Complex-PTSD Counselling

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Complex Post-Traumatic Stress Disorder Counselling In Singapore

“Through therapy, we find the strength to rewrite our stories.”

Complex post-traumatic stress disorder (CPTSD) results from prolonged exposure to repeated trauma. Seeking therapy can help survivors bravely explore their experiences, process trauma, and heal. If you’re dealing with CPTSD, consider seeking expert advice.

What is Complex PTSD?

CPTSD (Complex Post-Traumatic Stress Disorder) results from prolonged or repeated trauma, often during childhood. CPTSD involves learned maladaptive responses to stress. For example, a person might develop emotional numbness, hypervigilance, or avoidance behaviours to cope with ongoing trauma. These adaptations were developed as coping mechanisms to survive traumatic experiences. Stress responses are learned, so they can be unlearned and replaced with healthier ones. Understanding CPTSD in this way emphasizes that it’s about overcoming learned patterns, not inherent defects in personality.

What are the Symptoms of CPTSD?

The symptoms of CPTSD can be extensive and may include the following:

Emotional Symptoms of Complex PTSD - Insightful Counselling

Emotional Symptoms

  1. Persistent Sadness: A prolonged feeling of sadness or depression.
  2. Anger and Irritability: Frequent feelings of anger or intense irritability.
  3. Emotional Numbness: Difficulty feeling emotions or a sense of being detached from feelings.

Cognitive Symptoms

  1. Difficulty Concentrating: Trouble focusing or maintaining attention.
  2. Negative Self-Perception: Feelings of worthlessness, guilt, or shame.
  3. Hopelessness: A pervasive sense of hopelessness about the future.
Cognitive Symptoms of Complex PTSD - Insightful Counselling
Physical Symptoms - Insightful Counselling Singapore

Physical Symptoms

  1. Hyperarousal: Being easily startled, always on edge, or having difficulty sleeping.
  2. Physical Pain: Unexplained physical symptoms such as headaches or stomach aches.

Behavioral Symptoms

  1. Avoidance: Avoiding situations, places, or people that remind them of the trauma.
  2. Social Withdrawal: Isolating oneself from friends and family.
  3. Self-Destructive Behavior: Engaging in harmful behaviours such as substance abuse or self-harm.
Intrapersonal Symptoms of CPTSD - Insightful Counselling Singapore

Intrapersonal Symptoms

    1. Relationship Difficulties: Trouble forming or keeping close relationships.
    2. Trust Issues: Difficulty trusting others, often feeling suspicious or on guard.
    3. Emotional Dysregulation: Inability to manage emotions appropriately, leading to outbursts or emotional instability.

Additional Symptoms

  1. Dissociation: Feeling disconnected from oneself or reality, experiencing memory gaps.
  2. Detachment from trauma: Complete amnesia of the trauma.
  3. Intrusive Memories: Flashbacks or nightmares related to the trauma.
  4. Negative self-view: Feeling helpless, guilty, or ashamed; considering oneself different from others.
Key Differences Between CPTSD, PTSD, and BPD
Origin of Trauma Core Symptoms Emotional Regulation Relationship Patterns
Prolonged, repeated trauma, often feeling trapped.
Symptoms of PTSD plus emotional dysregulation, negative self-perception, and relationship difficulties.
Severe emotional dysregulation, feelings of helplessness, and worthlessness.
Difficulty forming and maintaining stable relationships.
Single or few traumatic events.
Re-experiencing trauma, avoidance, negative mood changes, hyperarousal.
Emotional numbness, hyperarousal.
Possible social withdrawal but not unstable relationships.
Often linked to childhood trauma, but not always specific events.
Unstable relationships, self-image issues, impulsivity, intense emotions.
Extreme emotional swings, intense anger, chronic emptiness.
Intense, unstable relationships, fear of abandonment, frequent conflicts.
What are some Causes of CPTSD?
What are the Causes of Complex PTSD - Insightful Counselling Singapore
  1. Chronic Childhood Abuse: Long-term physical, emotional, or sexual abuse during childhood.
  2. Domestic Violence: Ongoing abusive relationships where escape is difficult.
  3. Prolonged Exposure to War or Conflict: Living in war zones or conflict areas for extended periods.
  4. Captivity: Being held captive, such as prisoners of war or victims of human trafficking.
  5. Repeated Medical Trauma: Frequent, invasive medical procedures, especially in children.
How the Amygdala Processes Trauma?

