Understanding Trauma and CPTSD
Are you simultaneously too sensitive and too detached? Maybe your emotions feel overwhelming one day and completely absent the next, or you’re stuck in the same relationship patterns no matter how many attachment books you read. Somehow, you’re struggling to trust people, people pleasing, avoiding people, and lonely all at the same time. When you are alone with yourself, you’re a perfectionist, your mind races, and you have a constant sense that something is wrong with you. You may look successful on the outside while privately feeling exhausted from holding everything together.
If any of this sounds familiar, trauma may be part of your story.
Signs of complex trauma
Some signs of post-traumatic stress (also called PTSD, or simply "trauma"):
- Intrusive negative thoughts, memories, or nightmares
- Avoiding certain people, places, or things, or trying hard not to think of certain things
- Emotional numbness or feeling detached
- Memory problems, or not being able to remember certain events or periods of time
- Trouble sleeping
- Trouble concentrating
- Being easily startled or frightened
- Being on guard for danger
Complex post-traumatic stress (also called CPTSD or complex trauma) can include anything from the above list, but often also includes:
- Dissociation
- Mood swings and heightened emotions (sometimes called “emotional flashbacks”), like fear, anxiety, anger, sadness, and impulsiveness
- Ongoing challenges in maintaining healthy relationships, like conflict or avoidance
- Breakdown in your identity or sense of self (not really feeling real or knowing who you are)
- Suicidality
Closely related to CPTSD are experiences like:
- Insecure attachment strategies (also called “attachment styles”) like disorganized attachment, anxious attachment, and avoidant attachment
- Digestive disorders, chronic fatigue, stiffness, and pain
- Addictions to substances, or processes like skin picking, online shopping, app games, doom scrolling, and eating disorders
- Borderline Personality (BPD)
- Dissociative identities (DID), plurality, multiplicity, or OSDD (“other and unspecified dissociative disorders”)
- Functional trauma from chronically unmet needs around autism and ADHD
If this sounds like you, there's hope.
You’ve probably heard of fight or flight. The longer list also includes fawn (a strong urge to appease and people-please as a survival strategy), freeze and collapse (when you totally shut down). These are the moves your body learned because they worked, at least in keeping you safe enough to make it here.
Therapy fails trauma survivors when it tries to argue you out of these responses, or simply empathizes with the symptoms without offering you the tools to actually transform what is happening in your brain. With me, we will get curious about your nervous system, understand what you’re protecting, and help your brain update its threat assessment now that you’re older, and likely safer and more resourced. Over the past several decades, trauma treatment has evolved significantly. We now understand that healing involves more than simply talking about painful experiences. Trauma is held not only in your memories but also in your body, emotions, beliefs, and relationship patterns.
When we miss out on an important experience, especially in childhood, there is often a part of us that is still waiting for that need to be fulfilled. Luckily, our brains are neuroplastic, adaptable, and changing all the time. As we continue to have new experiences in life, our brain is checking in with itself: With this new information, does it make sense to keep running the existing programs?
Trauma resolution is not about changing your personality, blocking out memories, or forcing yourself into new habits. Instead, it’s about allowing yourself to be exactly who you are, comfortably and without shame. It’s very possible.
You do not need a diagnosis to access trauma therapy.
I use a non-pathologizing kind of therapy model that does not require diagnostics. Of course, any diagnosis you have received, agree with, and/or suspect is important to incorporate. Still, this work is open to everyone regardless.
• How trauma therapy works •
The basics of what to expect.
1. Free Consult
A 20-minute video call. We talk about who you are, what you’re looking for, and answer your questions.
2. Intake
A full session to map your history, current life, trauma recovery goals, and what safety looks like for you.
3. Modules
Weekly or biweekly sessions following your unique treatment plan: somatics, EMDR, IFS, and skills.
4. Reassess
We check in regularly about how your life is changing, and modify direction and pace to get you great results.
Resources and Tools.
Whether we’re doing therapy together or not, you may find these resources and tools valuable.
This worksheet is used in Nonviolent Communication (NVC) to help people better express a whole range of emotional states. They can also help people more easily connect to what they need in the moment.
