Online Counselling for Complex Trauma (C-PTSD)

What Is C-PTSD?

Complex post-traumatic stress disorder (C-PTSD) is a diagnosis in ICD-11, the World Health Organization’s international classification of diseases. It can follow trauma that was prolonged or repeated and hard or impossible to escape, such as long-term abuse in childhood. A person with C-PTSD has the symptoms of PTSD and, in addition, lasting difficulties in three areas:

• managing emotions
• how they see themselves, often as diminished, defeated or worthless, with shame or guilt
• staying in relationships and feeling close to others

The US diagnostic manual, DSM-5-TR, does not list C-PTSD as a separate diagnosis. Some of the same difficulties are covered there under PTSD.

Common Concerns

People often come to counselling for complex trauma with concerns such as:

• feeling on guard, tense or easily startled much of the time
• feeling numb, shut down or far away from your own life
• strong reactions that seem bigger than the situation
• harsh self-criticism or a deep sense of shame
• relationships that feel unsafe, or hard to keep

You do not need a diagnosis to start. Many people simply sense that old experiences still shape how they feel and act today.

Can C-PTSD Cause Anxiety or Depression?

C-PTSD, anxiety and depression can occur together, and some signs overlap, such as feeling on edge, sleeping badly or feeling worthless. Sessions can work with all of them. See also counselling for anxiety and depression.

What Kind of Therapy Is Best for C-PTSD?

No single approach has been shown to be best. A 2019 review of 51 trials looked at symptoms of complex PTSD. Trauma-focused therapies, including CBT, reduced PTSD symptoms and also helped with negative self-image and relationship problems. Few trials measured difficulties with emotions, and people whose trauma began in childhood tended to benefit less (Karatzias and colleagues, 2019).

The International Society for Traumatic Stress Studies notes that C-PTSD may need longer or more varied treatment. It describes flexible approaches that combine several methods as promising, though they still need more research.

What Kind of Therapist Is Best for Trauma?

Look for someone trained in trauma-focused approaches who explains how they work and lets you set the pace. Feeling able to be honest with them can matter as much as the method. The free intro call is a chance to find out.

How Long Does Counselling for C-PTSD Take?

It varies from person to person, and the number of sessions is reviewed together as you go. Because C-PTSD most often follows prolonged or repeated trauma, treatment may take longer than after a single event.

How Sessions Work

Sessions are online and last 60 or 90 minutes. They combine two kinds of work: steadying, with skills for handling strong reactions, and work on past trauma, which often shows itself in present reactions and relationships. The balance shifts with what you bring each time, rather than following fixed stages. You decide what you share and when.

How online sessions work explains what a session needs.

Methods Used

Sessions combine several approaches, chosen for what you bring:

• Somatic work drawn from Somatic Experiencing, for noticing how stress shows up in the body and finding ways to settle it.
• Parts work drawn from Internal Family Systems (IFS), for understanding the parts of you that protect against old pain.
• Narrative therapy, for separating who you are from what happened to you.
• CBT techniques and mindfulness, for practical tools to use between sessions.

Trauma Counselling in Yangon, Bangkok or Chiang Mai

If you are looking for a trauma therapist in Yangon, Bangkok, Chiang Mai or elsewhere in Myanmar or Thailand, sessions take place online. They are open to you wherever you live in either country.

• Online counselling in Myanmar
• Online counselling in Thailand

Fees

Couples and families are the same price.