Amygdala is a small part of the brain that helps us feel emotions, especially fear and stress. Here’s how it works with trauma:

  1. Hyperactivation: The amygdala becomes very active when something scary happens. This makes us feel scared and ready to fight or run away.
  2. Persistent Fear: In CPTSD, the amygdala stays very active even after the scary event is over. This makes people feel like they are always in danger.
  3. Memory and Emotion: The amygdala helps us remember emotional events. Traumatic memories can be very clear and come back quickly, causing flashbacks and intrusive thoughts.
  4. Interference with Thinking: The amygdala can interfere with the part of the brain that helps us think clearly and control our emotions. This makes it hard to manage feelings and stay calm.
  5. Chronic Stress: Long-term trauma keeps the body’s stress response system always on. This can change the brain and make it hard to feel safe even when there is no danger.

Understanding these mechanisms highlights the importance of addressing both the psychological and physiological aspects of CPTSD in treatment.

How is CPTSD diagnosed?

Disclaimer: A formal diagnosis can only be done by an expert such as a psychiatrist.

At Insightful, our counsellors help understand if a person may have Complex Post-Traumatic Stress Disorder (CPTSD), through a careful process that includes:

  1. Initial Talk: The counsellor will have a detailed conversation to understand the person’s experiences and symptoms. They will ask about the person’s history, any traumatic events, current emotional state, and relationships.
  2. Symptom Check: The counsellor will discuss specific symptoms of CPTSD, such as:

– Persistent sadness or depression.

– Feeling emotionally numb or detached.

– Difficulty controlling emotions, like frequent anger or intense sadness.

– Negative feelings about oneself, such as worthlessness or guilt.

– Problems with relationships, like difficulty trusting others.

– Intrusive memories or flashbacks of traumatic events.

– Constantly feeling on edge or having trouble sleeping.

  1. Diagnostic Criteria: The counsellor will use criteria from the International Classification of Diseases (ICD-11) to diagnose CPTSD. They will look for:

– Symptoms of PTSD, like reliving the trauma, avoiding reminders, and feeling on edge.

– Additional symptoms include difficulty managing emotions, negative self-perception, and relationship problems.

  1. Comprehensive Evaluation: The counsellor might gather information from other healthcare providers or review past medical or psychological records.

By following these steps, the counsellor can hypothesis if the client may have CPTSD and develop a treatment plan to help manage symptoms and promote healing.

If needed, they recommend their clients to visit the psychiatrist for a complete diagnosis and medications (if prescribed by the psychiatrist}

What are the Common CPTSD Coping Behaviours?

Symptoms of Complex Post-Traumatic Stress Disorder (CPTSD) are often managed through various coping behaviours. Here are some common ones:

  1. Avoidance:

– Staying away from places, people, or activities that remind them of the trauma.

– Avoiding thoughts or feelings related to the trauma.

  1. Hypervigilance:

– Being constantly on alert for danger.

– Having an exaggerated startle response.

  1. Self-Medication:

– Using alcohol, drugs, or overeating to numb emotional pain.

– Engaging in other addictive behaviours to cope.

  1. Isolation:

– Withdrawing from friends, family, and social activities.

– Preferring to be alone to avoid potential stressors.

  1. Emotional Numbing:

– Shutting down emotionally to avoid feeling pain.

– Difficulty experiencing positive emotions.

  1. Control-Seeking:

– Trying to control situations or make people feel safe.

– Becoming overly protective or controlling of one’s environment.

  1. Rituals and Routines:

– Creating strict routines to maintain a sense of predictability and security.

– Developing specific rituals to cope with anxiety.

  1. Physical Activities:

– Engaging in exercise to release stress and tension.

– Finding solace in hobbies or sports to distract from negative thoughts.

  1. Seeking Support:

– Talking to trusted friends, family members, or support groups for emotional support.

– Seeking professional help from therapists or counsellors.

  1. Mindfulness and Relaxation:

– Practicing meditation, deep breathing exercises, or yoga to calm the mind.

– Using relaxation techniques to reduce stress and anxiety.

  1. Creative Outlets:

– Expressing emotions through art, writing, or music.

– Using creative activities as a therapeutic outlet.

  1. Education and Awareness:

– Learning about CPTSD to better understand their condition.

– Keeping a journal to track symptoms, triggers, and progress.

  1. Boundary Setting:

– Setting clear boundaries in relationships to protect oneself.

– Learning to say no and prioritize self-care.

  1. Seeking Safe Spaces:

– Creating a safe, comfortable environment at home.

– Finding places where they feel secure and relaxed.

Many of the coping behaviours mentioned above can help individuals manage their CPTSD symptoms and improve their overall well-being. However, it’s important to note that some coping mechanisms, like self-medication, addictions etc. can be harmful and may require professional intervention to address.

