For those of us who have sought treatment for the symptoms of complex post-traumatic stress disorder, here at CPTSD Foundation, know how difficult it is to find a therapist trained to treat us. In fact, in the United States, finding a therapist specifically for CPTSD is exceedingly arduous.
This set of articles will explore the mental health disparities displayed in finding help for one of the nation’s most significant and fastest-growing mental health disorders.
Attempting to Find Treatment
We have already discussed the futility of searching Google to find a specialist in CPSD, what about the other resources out there to find a therapist.
There are dozens of websites, including the site for the Substance Abuse and Mental Health Service Administration (SAMHSA). However, most, if not all, of these sites do not search for complex post-traumatic stress disorder. Instead, they may search for therapists who are trauma-informed or treat post-traumatic stress disorder instead.
Finding a therapist who is trauma-informed or treats PTSD is enormously easier than searching for someone who treats CPTSD specifically. Psychology Today has its own search program to help one find a therapist that treats PTSD and is trauma-informed.
Trauma-informed care (TIFC) done by a trained therapist offers an approach to understanding the entire person who is seeking treatment. Since trauma affects one’s sense of self and their beliefs about the world, TIFC serves to directly challenge the assumptions that a trauma victim may have about themselves and others.
The therapist who is trained in trauma-informed care will strive to aid their client in recognizing how the events changed how they see themselves but also fights not to retraumatize the person seeking treatment.
The Differences in Treatment
So far, the treatment for complex post-traumatic stress disorder and post-traumatic stress disorder are strikingly the same.
The treatment options commonly adopted for the care of post-traumatic stress disorder include trauma-focused psychotherapies, including cognitive processing therapy (CPT) and prolonged exposure (PE).
Cognitive processing therapy teaches trauma victims to reframe their negative thoughts about what happened during the traumatic event. CPT involves victims talking with a therapist about their negative thoughts and doing short writing assignments to change the story of what happened to them.
Prolonged exposure therapy (PE) teaches victims of trauma living with PTSD to gain control by talking about the trauma in treatment. During therapy, the client will be encouraged to go ahead and do the things they have avoided. This intentional exposure to triggers will desensitize the brain of victims, calming the fight/flight/freeze response.
To treat complex post-traumatic stress disorder, therapists often take a drastically different approach. They may use cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing therapy (EMDR).
Cognitive-behavioral therapy involves talking to a therapist who will help steer one away from the traumatic events in the past. They will then replace those memories with new methods of thinking to help the client navigate their way through the trauma to health.
EMDR is a treatment option that is available for both CPTSD and PTSD. Eye movement desensitization and reprocessing therapy help people who live with the diagnosis of CPTSD by using the movements of their eyes to process and deal with the emotions and flashbacks that occur during treatment.
Using EMDR involves remembering the trauma while paying close attention to a back and forth movement of fingers or a repetitive sound. This combination of remembering and movement somehow has been found to desensitize the brain to the trauma of the past.
Doing a Google Search
Like many of us who live with the effects of CPTSD on our lives, you have probably conducted a search on Google to try and find a therapist. When you do carry out a search for a CPTSD trained therapist, one is met with a long list of ads for therapists with treatment options for post-traumatic stress disorder.
There are distinct differences between complex post-traumatic stress disorder and post-traumatic stress disorder, such as the following.
Post-traumatic stress disorder is caused by a single event such as a natural disaster, a terrorist attack, or a rape.
Unlike PTSD, Complex post-traumatic stress disorder is caused by a series of brutal, traumatic events that may last decades. These traumatic events may include:
- Emotional abuse
- Sexual abuse
- Mental abuse
- Human trafficking
- Physical abuse
- Domestic violence
- Being a prisoner of war
- Surviving a concentration or internment camp
- Living in a war zone
The symptomology of each of these chronic mental health disorders is also different. While some do overlap, the difference between the two disorders is striking.
