Complex PTSD often doesn’t look like the trauma we see in films. There may be no single event, no obvious flashback and no clear ‘before’. Instead, it can show up as a constant sense of not being good enough, never fully switching off, struggling in relationships or feeling numb, often in someone who seems to be coping well.
By Dr Gurpreet Kaur, Clinical Psychologist. 25+ years in mental health, 15+ as a Clinical Psychologist, including treating people with PTSD at the Traumatic Stress Service at Springfield Hospital in Tooting, London.
What makes complex PTSD different?
With PTSD after a single event, many people can remember a different version of themselves before it happened. Complex PTSD usually grows over time, often in childhood or in close relationships. So there may be no clear ‘before’.
PTSD
There is often a ‘before’. It can feel like: “Something happened to me.”
Complex PTSD
There may be no clear ‘before’. It can feel like: “This is just who I am.”
That’s what makes it so hard to spot. I explain the differences in more detail on my online PTSD therapy page.
8 signs of complex PTSD you might not recognise
You feel ‘not good enough’, however much you achieve
Praise doesn’t land. Success feels like luck. There’s a quiet belief that something about you is wrong, and you’re waiting to be found out.
You can’t fully switch off
Even on holiday or at the end of the day, part of you stays on alert. Rest can feel uncomfortable, so you keep busy.
You feel numb or far away
Sometimes you go through the motions without feeling present. You might lose time or feel detached from your body. This is sometimes called dissociation.
Your reactions feel bigger than the moment
A small comment can bring a wave of anger, panic or tears, followed by shame. Often it isn’t really about now. Something old has been touched.
Relationships feel unsafe, even good ones
You might people-please, avoid conflict at all costs, or pull away when someone gets close. Trusting that people will stay can feel very hard.
You don’t always know what you feel or need
If your feelings weren’t welcome growing up, you may have learned to put them away. Being asked “what do you need?” can draw a blank.
Your body carries it
Many people notice tension, exhaustion, poor sleep, headaches or stomach problems that never quite settle. The body often holds what the mind has learned to push down.
You don’t think it ‘counts’ as trauma
“Other people had it worse.” “Nothing really bad happened.” Minimising is very common, especially when the hurt came from neglect, criticism or what was missing.
Why complex PTSD is so easy to miss
There are many layers
There often isn’t one single event that helps you make sense of how you feel.
It feels normal
When something has always been there, it’s hard to see it as a reaction to what happened.
It can be passed down
Patterns in families and cultures can carry hurt across generations without anyone naming it.
You may look like you’re coping
Many people carry complex PTSD quietly behind a busy, capable life.
You can be capable and struggling at the same time. Both are true.
Complex PTSD and imposter syndrome
Many people first come to me because of imposter syndrome. They’re good at their jobs, often very good, but they don’t feel it. Every success feels borrowed, and they’re waiting to be found out.
Underneath, there’s often an older belief. For some, imposter feelings sit on top of complex trauma, such as years of criticism, having to earn approval, or being the one who held everything together. Work environments can press on exactly those places.
“I’m not good enough” is often not a thought about work. It’s an old belief that work keeps touching.
That’s why I work with trauma. Tips and confidence strategies have their place, but when the roots are older, working with what sits underneath can sometimes shift what strategies haven’t. You can read more about the root causes of imposter syndrome.
Culture, family and the burdens we carry
Trauma never happens in a vacuum. Culture, family history, gender, race and class all shape what happens to us, how we respond, and whether anyone names it as trauma at all. This overlap is sometimes called intersectionality.
For some people, especially those growing up between cultures, this can look like:
- Taking on adult responsibilities early, like caring for siblings or translating for parents
- Family burdens passed down, including losses and hardships from earlier generations that were never spoken about
- Strong expectations to succeed, to keep the peace or to protect the family’s reputation
- Silence or shame around mental health
- Experiences of racism or discrimination that build up over time
None of this means a family or a culture is ‘bad’. Families often carry real love alongside real hurt. Both can be true.
Alongside my clinical training, I pay close attention to this wider context. We work with your story as it really is, including the parts of your culture and family that matter to you and that you want to keep.
How I work with complex PTSD
Complex PTSD usually needs therapy that goes at the right pace and works with the layers. In my work that often means:
Safety and pace first
We build ways to steady yourself before any memory work.
Understanding your story in context
Not just what happened to you, but what surrounded it: family, culture, generations and work.
EMDR
To help the brain process memories that still feel raw.
IFS (Internal Family Systems)
To get to know the parts of you that learned to protect you, like the inner critic, the over-achiever or the part that keeps the peace.
Reclaiming your life
The aim isn’t only to process the past. It’s to reclaim the parts of life that trauma took or put on hold, like rest, closeness, confidence and joy. This matters whether PTSD followed one event, several events, or grew over many years.
It may take longer than therapy for a single event, and that’s okay.
Could an EMDR intensive help?
An EMDR intensive brings several hours of focused trauma therapy together over a short period, online, instead of one hour a week for months. For some people with complex PTSD, it can be a way to work on what sits underneath without stopping and starting each week.
Free guide
Is an EMDR intensive right for me?
Not ready to book yet? Get my free 10-minute self-check. A gentle way to think through whether focused trauma therapy could suit you right now, sent to your inbox.
A gentle note
Reading a list like this can stir things up. If something here touched a nerve, go gently with yourself. If you’re struggling right now, you can call Samaritans on 116 123 or NHS 111 (option 2 for mental health). In an emergency, call 999.
If you’ve spent years thinking this is just who I am, I’d gently offer another possibility. It may be what happened to you. And that is something that can be worked with.
About Dr Gurpreet Kaur
Clinical Psychologist (HCPC registered), EMDR and IFS practitioner. 25+ years in mental health, 15+ as a Clinical Psychologist. I work online with adults across the UK, including people carrying hidden hurts behind a capable life.
Related reading
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