PTSD & Complex Trauma

Post-Traumatic Stress Disorder (PTSD) can develop as a result of experiencing an overwhelming trauma that threatens your safety or makes you feel helpless. Being witness to or personally involved in physical or sexual abuse, rape, combat, domestic violence, an accident, and/or a natural disaster can lead sufferers of the event to experience symptoms such as intrusive thoughts, memories and/or nightmares, mood swings such as depression and severe anxiety, difficulty with concentration and sleeping, and feelings of being ‘on edge’.

People suffering from PTSD usually experience intense emotional reactivity as well as avoidance symptoms such as avoiding people, places, and memories that bring up images of the trauma.   Individuals with PTSD often engage in high-risk behaviors such as self-harm, alcohol and/or drug abuse as a coping strategy as well as experiencing difficulty trusting others, increased sensitivity to others, hypersensitivity, difficulty with assertiveness, and unstable relationships. Research shows that early treatment of PTSD prevents symptoms from growing worse.

PTSD can arise from the following:

  • Natural disasters
  • War
  • Car or plane crashes
  • Rape
  • Sexual Assault
  • Physical abuse
  • Childhood neglect
  • Terrorist attacks
  • Kidnapping
  • Sudden death of a loved one
  • Shattering event that leaves you feeling stuck, helpless, and hopeless

Signs of PTSD and Complex Trauma

  • Intrusive, upsetting memories of the event, nightmares, and/or flashbacks
  • Avoidance of any triggers of the trauma, including intense physical reactions to reminders of the event like sweating, heart palpitations, nausea, and vomiting
  • Increased anxiety, agitation, and outbursts of anger
  • Detachment and loss of interest in activities and life in general
  • Hypervigilance
  • Suicidal thoughts and feelings
  • Substance Abuse



Complex trauma is a relatively new term that was developed to refer to traumatic events or experiences that are particularly complicated by the fact that they are interpersonal in causation and usually committed by someone related or known to the victim. This very fact makes the feelings of betrayal even more traumatic. Additionally, trauma of this sort most often begins in childhood, occurs repeatedly, progresses in severity over time, and is a set-up for additional re-victimization over the entire lifespan.

Rather than a single event trauma, the impact of ‘complex trauma’ is compounded and cumulative. Complex trauma usually originates in childhood and is often found in victims who have been abused sexually, physically, and emotionally. It affects the individual’s identity and ability to form trusting relationships with others.

How can DBT help?

DBT is a powerful and effective method of thought control where individuals are taught skills to deal with unpleasant thoughts and situations causing them suffering. Through acceptance and change strategies patients learn to:

  • Become aware of triggers causing negative reactivity
  • Practice self-soothe strategies to calm mind and body
  • Learn Distress Tolerance skills to deal with uncomfortable thoughts, feelings, and situations

DBT and Prolonged Exposure (PE) protocols are used to treat PTSD and Complex Trauma if indicated. Prolonged Exposure is based on the theory that PTSD is maintained when individuals avoid thoughts and memories of the trauma as well as people, places, activities, and situations that are associated with the trauma.

This treatment focuses on helping individuals approach trauma-related memories and situations that have been avoided and through repeated exposure, the distress that these memories cause decrease and symptoms of PTSD improve. Through real-world exposure, the individual is guided to take control of thoughts and feelings about the trauma to the point that it is no longer psychologically disruptive and leads to peaceful resolution.