What are the Treatments for CPTSD?

Treating Complex Post-Traumatic Stress Disorder (CPTSD) involves various therapeutic approaches to address the emotional, psychological, and physical symptoms. Here are some common treatments:

  1. Psychotherapy:

Transactional Analysis (TA): TA helps treat CPTSD by examining the interactions and communication patterns that stem from childhood trauma. TA focuses on understanding and changing these learned behaviors to foster healthier relationships and emotional responses.

Cognitive Behavioral Therapy (CBT): Helps individuals understand and change negative thought patterns and behaviours.

  1. Trauma-Focused Therapies

– Eye Movement Desensitization and Reprocessing (EMDR):

– Uses guided eye movements to help process and integrate traumatic memories.

– Helps reduce the distress associated with traumatic memories.

– Brainspotting:

– Identifies, processes, and releases trauma held in the body.

– Uses focused eye positions to access and process traumatic memories.

– Flash Technique:

– Involves briefly focusing on a traumatic memory while simultaneously engaging in positive, distracting thoughts.

– Designed to reduce the emotional intensity of traumatic memories quickly.

  1. Somatic Therapies

– Somatic Experiencing: Focuses on body sensations to release trauma stored in the body.

– Sensorimotor Psychotherapy: Integrates body awareness with traditional talk therapy to address trauma.

  1. Medication

– Antidepressants: Such as SSRIs (Selective Serotonin Reuptake Inhibitors) to help manage symptoms of depression and anxiety.

– Anti-anxiety Medications: To help reduce severe anxiety and panic symptoms.

– Mood Stabilizers: To help manage mood swings and emotional dysregulation.

Important Note: Doctors and psychiatrists can only prescribe medication. We at Insightful Counselling do not prescribe them.

  1. Mindfulness and Relaxation Techniques

– Mindfulness-Based Stress Reduction (MBSR): Combines mindfulness meditation and yoga to reduce stress.

– Relaxation Techniques include deep breathing exercises, progressive muscle relaxation, and guided imagery.

  1. Creative Therapies:

– Art Therapy: Uses creative expression to help process and communicate feelings.

– Music Therapy: Uses music to help individuals explore and express emotions.

  1. Lifestyle Changes

– Regular Exercise: Helps reduce stress and improve mood.

– Healthy Diet: Supports overall mental health and well-being.

– Adequate Sleep: Essential for emotional and physical recovery.

Combining these treatments can provide a comprehensive approach to managing CPTSD, helping individuals reduce symptoms and improve their quality of life. Each person’s treatment plan should be tailored to their needs and circumstances.

How to Find the Right Therapist for CPTSD Counselling?

Finding the right therapist to work with CPTSD can significantly impact your healing journey. Here are some steps to help you find the right match:

  1. Look for Specialized Experience: Ensure the therapist has experience and training specifically in trauma therapy like certified in EMDR therapy.
  2. Check Credentials: Verify their qualifications and certifications.
  3. Ask About Therapeutic Approaches: Inquire about their methods, such as EMDR, Brainspotting, or any other method.
  4. Consider Personal Compatibility: Choose someone you feel comfortable with and trust.
  5. Read Reviews: Look for testimonials or reviews from other clients.
  6. Initial Consultation: Schedule a consultation to see if their approach aligns with your needs.
Benefits Of Complex-PTSD Counselling - Insightful Counselling

How Insightful Counselling Can Help with CPTSD?

Insightful Counselling offers a supportive and professional environment to help individuals with CPTSD. Here’s how we can assist:

Fear-Less Life Ahead

Engaging in complex PTSD counselling can offer numerous benefits, including:

Healing From Complex Trauma & PTSD - Insightful Counselling Singapore

Our Counsellors for Complex PTSD Counselling

Reena Goenka

Reena Goenka, MSc (Counseling), SAC Master Clinical Member:

– Specializes in trauma therapy.

– She is a certified EMDR therapist and Brainspotting therapist

– She is a certified Transactional Analyst

– Over 15 years of experience helping clients heal from trauma and CPTSD.

– Known for her compassionate and empathetic approach.

Yap Huay Khem

Huay Khem - Counsellor at Insightful Counselling SingaporeYap Huay Khem, MSc (Counseling), SAC Registered Member :

– Expert in EMDR and Brainspotting therapy

– Expert Clinical Hypnotherapist.

– Focuses on integrating body and mind healing techniques.

– Experienced in working with complex trauma and emotional regulation.

