying away from memories, emotions, people, places or situations associated with what happened.
- Emotional overwhelm, experiencing emotions very intensely or finding it difficult to return to baseline once something has been activated.
- Emotional shutdown, feeling numb, disconnected or detached when experiences become too much.
- Persistent shame or low self-worth, feeling fundamentally inadequate, damaged, unlovable or different from other people.
- Self-criticism, judging yourself harshly or feeling responsible for things that weren’t entirely within your control.
- Relationship difficulties, wanting connection whilst finding trust, closeness, dependence or vulnerability difficult.
- People-pleasing, becoming highly focused on keeping other people happy, preventing conflict or anticipating what others need.
- Hyper-independence, feeling safer doing everything yourself rather than depending on somebody who could disappoint or hurt you.
- Difficulty recognising your own needs, particularly when attending to other people’s needs became more important than expressing your own.
- Uncertainty about identity, struggling to know who you are outside survival, relationships, expectations or the roles you learned to occupy.
Some people appear highly capable from the outside whilst internally spending enormous amounts of energy monitoring, anticipating, adapting and holding everything together.
CPTSD can also coexist with anxiety, depression, dissociation, eating disorders, OCD and other psychological difficulties. We shouldn’t automatically assume these are caused by trauma simply because trauma is part of someone’s history. Instead, therapy helps us understand how the different parts of your experience relate to one another and what is actually maintaining the difficulties now.
What Keeps Complex PTSD Going?
Many patterns associated with Complex PTSD developed because, at some point, they helped someone navigate circumstances that were genuinely difficult, unsafe or unpredictable.
These processes can reinforce one another. If you expect rejection, for example, you may monitor relationships closely, hide your needs or withdraw when closeness feels risky. This may reduce vulnerability in the moment, but it also gives you fewer opportunities to experience relationships in which disagreement can be repaired, needs can be expressed and connection doesn’t depend on being perfect.
Similarly, self-criticism may feel protective if mistakes once had significant consequences. Hyper-independence may feel safer if relying on other people repeatedly led to disappointment. Emotional shutdown may reduce overwhelm whilst making it harder to feel connected to yourself or others.
Understanding the function of these patterns matters because therapy isn’t about simply taking them away. It’s about creating enough safety, flexibility and new experience that old survival strategies no longer have to be your only option.
How Therapy Can Help
Complex PTSD affects far more than traumatic memories alone, which is why I believe therapy should address the whole person rather than focusing on one symptom or one therapeutic model.
Our work begins by developing a shared understanding of your experiences, the survival responses that developed over time and the ways these continue to influence your relationships, emotions, identity and everyday life.
Depending on your formulation, I integrate EMDR, Schema Therapy, Compassion Focused Therapy (CFT), Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Acceptance and Commitment Therapy (ACT) and elements of Integrative Psychotherapy. Each approach brings something different.
An important part of therapy is helping your nervous system experience something it may not have consistently known before: Safety. Not simply physical safety, but emotional safety. Safety within relationships. Safety within your own body. Safety to experience emotions without becoming overwhelmed. Safety to be yourself without constantly preparing for danger.
Where neurodivergence, sensory processing, dissociation, communication or other individual needs are relevant, therapy can also be adapted accordingly.
Integration doesn’t mean using everything at once. The formulation guides what we use, when and why.
The aim isn’t to turn you into somebody different or return you to a version of yourself that existed before trauma. For many people, recovery involves developing something they may not previously have had enough opportunity to experience: greater safety, connection and freedom to decide how they want to live now.
Common Misconceptions About Complex PTSD
“Complex PTSD is just more severe PTSD.”
Not quite.
Although PTSD and Complex PTSD share many features, Complex PTSD often develops following prolonged or repeated trauma, particularly where escape was difficult or relationships themselves became sources of danger. As well as traumatic memories, it often affects identity, emotional regulation and relationships.
“I’ve always been like this.”
Many people with Complex PTSD feel that their survival responses are simply part of their personality.
More often, they reflect understandable adaptations to experiences that occurred over many years. Therapy helps us understand where these patterns came from and whether they are still serving you today.
“If I let my guard down, I’ll get hurt.”
This belief often makes perfect sense.
If staying alert once protected you, your nervous system will naturally continue using that strategy. Therapy doesn’t ask you to abandon caution overnight. Instead, it gradually helps your brain distinguish between situations that genuinely require protection and those where safety is now possible.
“I should be over it by now.”
There is no timeline for survival responses to settle.
