Trauma · Treatment guide
Complex Trauma / C-PTSD
Prolonged, repeated interpersonal trauma with disturbances in self-organization, affect, and relationships.
In this guide
Overview
Complex trauma requires phase-based treatment: safety/stabilization → processing → integration/reconnection (Herman). Single-shot trauma protocols often destabilize without preparation. Parts-based and somatic approaches are well-suited.
First-line treatments
- IFS — Internal Family Systems
Strong fit — explicit work with protectors before approaching exiles.
- SE — Somatic Experiencing
Restores nervous-system regulation underneath the cognitive content.
Also consider
- Schema
Maps maladaptive schemas formed in chronic invalidation; uses limited reparenting.
- EMDR
Adapted with extended resourcing and titration.
- DBT
When emotion dysregulation and self-harm are prominent (DBT-PTSD adaptation).
- CFT
Addresses pervasive shame; builds the soothing system absent from early environment.
Cautions
- Skipping stabilization is the most common error and the main cause of destabilization.
- Therapist self-of-the-therapist work matters — vicarious trauma is real.