A few of the host of symptoms of PTSD:
- Intrusive and distressing memories of the traumatic event
- Intense distress when triggered by a similar event to the traumatic event
- Persistent and exaggerated negative expectations about oneself or the world
- Have distorted blame of self or others for the consequences or cause of a traumatic event
- Persistent anger, shame, horror, and guilt
A few of the host of symptoms of CPTSD:
- Difficulty regulating emotions especially rage
- Losing memories of the trauma
- Suicidal thoughts or actions
- Feeling ashamed
- Having difficulty forming or maintaining relationships
The list above contains only a few of the myriad of symptoms of both post-traumatic stress disorder and complex post-traumatic stress disorder.
As one can see, many of the symptoms of post-traumatic stress disorder are more outwardly focused while the symptoms of complex post-traumatic stress disorder are focused inward.
Follow the Money
The reason behind this difficulty in even finding a listing for a therapist in the United States who treat complex post-traumatic stress disorder is that it is not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).
The DSM-5 is the bible, published by the American Psychological Association, that all therapists follow to diagnose and treat mental health disorders. It is also, unfortunately, where therapists get their diagnosis codes for payment from insurance companies, Medicare, and Medicaid.
This lack of listing in this crucial reference for therapists means that therapists will not get paid by insurances if they treat CPTSD. All the more reason to lobby the American Psychological Association to include complex post-traumatic stress disorder under its own heading.
A Call To Action
Are you a survivor or someone who loves a survivor and cannot find a therapist who treats complex post-traumatic stress disorder? Please, contact CPTSD Foundation. We have a staff of volunteers who have been compiling a list of providers who treat CPTSD.
Are you a therapist who treats CPTSD? Please, consider dropping us a line to add you to our growing list of providers. You would not only get aid in finding clients but also you would be helping someone find the peace they deserve.
If you or a loved one are living in the despair and isolation that comes with complex post-traumatic stress disorder, please, come to us for help. CPTSD Foundation offers a wide range of services including:
- Daily Calls
- The Healing Book Club
- Mindfulness, Prayer, and Meditation Circle
- Support Groups
- Our Blog
- The Trauma-Informed Newsletter
- Daily Encouragement Texts
All our services are reasonably priced, and some are even free. So, to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it, sign-up, we will be glad to help you. If you cannot afford to pay go to www.cptsdfoundation.org/scholarship to apply for aid. We only wish to serve you.
Harris, M. & Fallot, R. D. (Eds.) (2001). Using Trauma Theory to Design Service Systems. New Directions for Mental Health Services. San Francisco: Jossey-Bass.
Substance Abuse and Mental Health Services Administration (2014). A Treatment Improvement Protocol: Trauma-Informed Care in Behavioral Health Services, Tip 57. U.S. Department of Health and Human Services, 14-4816.
My name is Shirley Davis and I am a freelance writer with over 40-years- experience writing short stories and poetry. Living as I do among the corn and bean fields of Illinois (USA), working from home using the Internet has become the best way to communicate with the world. My interests are wide and varied. I love any kind of science and read several research papers per week to satisfy my curiosity. I have earned an Associate Degree in Psychology and enjoy writing books on the subjects that most interest me.
It seems therapists with cptsd ability charge really high fees.
Why is this?
They may charge such high rates because they are in high demand. I really don’t know the exact reason. The high fees are a great reason to check what kind of insurance they accept if any. Shirley
Hi Shirley, I’m interested in getting some info on therapists for CPSTD in my area. Thanks! You can also email me back directly if you wish at [email protected]
Go to CPTSD Foundation’s contact us page and send an email asking for help. They will route you to the help that you need. Shirley
The Insurance part is a big factor impacting the the entire process of treatment. With so much high fees it gets very difficult to continue therapy for a long time. Are there any alternate ways to this? Any organisation that supports??