Internationally recognized clinical psychologist, EMDR expert, and author Laurel Parnell, PhD demonstrates a simple bilateral tapping technique to calm yourself down when you feel anxious.
A flow chart adapted from Ruth Lanius, MD, PhD, illustrating how the nervous system figures out what to do during a crisis. Your nervous system needs to make the choice between flee, fight, freeze, or collapse almost immediately.
Frequently asked questions.
What is EMDR?
EMDR stands for Eye Movement Desensitization and Reprocessing. It is a trauma therapy originally developed for veterans, which has since expanded to support people living with all kinds of disturbances and traumatic life experiences. If it’s the right fit for you, EMDR can successfully transform depression, anxiety, phobias, nightmares, flashbacks, and all kinds of negative beliefs we hold about ourselves.
EMDR is a structured 8-phase treatment which is often best used in extended 75 minute sessions.
You can learn more about EMDR here.
What is IFS?
IFS stands for Internal Family Systems. It is a mindfulness-based therapy originally developed for behavioral concerns like self harm and eating disorders, which has since expanded to support people living with all kinds of self-protective behaviours and internal conflicts. If it’s the right fit for you, IFS can successfully calm your nervous system, build self compassion, and help you connect to your true self.
IFS is a practice that can be incorporated into other therapy models, or done as a whole session on its own. Like other practices (imagine: yoga, writing, exercise), IFS gets easier the more you do it, and benefits from consistent attention. This is why I like to use IFS as a stand-alone therapy module, as well as a ritual for beginning or ending sessions, and for reassessing treatment goals.
What is somatics?
Somatic therapy is a generic term for any therapy that prioritizes the body: how it feels, moves, and responds to emotions. If it’s the right fit for you, somatic therapy can support you with chronic pain and chronic pain, as well as anxiety, depression, CPTSD, or trauma.
Somatic therapy is a practice that can be incorporated into other therapy models, and honestly makes most therapy work better. That’s why I always bring in somatic resourcing tools to the treatment plan as early as possible.
You can learn more about somatics here.
How do you integrate nature?
I am trained as a Certified Forest & Nature Therapy Guide. This means that, if it’s a good fit for you, I love to take walk-and-talk sessions on good weather days. Being outside in a quiet, green area is naturally supportive to human healing.
I also offer intensives and community events which lead you through quiet nature invitations. These are amazing for slowing down and quieting the mind and body, and they are also joyful, connective, and fun to experience with family and friends. If you are interested in a nature therapy intensive, let me know during your treatment planning, or email me anytime at milo@therapywithmilo.com
How do you integrate personal spirituality?
Spirituality is intensely personal, and always something that is client-led in my therapy sessions. Many trauma survivors, especially those who have experienced religious trauma or cult abuse, have a lot of protection up around the idea of spirituality in general, and that makes so much sense! Spirituality is never mandatory, and atheists are extremely welcome in my practice.
At the same time, many trauma survivors experience a lot of relief and transformation connecting to something “bigger” or something that can bring meaning to the pain that they have been through, and spiritual or cultural practices are one way this can be done.
Many of my clients identify as pagan, witches, astrologers, tarot readers, or mystics as part of their path toward reclaiming spiritual agency after a lifetime of abuse or neglect. Others connect to their cultural roots, folklore, ancestors, or spirits of the land. Still others dive deep into a large religious tradition like Buddhism, Christianity, Islam, Judaism, or Hinduism, whether or not it was the tradition they were raised in. I am trained in ways to utilize your personal spiritual beliefs as a powerful resource in your trauma healing, as well as support you in using them in session to make therapy more effective.
Feel free to ask me how we can adapt this practice to your needs.
How can you tell if it's CPTSD, BPD, OCD, autism, or ADHD?
Each of these has specific diagnostic criteria, but in my practice, I do not currently offer assessments for psychiatric conditions. That said, I have a lot of fluency in neurodivergence and trauma, and there are plenty of ways to make sure that the work we are doing is safe for the specific brain you have.
No one’s brain is one-size-fits-all, so the therapy we do together will always be adapted to your needs. If you already have a diagnosis you agree with, that it great, we will make sure to incorporate accommodations into the therapy work. If you aren’t sure exactly what your suspected neurodivergence might be, that’s okay too. There are lots of ways for us to test and experiment to make sure that the therapy we are doing together is creating the kind of results you are looking for.