Insightful Counselling Success Stories for CPTSD

Case Study 1:

Client: Kirti

Background: Kirti experienced prolonged sexual and emotional abuse during her childhood and teenage years at home, leading to severe symptoms of CPTSD, including flashbacks, emotional numbness, and difficulty trusting others.

Treatment: EMDR and Brainspotting.

Outcome: Through EMDR, Kirti was able to process and reduce the distress associated with her traumatic memories. Brainspotting further helped her release trauma held in her body, leading to significant improvements in emotional regulation and a reduction in flashbacks. Over time, Kirti developed a stronger sense of self-worth and found building and maintaining healthy relationships easier.

Case Study 2:

Client: Chee Wei

Background: Chee Wei endured repeated physical and verbal abuse at home in his early childhood, resulting in symptoms such as persistent sadness, negative self-perception, and chronic relationship difficulties.

Treatment: Transactional Analysis and EMDR.

Outcome: Using Transactional Analysis, Chee Wei gained insight into his past triggers, beliefs, and patterns, understanding how past traumas influenced his interactions with others. EMDR further helped him desensitize and reprocess his traumatic memories, reducing the intensity of his symptoms. This combination enabled Chee Wei to improve his emotional regulation, develop healthier relationship dynamics, and foster a more positive self-image.

Frequently Asked Questions

What should I expect during my first counselling session for Complex PTSD?

During your first counselling session for complex PTSD at Insightful Counselling, you can expect a safe, empathic, non-judgemental, confidential and supportive environment. Our psychotherapist will discuss at your pace your treatment goals to create a personalized plan tailored to your needs. This session is an opportunity to build trust and set the foundation for your healing journey.

Why does it take so long to actually get that you're recovering?

– Healing deep emotional wounds take time.

– Recovery involves changing long-established coping mechanisms.

– Progress may be gradual and sometimes hard to notice.

What are the signs that I am recovering?

– Fewer flashbacks and intrusive memories.

– Better emotional control and less frequent emotional outbursts.

– Improved relationships and a more positive self-image.

Can I be misdiagnosed?

– Clients with CPTSD are often misdiagnosed with anxiety, depression, bipolar disorder, narcissistic, codependent, or borderline disorders.

– Misdiagnoses can include ADHD and OCD, which may be responses to trauma.

– Other possible misdiagnoses are ADD and some dissociative disorders, which are also trauma responses.

How long does it take to recover from CPTSD?

– Recovery time varies for each person.

– It can take months or even years.

– Depends on the severity of the trauma and the support received.

How do I know I am in a flashback?

– Feeling as if you are reliving the traumatic event.

– Experiencing intense fear, vivid images, or physical sensations from the past.

– Feeling disconnected from the present moment.

What is a trigger?

– An object, situation, or person that reminds you of past trauma.

– Causes a strong emotional or physical reaction.

– Can lead to flashbacks or intense distress.

Are online counselling sessions available for Complex PTSD?

Yes, Insightful Counselling offers online counselling sessions for complex PTSD. Our online services are designed to provide the same level of care and confidentiality as in-person sessions, making it easier for clients to access the support they need from the comfort of their own homes.

Is it possible to live an everyday life with CPTSD?

– Yes, with the proper treatment and support.

– Therapy and coping strategies can help manage symptoms.

– Many people lead fulfilling and productive lives despite having CPTSD.

Contact Us for Support

If you’re ready to take the first step towards healing, we’re here to help. Contact us by clicking here (make an appointment). Our team at Insightful Counselling is committed to helping you overcome CPTSD and lead a healthier, happier life.


I was diagnosed with CPTSD by my psychiatrist after enduring 13 years of abuse and moving from one foster home to another. Despite years of therapy and meds, I struggled deeply. I was suggested to try EMDR therapy by my friend Huay Khem, and it was a game-changer. We clicked immediately, and within six months, my trauma started to resolve. I am still working with her, and she is a blessing to me. After 15 years of marriage, being mentally healthy and able to improve my relationship with my husband is incredible. I'm not triggered anymore most of the time, and my anxiety is manageable. I feel great and ready for whatever comes next.

Reena healed me. We have journeyed for three years together. We started by understanding my childhood history, and my beliefs, especially, around ‘I am a failure' using Transactional Analysis and my internal mode of communication with myself. I was a Critical Parent all the time to my inner Child. I did a lot of inner child work that helped me to reconnect with and heal my younger self and nurture myself. She then started working with my past very hurtful memories using EMDR therapy; EMDR helped me process my haunting childhood memories, and Reena's caring and skilled approach made me feel safe and understood. Now, I feel more confident and balanced. Thank you, Reena, for being there for me.

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