While CPTSD Foundation services are not professional help, we are able to offer support through peers who understand. Please, feel free to explore all the programs we offer. Shirley
I am so sorry you have had such bad experiences with doctors. Please, don’t advise people not to seek out professional help. What worked for you may not work for them. I’m thankful you commented. Shirley
Thank you for tackling this topic. It’s a hot one for sure, thanks not only to the DSM debacle, but also the sad fact that many insurance companies don’t cover therapy, unless it’s in-patient psychiatric therapy.
It seems that most employers who offer health insurance these days, only offer crappy plans that are really nothing more than what we used to call, “catastrophic” plans. Back in the day, those were very cheap plans with very high deductibles and were basically only good if you were in a terrible accident or got a deadly disease. They were the plans favored by young, healthy folks who rarely if ever, went to a doctor. Now, these same plans have been dressed up with catchy names like, “silver”, or “gold”, but underneath, they’re basically the same-old, same-old.
How times have changed.
Agreed to the power..
in past six years despite being a expert on ptsd. my abusers and assailants removed mmy tools i used to be my own best dr taking years to speak walk talk and thrive and work and living my best life and unbroken by 11 years of isolated feral abuse. not one dr helped me. no one mention trauma but burried me in lies and abuse. coward inept and what evil.. i manage to come up over it with the 411 on to many people . It took insight and discipline and moves. one person could spared me from every suffer and help me but no one cme forth but i had a boss and lucky to jobs. they myboss and wife were killed off, i kept alive 24 years and had removed family and anyone to defy me and rise up. stalked by abusers and put inn company of evil. i was not every given care. so i had to do it alone and god had me. i was at teh apex of the recovery game when i was intentional hit and damage by one split second by a man showing off powers and my tools removed my soul identity all of my work talent and they removed any way for me to self heal and i asked for ptsd care and got pissed on and shi ton until i began to die of all kinds of sickness to my brain injured by a game. murder call it. drs refused to give me respect and i began to suffer and witness the loss of two miracles of a stellar life. So suggest to do god if yu see and feel god and have sense do god. in six years drs tortured me abuse and failed mixed up refused to give me a chance to live and left me to suffer to homeless and madness and never come back. i was a super star and so light hearted and kind and now im a mess. that is what my family and they wanted. i wont live past this year and endured six begging for ptsd care. arrogant and disposable drs. ptsd trauma is common sense it took alot of travel work and process to heal but i got places and in one second a man on drugs came and wiped me out and left me to die.. they are all arrogant drs and it was to easy to save me and they refused.
Can you refer me to a therapist experienced in treating complex ptsd who practices in New York City?
You need to go to contact us and fill out a request. Someone will get back to you quickly and hopefully, they can help you. Good luck on your healing journey. Shirley
I tried to get in touch Shirley and no one replied. My name is Prema. Why is that. Or what did I do wrong. I filled out something but no one responded
I apologize that no one got back with you. My email is [email protected] Shirley
Oh I need to find someone who can handle a severe case of complex PTSD licensed in New Hampshire. Thanks
Okay. Go to the “contact us” page and send an email. The proper staff will contact you as soon as possible. Sometime in the near future, we will have a dedicated page for this but we do not currently have one. Shirley
Is there any work being done currently to push for the DSM to include CPTSD?
I believe Bessell von der Kolk is still doing research and so are others but I do not know if there is a push to get CPTSD into the next DSM. They won’t add it to the current one as it is pretty much set in stone and I haven’t heard of plans to make a DSM6 yet. Shirley
What’s would be a good idea.. Is to network with other therapists and radiate your research and studies… Never a trial study group, discussion group, secure, confidential, patient, group,.. I’ve been referred to therapists that are too old and milking the clock, giving you psychological kicks.. Are not educated in ptsd…blah so much time lost, wasted, to get solace, healing..
Also, I’m curious as to why the ICD recognizes CPTSD as a disorder separate from PTSD but the DSM doesn’t?