Can I have trauma even if I wasn't physically abused?
Yes. Physical abuse is one experience that can sometimes be stored in the body as trauma. However, it is not the experience itself that defines whether or not something is traumatic: it’s the way that your body adapts to the shock of nervous system overwhelm.
A very incomplete list of things that can cause trauma:
- Serious accidents or injuries, or witnessing a serious accident or injury.
- Neglect, or being left alone for long periods of time as a child.
- Emotional neglect, growing up without emotional support, validation, or consistent care.
- Witnessing domestic violence or experiencing high-conflict relationships.
- Sudden or complicated losses.
- Bullying or ongoing harassment.
- Ongoing microaggressions, sexism, racism, homophobia, ableism, or transphobia.
- Serious illnesses, hospitalizations, or surgeries.
- Repeated exposure to violence or disturbing events through the media.
- Living in unstable or unsafe conditions; going without food, clothing, shelter.
How do I know if I'm dissociating?
Dissociation our brain learns how to do in response to overwhelming stress, trauma, or emotional overload. Your mind creates distance from an experience that feels too intense, threatening, or difficult to process in the moment. Sometimes, though, people notice that the dissociation starts to happen more frequently, even when life feels safe, being triggered by things you might not classify as “objectively overwhelming”. It can be frustrating!
It looks different from person to person, but it’s generally characterized by your brain involuntarily creating distance from your emotions, body, memories, surroundings, or sense of self. This can look like numbing out, losing track of time, or finding it difficult to remember parts of your day. In more extreme cases, it can feel like you’re watching yourself from outside your body or experiencing the world as foggy, dreamlike, distant, or unreal for long periods of time.
Often, it can show up in relationships: struggling to stay present when discussing difficult topics, or even spacing out during what could be positive interactions like cuddling, hugs, or sex!
If you think you dissociate, definitely let me know, because it will probably happen during therapy too. We can put a plan together to go slow and keep you grounded through trauma processing.
Do I have to talk about my trauma in therapy?
No! You do not need to share every detail of what happened to benefit from therapy.
I am trained in some specialized techniques like Flash (a kind of EMDR), Deep Brain Reorienting, and somatic IFS, which can successfully resolve trauma without ever having to tell me what happened.
It makes sense to worry that trauma therapy might mean retelling painful experiences over and over again. While I want to understand you and your history, I don’t want you to have to relive anything, or go into that intellectualizing mode where you “recap” the story in the same way you always do.
You are never expected to share more than feels safe. Also, you can tell me anything, and it won’t be too much for me.
What if I am in crisis right now?
If you are having thoughts of suicide or a huge emotional reaction that you are not sure how to respond to, call one of the numbers below. You can also call if you have a loved one who you think needs help, but aren’t sure what to do. Here are some options:
- Brite Line 1-844-702-7483. Edmonton’s LGBTQ+ mental health and wellness helpline, available 24/7. Answered by trained LGBTQ+ volunteers and allies. If a staff member is not available to answer, your call will be directed to the Edmonton Distress Line, 211 or 988 dependent on your needs.
- Distress Line: 780-482-4357. Trained volunteers respond to individuals needing emotional support, information, and/or referrals. Uses call tracing and will call 911 and/or police if caller is at high risk to imminently harm self or others.
- Alberta’s One Line for Sexual Violence: 1-866-403-8000. Talk, text, and chat service that provides emotional support, information, and referral to anyone who has experienced or been impacted by sexual violence. Uses call tracing and will call 911 and/or police if caller is at high risk to imminently harm self or others. Available 9am-9pm.
- Access 24/7: 780-424-2424. Run by Alberta Health Services, available 24/7. A central hub for urgent services and centralized intake for all AHS-funded mental health services. Available to concerned friends and family. Interactions with Access 24-7 appear on your health record. Collaborates with police if there is concern that a person requires hospitalization due to high, imminent risk to self or others.
Begin when you are ready.
A free 20-minute consultation is a chance to ask questions and see if we’re a fit. No pressure and no commitment.