Complex post-traumatic stress disorder (CPTSD or C-PTSD) is recognised in ICD-11. It can develop after extremely threatening or horrific experiences, often repeated or prolonged, where escape was difficult. It can follow trauma in childhood or adulthood.

It includes PTSD symptoms: re-experiencing the trauma as if it is happening now, avoiding reminders, and a continuing sense of threat.

There are also persistent difficulties with emotion regulation, a deeply negative view of oneself, and relationships or closeness.

Complex trauma describes experiences; Complex PTSD describes a particular symptom pattern. Not everyone who experiences complex trauma develops CPTSD. Assessment considers symptoms, their impact and other possible explanations.

You may feel constantly on guard, have nightmares or flashbacks, avoid reminders, or struggle to feel settled. Strong emotions, emotional numbness, shame and difficulty trusting others can also occur.

Some people describe an “emotional flashback”: a sudden wave of fear, shame or helplessness without a clear visual memory. This phrase describes an experience; it is not a separate diagnostic test.

Dissociation may involve feeling detached, unreal or disconnected. These experiences can occur with CPTSD but also have other causes. New or unexplained symptoms deserve assessment.

A GP or qualified mental health professional can assess trauma symptoms, risk, daily functioning and coexisting conditions. You can ask how they understand your difficulties and what treatment they recommend.

Trauma-focused CBT and EMDR are recommended PTSD treatments. CPTSD care may need more time, support for trust and safety, and adaptations for dissociation, emotion regulation and relationship difficulties. Treatment should be agreed with you and paced appropriately.

Some people benefit from coping and stabilisation work alongside or before trauma processing. There is no single timetable for everyone, and needing support should not become a reason to indefinitely withhold suitable treatment.

Medicines may be considered for PTSD or related symptoms according to preferences, benefits and risks. Discuss sensitivities and side effects with your prescriber; do not change medication using this page.

Quick tool: “What is the plan? How will we adapt it? How will we know if it is helping?”

Sensory & neurodevelopmental: offer a quiet room, literal language, written summaries, predictable sessions and alternatives to eye contact. Sensory overload, autistic shutdown and trauma responses can overlap; they are not interchangeable.

Anxiety & autonomic: trauma-related arousal can affect bodily sensations. Palpitations, dizziness or fainting can also have physical causes, including dysautonomia; assess them appropriately.

Pain & bodily sensitivity: choose comfortable positioning and gentle grounding. Migraine and other pain deserve treatment alongside trauma care.

Laxity & connective tissue: if joint problems coexist, adapt seating, movement and physical exercises to avoid strain.

Immune & inflammatory: if allergy, MCAS or irritant sensitivity coexist, discuss tolerated spaces and materials. These conditions are not established consequences of CPTSD.

Mood & mental health: depression, anxiety and dissociation may need additional assessment and support. With FND, symptoms deserve their own neurological explanation and care; trauma is not required for an FND diagnosis.

ALPIMS is an organising framework, not a diagnostic model. These are practical adaptations for overlapping needs, not proof that trauma causes another condition.

Rest, reduce load, regulate, pace and expand can organise practical support. Expansion is optional, guided by your goals and capacity, rather than pressure to push through symptoms.

A meaningful step might be accepting help, returning to an enjoyable activity briefly, or asking for an accommodation. Recovery can be uneven; a difficult day does not erase progress.

Quick tool: “What matters to me? What is one manageable way to support it?”

Clinical explanations and treatment information draw on the NHS and NICE resources above. Practical prompts and ALPIMS adaptations are suggestions, not validated clinical tests. Linked organisations do not endorse ALPIMS.

If you are in immediate danger, have seriously harmed yourself, or cannot keep yourself safe, call 000 or go to an emergency department.

For crisis support, contact Lifeline on 13 11 14. For domestic, family or sexual violence support, visit 1800RESPECT.

For ongoing or worsening distress, increasing dissociation, or major difficulty managing daily life, seek help from your GP or treating team. Ask for a support plan that fits your communication and access needs.

This page does not diagnose CPTSD, provide personalised treatment or replace medical or psychological care. Diagnosis requires professional assessment; experiencing some of these difficulties does not establish CPTSD.

Tools are optional and may not suit everyone. Pause if they increase distress and discuss alternatives with a qualified clinician. Avoid processing traumatic memories on your own using this page.

New, severe or unexplained physical symptoms should not automatically be attributed to trauma. Coexisting conditions need their own assessment and treatment.

Share only what you choose. You do not need to disclose trauma details here. This page has no forms and does not save your answers. External services have their own privacy policies.