For adults carrying trauma that started long before the thing they came in to talk about.
PTSD usually traces back to a specific event or events: an accident, an assault, a single overwhelming experience. Complex PTSD (C-PTSD) is different. It tends to come from prolonged or repeated exposure to difficult or unsafe circumstances, often starting early in life, things like childhood neglect, ongoing family dysfunction, or repeated relational harm.
It doesn't always look like flashbacks or hypervigilance. More often it looks like a harsh inner critic, trouble trusting people or feeling safe in relationships, difficulty regulating emotion, and a shaky sense of who you actually are underneath it all. A lot of what gets written off as "just my personality" or "just how I am" is often complex trauma wearing a disguise. This is the area of the work I care about most.
The two get used interchangeably, and they aren't the same thing. The distinction isn't academic: it changes what the work looks like and how long it tends to take.
Usually traces to a specific event or set of events — an assault, a crash, combat, a medical emergency. Often shows up as intrusive memories, flashbacks, nightmares, hypervigilance, and avoidance of reminders. There's typically a clear before and after.
Comes from prolonged or repeated exposure, often early in life and often inside relationships you couldn't leave — neglect, ongoing family dysfunction, repeated relational harm. Includes the PTSD symptoms, and adds trouble regulating emotion, a persistent sense of being bad or broken, and difficulty feeling safe with people. There's often no clear before.
Not a diagnostic checklist, only an evaluation can do that. But these are the things people describe most often when what they're dealing with turns out to be complex trauma.
A lot of what gets named as low self-esteem is not really about esteem. It's what happens when a person spends years adapting to an environment that wasn't safe or predictable, and the adaptations outlive the environment. The harsh inner voice was useful once. So was the vigilance, and the shape-shifting, and the not-needing-anything.
That's also why “just think more positively about yourself” tends to fall flat. The belief isn't irrational — it's a conclusion someone drew from real evidence, at an age when they had no other way to make sense of what was happening. Identity work in this context is less about building confidence and more about separating who you actually are from who you had to become.
We'll work together to better understand how your experiences of trauma have impacted you. Some of that happens through you sharing your own experience. Some of it happens through education about the ways trauma can affect us.
If symptoms like anxiety, dissociation, intrusive thoughts, or flashbacks are severe, we'll work on coping skills, containment, and creating safety in your world so you can feel more present and fulfilled day to day. When it makes sense, we might use approaches like IFS, CBT, somatic strategies, and EMDR to address the more deeply rooted layers.
What people usually notice first is a little more space: less hijacked by the next trigger, a bit more able to stay in the day instead of getting pulled back into the past.
In our first few sessions I'll ask questions so I can actually understand you, not just the problem that brought you in. We'll talk about why you reached out, what happened along the way in your life that contributed to how you got here, and other parts of your world so I can see the full picture.
We'll also talk about how therapy works with me, and I'll answer any questions you have. Then we'll start discussing goals. If you don't have clear goals yet, that's completely fine. We'll figure that out together.
PTSD generally follows a specific traumatic event or a set of events. Complex PTSD tends to develop out of prolonged or repeated exposure, often beginning early in life and often inside relationships you couldn't leave. The symptoms overlap, but C-PTSD usually adds difficulty with emotional regulation, a persistent negative self-concept, and trouble in relationships.
It's recognized in the ICD-11, the World Health Organization's diagnostic system. It is not a separate diagnosis in the DSM-5, which is what most U.S. insurers use, so it's often documented as PTSD. The label matters less than whether the treatment fits what you're actually dealing with.
You get to be in charge of where we go and how deep. Therapy doesn't work when we don't listen to the parts of you that need safety. We'll honor whatever needs or boundaries you have around details, and there'll be room for whatever you want to share if and when the time comes.
Yes. A lot of complex trauma isn't a single event you can point to. It's the accumulation of things that kept happening, or things that never happened and should have. People often arrive convinced their history “wasn't bad enough” to explain how they feel.
Everybody's needs, desires, and goals are different. Some of my clients come in looking for a brief, structured approach to deal with specific issues, build skills, and get themselves on the track they want to be on. That may be weeks to a few months. Others need or want more time than that, whether that's wanting longer-term care, needing to address more complex issues, or something else that warrants a longer course of treatment. There's no one-size-fits-all. That said, healing often takes time, and we can't rush the process.
I'm always honored when someone shares this with me. I do sometimes hear from people who went to therapy and had a negative, or just generally unhelpful, experience. So I like to ask what therapy was like before, how it felt, and what specifically about it you found unhelpful. I don't force a particular course of treatment on anyone. I want to understand what healing or getting better actually means to you. The way there is different for everyone, and I'll check in along the way so we know we're going the right direction.
Yes. I'm in-network with ten plans, including Kaiser, UnitedHealthcare, Aetna, Cigna, and Anthem Blue Cross Blue Shield. The full list and the private-pay rate are on the insurance and fees page.
That's a normal place to start. A free 15-minute call is usually enough to get a sense of it.
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