The ICD is published by the World Health Organization (WHO) and they classified CPTSD under its own title. However, psychiatrists and other specialists who put together the DSM5 kept post-traumatic stress disorder and added that it could be experienced on a spectrum. I’m not sure why. Shirley
I am a practitioner in Seattle, WA. I treat CPTSD and dissociative disorders exclusively. You are welcome to put my information on your website, though I am usually full. You have done a very nice job with your site. There are, though, some things you have left out in terms of treatment options that you might want to know about that I would be glad to share with you. Feel free to email me.
Hello Wendy, I am in dire need of assistance can you leave your email?
I too am in desperate need of a therapist with experience regarding CPTSD: Effects on daughters by lost/absent fathers. From the age of 16 I started my ongoing search for the truth about me, my family, my confusion, my pain depression anxiety and to top it all off ADD. I am 65 going on 37 and am reclaiming my lost life. I’m going to live another 30+ years and having regained my authentic self (I remember being happy and myself till 5 years old. I’ve done talk therapy in bouts over the years as symptoms became problems. John Bradshaw was popular when I was a teen and I watched on tv and read his book. He described my toxic family but he was too ahead of his time. I completed a year of DBT group class and workshop and have healed my dysregulation issues. It gave me many tools to stop dysregulation before it starts.
My last big foundational issue seems stuck in my body and is remaining factor running the last of my depression but increasing my anxiety. I’m on Ketamine iv and inhaler which has been miraculous. I’ve been on zoloft since 1997.
In a nutshell my narc mother ruined my fathers life by getting pregnant with me so she could get married and escape her irish catholic home. this is in 1956. Until I was about 5 he and I w\had a great relationship and he was a happy good daddy
We had healthy attachment (none with mother) and he was an on the floor, in the swimming pool playing dad.
I heard them fighting extraloud one night
The next morning my father was present, always present but never there. He just changed into a stone wall overnight
I,m pretty sure my mother had revealed the secret of manipulating him with me.
My father was my mothers biggest victim. She stole his life. I was the runner up
My issue with this untreated wounding is
1. How many different ways was I wounded by becoming invisible to my father with zero relationship/attachment after 5 years old. He always provided and was never intentionally mean. He just couldnt look at me the same.
2. How many healthly developmental skills lessons did I miss by having only a provider not a father
3. Why is it only this ONE issue of many that is stuck in my body (free floating anxiety around heart and solar plexus) which feeds the last remaining depression sx.
4. I am blind in this on area which must be addressed with answers and treatment so I can get on with my life.
5. I was never angry at him as it was her creation. I had only empathy for what she reduced him to…yet those wounds did occur from 5 until his death around 2008.
6. I was the truth teller and asked ongoingly: Why doesnt daddy love me anymore. I was told that wasnt true, I was imagining things, I was being dramatic, of course my father loved me.
Perhaps we could teleheath a few sessions to get me headed in the right direction
I’ve read all the current books by the experts. I feel like an expert myself Perhaps you could recommend a therapist you know of. I cant do this one on my own. I’m blind in this except for knowing my history with him in detail and I’m ready to finish this depression anxiety and be happy. Everything else has been attended to by me I travel in my fifth wheel so can go anywhere. Currently in the middle of nowhere Missouri 2 hours from St Louis HELP … EVEN IF JUST A LITTLE?
I am desperate for my 20 year old daughter that has complex PTSD, cannot
find help and also need a Pyschiatrist
CPTSD Foundation has helped to aid people like yourself in finding a therapist. Please go to https://cptsdfoundation.org/helpmefindatherapist
Not only is there a scarcity of specialists in the field of C-PTSD but, there even less access to stories of growth and achievement, in spite of it all!
This is not to say that awareness and accomplishment means the absence of pain but, I continue to find hope in being able to maintain balance.
I need a C-PTSD informed therapist in Canada. The page you link to is just a list of websites and repeated search tips.
