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Complex Trauma or Complex Post-traumatic stress disorder (C-PTSD) is a mental health condition that can emerge following exposure to repeated or prolonged traumatic experiences. Experiencing a traumatic event can lead to PTSD symptoms and may require therapy to cope with the aftermath. Experiencing complex trauma can lead to a range of trauma symptoms, which may include emotional disturbances, physical symptoms, and psychological issues. Unlike in single incident PTSD, complex trauma involves multiple traumatic experiences, often including childhood trauma, and may involve:
Complex post-traumatic stress disorder (C-PTSD) is a diagnostic category in the International Classification of Diseases, 11th Edition, and consists of six symptom clusters.
These symptom clusters are:
These symptoms make you feel as though you are re-living the event and include flashbacks, nightmares, and painful memories. These symptoms are often accompanied by changes to our nervous system where we feel high levels of arousal, fear, distress etc. The symptoms themselves can also be highly distressing. These symptoms can also manifest as physical symptoms such as sleep problems, fatigue, and body aches.
Avoidance symptoms include urges and/or efforts to avoid triggers of the traumatic memories, which can include external stimuli such as places, people, sensory information (smells, sounds etc) and environments, as well as internal stimuli such as the traumatic memories themselves and certain thought patterns. We may avoid triggering stimuli physically, though we also may escape through changes to our nervous system, such as via using dissociation where our mind detaches or disconnects from present internal or external experiences.
Hypervigilance means that one’s nervous system is prepared for something threatening to occur, even in the absence of anything threatening within the environment. This results in feelings of being hyperaware of one’s environment and/or oneself, as well as feelings of being on edge and unable to relax.
Emotional dysregulation involves difficulty identifying, understanding, and regulating emotional states. Compounding this may be heightened emotional sensitivity or reactivity where when triggered, emotions elevate very rapidly. Individuals may struggle with managing very specific emotional states and/or a whole range of emotions. In addition, individuals may turn to unhelpful or destructive ways to manage or escape painful emotions.
Complex trauma can make relationships challenging. The trauma may have led to unhelpful beliefs about relationships, such as that “others are unsafe,” or that “others will abandon me.” Individuals may unconsciously play out patterns related to their trauma within their relationships which can have the impact of sabotaging or undermining their connections to others.
Complex trauma impacts our sense of self and can lead to painful changes in our relationship with ourselves. For example, trauma can leave us with a profound sense of shame and self-loathing. We can feel inadequate, defective, or not good enough. The impact of these changes is pervasive and can flow through to our experience of mood, our capacity to function day to day, and our relationships with others. Complex trauma can also lead to low self-esteem, affecting one’s mood and capacity to function day to day.
At Cova Psychology, our approach balances drawing from evidenced based therapeutic techniques with tailoring these treatments to each individual’s experience and symptoms. For complex trauma we utilise a range of therapies to work through 3 recommended stages of treatment which include:
A trauma psychologist in Melbourne can guide you through these phases of treatment, offering both in-person and Telehealth appointments.
This phase of treatment involves helping clients to stabilise their emotional states by increasing emotional regulation and distress tolerance skills. Clients may be equipped with a whole range of skills including relaxation, mindfulness, grounding, self-soothing, and skills for managing heightened emotion and experiences of dissociation.
Often the skills learnt in safety and stabilisation are important components of the next phase, trauma processing. In this phase, clients target traumatic memories in therapy with a goal to reduce their emotional impact as well as shift unhelpful beliefs that may have been stored within the memory.
This phase involves assisting clients to achieve the goals and milestones that they have struggled to reach due to the experience of Complex PTSD. These may be goals related to work and vocation, reaction and leisure, socialising and relationships, or other major domains of life that have been impacted by the trauma.
A trauma psychologist in Melbourne is available to help you navigate these stages.
Our Melbourne psychologists use a range of evidenced based therapies to help clients work through the three stages of complex trauma treatment. These psychological treatments include:
Cognitive behavioural therapy (CBT): Cognitive behavioural approaches involve assisting clients to identify unhelpful or destructive thought patterns, perpetuating behaviours, and painful emotions states. The therapy assists clients to move to more helpful and self-enhancing ways thinking, feeling, and behaving.
Eye movement desensitisation reprocessing (EMDR): EMDR Therapy is a type of therapy specifically designed to treat PTSD though we also us it treat anxiety disorders more broadly. EMDR involves targeting traumatic memories whilst engaging in bilateral stimulation where the client’s eyes are directed to move from side to side. Through this process, the degree of intensity of the emotional charge is reduced whilst unhelpful beliefs are also modified. Cova Psychology is a leading provider of EMDR in Melbourne, and all of our psychologists are trained in this innovative form of trauma therapy.
Mindfulness-based interventions: These interventions include Mindfulness based Cognitive Therapy and Acceptance and Commitment therapy (ACT). They have a focus on connecting with the present moment and assisting clients to let go of unhelpful ways of thinking and attending to values based activities in the here and now.
Schema Therapy: Schema therapy is an advanced form of CBT which targets unhelpful ways of thinking that are often linked to childhood or attachment trauma.
Acceptance and Commitment Therapy (ACT): ACT is a type of therapy which combines mindfulness strategies, connecting with one’s values, accepting and regulating emotional states, and commitment to engaging in helpful and values-aligned behaviours.
Compassion-based and attachment-based therapies: These therapies focus on developing self-compassion and understanding past relationships and their impact on current behaviour and emotions.
Dialectical Behaviour Therapy (DBT): This therapy helps clients learn valuable coping skills which are often an important component of the safety and stabilisation phase of trauma treatment. These skills help to regulate emotions and tolerate distress, which allow client’s to access and process their traumatic memories safely.
Cognitive Processing Therapy (CPT): CPT is a form of CBT and is structured approach where clients process traumatic events linked to PTSD through a cognitive behavioural approach. This is most often done by writing down or recording recollections of trauma memories.
Prolonged Exposure Therapy: This therapy is also a form of CBT which teaches clients to gradually approach trauma memories and either triggers or environments associated with trauma. Clients are taught coping skills to enable this work to be done safely.
Our experienced Melbourne psychologists will collaboratively work with you to design a treatment plan, which may involve one or more of these therapies, based on a comprehensive psychological assessment which explores your current mental health, your preferences, and your history. We offer trauma therapy in Melbourne, including options for both in-person and telehealth appointments.
If you or a loved one may be experiencing Complex Trauma our Melbourne psychologists and trauma therapists are here to help. We are located in the Melbourne CBD and offer both in-person and telehealth appointments. Recognising trauma symptoms is a critical step in the therapeutic process, and our psychologists are here to help you through it. Get in touch with our friendly reception team to book an appointment by either:
Let’s discuss your needs and match you with the right Melbourne psychologist.
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Let’s discuss your needs and match you with the right Melbourne psychologist.
Let’s discuss your needs and match you with the right Melbourne psychologist
Acknowledgement of Country
Cova Psychology acknowledges the Traditional Owners of the land where our Melbourne CBD practice is located—the Wurundjeri Woi-wurrung and Bunurong/Boon Wurrung peoples of the Kulin Nation. We pay respect to their Elders, past and present, as well as the Elders of other Aboriginal communities in Melbourne and beyond.
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We would like to acknowledge the Traditional Owners of the land on which the practice is located. We pay our respects to their Elders, past and present, and the Aboriginal Elders of other communities who may be here today.
