Understanding Complex PTSD
"In my years of experience, I’ve seen that healing from complex trauma happens through connection. As safety is established, awareness grows, and tools for somatic release and regulation are developed, individuals can rediscover meaning and connection after years of feeling stuck and isolated."
- Emily Hackenburg, FNP
Most people have heard of Post-Traumatic Stress Disorder (PTSD)
Often connected to a single life-threatening or overwhelming event like an accident, assault, or natural disaster. This type of trauma is sometimes called “big T trauma.” But trauma doesn't always happen in isolated moments. For some, it unfolds over time—through repeated harm, chronic neglect, or environments where they felt unsafe or powerless.
PTSD typically develops after a specific traumatic event and can include:
Re-experiencing symptoms
Flashbacks, nightmares, and intrusive thoughts related to the trauma
Avoidance symptoms
Avoiding places, people, or conversations that bring up memories of the trauma
Mood and emotional changes
Guilt, shame, hopelessness, or feeling emotionally disconnected or numb
Hyperarousal
Trouble sleeping, irritability, difficulty concentrating, or feeling constantly on edge
But trauma doesn't always happen in isolated moments. For some, it unfolds over time—through repeated harm, chronic neglect, or environments where they felt unsafe or powerless.
This is where Complex PTSD (C-PTSD) comes in.
C-PTSD results from prolonged or repeated trauma, especially in early life or situations where someone felt trapped, helpless, or chronically unsafe—such as childhood abuse, emotional neglect, or long-term domestic violence.
While C-PTSD shares many features with PTSD, it often includes additional, more persistent symptoms such as:
Emotional regulation difficulties: Intense or unpredictable emotions that feel hard to manage or understand
Negative self-beliefs: Deep-seated feelings of worthlessness, shame, or being fundamentally damaged
Relational struggles: Difficulty trusting others, maintaining boundaries, or feeling safe in connection
Because of its complexity and the ways it impacts multiple areas of a person’s life, C-PTSD typically requires a comprehensive and long-term treatment approach—one that goes beyond addressing trauma memories to also support emotional healing, nervous system regulation, and relational repair.
Integrative Treatment Approaches for Complex PTSD
Because C-PTSD touches so many aspects of a person’s well-being, treatment often calls for a blend of therapeutic modalities that address emotional, physical, and relational dimensions. Below are some of the methods frequently used in treatment:
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Cognitive Behavioral Therapy (TF-CBT) helps reframe negative thought patterns and build healthier coping tools.
Dialectical Behavior Therapy (DBT) supports emotional regulation, relationship skills, and mindfulness—especially helpful for managing the ups and downs of C-PTSD.
Eye Movement Desensitization and Reprocessing (EMDR) reduces the emotional charge of traumatic memories and supports resolution over time.
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Somatic Experiencing focuses on bodily sensations to gently release trauma stored in the nervous system.
Trauma-informed yoga offers a grounding way to reconnect with your body and build emotional resilience.
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Explores early life experiences and unconscious patterns that shape emotional responses, helping bring deeper understanding and healing.
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Mindfulness-Based Stress Reduction (MBSR) teaches breath and body awareness to reduce stress and regulate the nervous system.
Regular meditation can support emotional regulation, reduce reactivity, and help cultivate a sense of inner stability.
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Antidepressants or anti-anxiety medications may ease symptoms enough to make therapy more accessible.
Sleep aids can help restore healthy rest, which is critical for healing from trauma.
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Art therapy, music, and dance offer powerful, non-verbal ways to process emotions and express what may be hard to say out loud.
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Support groups or peer communities provide shared understanding and reduce the sense of isolation that often accompanies complex trauma.
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In a safe, therapeutic setting, ketamine can support neuroplasticity and emotional breakthroughs, especially when traditional approaches haven’t been effective.
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Practical tools to stay present and connected to the here and now—especially helpful during moments of distress or flashbacks.
Healing from C-PTSD is a gradual, non-linear process that takes time, patience, and the right kind of support. Because it impacts emotional well-being, nervous system function, and relationships, treatment often requires a comprehensive, personalized approach. By integrating multiple therapeutic modalities, care can support the restoration of safety, emotional regulation, and the capacity for meaningful connection—with yourself and others.
If you’re looking for support with PTSD or complex trauma therapy in New York, we’re here to help. We offer personalized, evidence-based care grounded in compassion and connection. You don’t have to navigate this alone.