Try this link: https://www.goodtherapy.org/therapists/canada
I have been fighting this disorder since 1987 . I’ve been to so many therapists but no one has even gotten close to helping me .. Along with CPTSD I have anxiety that interrupts me anytime and any place . I start sweating and get nauseous and have passed out before a couple times . I need help so bad that I’m exhausted. There is a situation going on now that’s crippling me . I cry so hard that I throw up . I need your help drastically . Thank you for your time .
I am so sorry you are experiencing those symptoms. If you are looking for a therapist, go to our contact page and scroll to the bottom where you will see a link to help you find a therapist. Good luck my friend. Shirley
Frances have you found any help since posting here? I have been to 3 therapists and no one has even gotten close to helping me either and my checkbook is almost empty – although I would pay ANYTHING to have this cptsd gone! I cry so hard that my hands shake, as snot falls from my nose and I can hardly catch my breath as I reign in the screams to not wake up my son and I stutter when I try to talk in between the sobs crying out for help! I HATE THIS I hate me! Last month my fingers and toes started to go numb and turn white, then last week my fingers turned BLUE and the doctor said it’s probably Raynaud’s from stress 🙁 I hate that my abuser has ruined my mind and my body – how did I escape his torture just to live in constant pain and fear and anger? I think I will lose my job, unable to focus on the work, distracted instead with hypervigilance, rage and self disgust at my failure to heal – why can’t I get help – how will I support my child if I lose my job because I am so overwhelmed to function ‘normally’? I beg for it, so desperate to find some peace.
1. You are not supposed to experience flashbacks during EMDR or exposure therapy. That can actually disturb the healing process. Also, it is not the eye movement part that desensitized. It’s been found that EMDR is not more helpful than just Exposure Therapy (talking in detail about the trauma multiple times), which is basically EMDR without the eye-movement part. All the explanations for why the eye-movement helps is purely pseudo-science.
2. In those little symptom lists, PTSD sounds a lot more inward and CPTSD more outward. You might want to tweak those a bit.
Please help i need all of it there is.
If you need help finding a therapist, please go to scroll all the way to the bottom and click Help Me Find a Therapist.
Hi, I’m also a psychotherapist working with CPTSD in the UK. My website is http://www.exploreyourmind.co.uk
I found one. Here’s how:
Reddit has a good support group /r/CPTSD. Ask here for methods, and resources.
A redditor recommended “Janina Fisher’s book, “Healing the Shattered Selves o Trauma Survivors” I read it, and got started on self healing with some mixed results.
Used the “find a therapist” on the Psychology Today website. Put in my location, and limited the search to “Trauma Informed” This doesn’t mean as much as you’d think. You are just saying you don’t want to see them if they don’t use trauma in their description.
For each one, I clicked the more info. Read their blurb. Looked for key words “PTSD” as one of the first items. “Trauma Trained” is good. “CPTSD” is good.
Wrote an initial email saying I had CPTSD from childhood sexual abuse. Ask them how they would treat it. Answers of CBT aren’t good. DBT can be ok, but tends more to working with residual symptoms. Somatic Experiencing and EMDR can be useful if you have current flashbacks. Lots of CPTSD clients don’t.
If they answered reasonably, I then sent a second email with a more detailed history, and asked if we would be a good match.
In my case I also wanted them to be familiar with Dr. Fisher’s work.
It took me 40 rounds of this to find a therapist who had trained with Fisher.
I used a doc to track who I sent emails to, and the followup. I did batches of about 10, then waited a couple days for replies. Took about 10 days I think to find my therapist.
Thank you for typing this out. It sounds like a really good, actionable guide to finding a therapist without as much trial and error and wasted time. Really appreciate you sharing your method.
Thank you so much for taking the time to share this very helpful information. So many of us are struggling to find a CPTSD trained therapist and cannot afford the resources of time, money, and emotional cost of working with the wrong one. I would be curious to know if you found a local person or if you are doing therapy virtually. I hope it is going well and you are making good strides. Much love and healing to you.
Thanks so much for this!