The nervous system isn’t responding according to how much time has passed. It’s responding according to what it has learned about safety and danger. Recovery involves helping the brain update that learning rather than blaming yourself for still struggling.
“Talking about trauma will make everything worse.”
Good trauma therapy isn’t about reliving painful experiences before you’re ready.
Developing safety, emotional regulation and trust comes first. Processing traumatic memories only happens when it feels appropriate and is always guided collaboratively.
“I’ve lost who I really am.”
Many people with Complex PTSD feel disconnected from themselves.
Often this isn’t because the person you were has disappeared.
It’s because survival has taken centre stage for so long that there has been very little space left for everything else.
Therapy helps create that space again.
Food For Thought
What might become possible if the ways you learned to survive could become choices rather than rules you still have to live by?
A Note from Agi
One of the things I notice most often in work with Complex PTSD is how easily adaptation becomes mistaken for identity. People describe themselves as too sensitive, too emotional, too needy, too independent, difficult to trust, impossible to please, often without recognising the experiences through which those patterns developed.
When we understand the context, the question can begin to change from: “Why am I like this?” to: “What did I learn, and what was that helping me navigate?” That shift matters. Not because everything should be blamed on the past, and not because every coping strategy needs to disappear, but because understanding creates choice.
Some patterns may still protect you. Some may reflect genuine parts of who you are. Others may have been necessary once but now cost far more than they give back.
Therapy helps us work out the difference.
Recovery isn’t about removing the person you became in order to survive. It’s about making sure survival isn’t the only thing shaping who you get to be now.
Frequently Asked Questions
How is Complex PTSD different from PTSD?
PTSD often develops following one or more traumatic events and is characterised by intrusive memories, avoidance and a heightened sense of threat.
Complex PTSD also involves these experiences but often includes additional difficulties with emotional regulation, identity, relationships and persistent feelings of shame or worthlessness following prolonged or repeated trauma.
Can childhood experiences still affect me as an adult?
Yes.
Experiences during childhood play an important role in shaping how we understand ourselves, relationships and the world around us. When early environments were unsafe or inconsistent, survival responses that made sense at the time can continue into adult life even when circumstances have changed.
Why do I struggle so much with relationships?
Relationships are often where Complex PTSD has its greatest impact.
If closeness once involved danger, criticism, inconsistency or rejection, it makes sense that trust, vulnerability or emotional intimacy may feel difficult. Therapy helps us understand these patterns with compassion rather than judgement.
Will I always feel this way?
No.
Although survival responses can feel deeply ingrained, our brains remain capable of learning throughout life. Recovery doesn’t erase the past, but it can help your nervous system develop new experiences of safety, connection and flexibility.
Why do I criticise myself so much?
For many people, self-criticism developed as a way of preventing rejection, avoiding mistakes or maintaining some sense of control.
Although it may once have felt protective, it often continues long after it is needed. Therapy helps us understand the function of self-criticism before gradually developing more compassionate and sustainable ways of relating to yourself.
Can therapy be delivered online?
Yes. Many psychological therapies can be delivered effectively online, depending on the individual and the type of therapy being offered.
I provide online therapy across the UK, as well as working internationally where appropriate and where professional and regulatory requirements allow. For people who prefer face-to-face therapy, I offer in-person appointments in Menai Bridge, Anglesey and Llandudno, Conwy, North Wales.
During the initial assessment, we can consider whether online or in-person therapy is the best fit and discuss any practical or clinical factors that may influence how therapy is delivered.
How Do We Start?
If the effects of prolonged or repeated trauma continue to influence your relationships, emotions, confidence or everyday life, you’re welcome to book a free 15-minute discovery call.
Together, we’ll explore how your experiences have shaped your nervous system, your relationships and the ways you understand yourself today. Rather than viewing these patterns as flaws to be removed, we’ll develop a shared understanding of the survival responses that once helped you cope and consider which of them may no longer be serving you.
Therapy isn’t about becoming the person you were before trauma. For many people, it’s about discovering the person who has been there all along, beneath years of adaptation, protection and survival. By making sense of your survival responses rather than judging them, we can gradually help your nervous system experience something that may once have felt out of reach:
The freedom to live a life that is guided by safety, connection and choice, rather than by survival alone.
If You Only Take One Thing Away…
Complex PTSD can shape far more than memories of what happened. It can influence how you experience emotions, relationships and yourself. Understanding how those patterns developed gives us the opportunity to decide which still protect you, which no longer serve you and what you want to become possible instead.