C-PTSD and Attachment Trauma: What's the Relationship?
Silence. Anger. Distance. Sometimes, what your teen isn’t saying is just as important as what they do. As a parent, you may be wondering, Is this just a normal part of being a teenager? Or is something else going on…?
For many teens, complex PTSD (CPTSD) and attachment trauma can significantly affect how they see and relate to themselves, their families, and the world around them. This guide is here to help you understand what may be happening and how to support your teen with compassion.
On this page, you’ll learn:
- What CPTSD and attachment trauma are
- The link between CPTSD and attachment
- Signs of CPTSD and attachment trauma in teens
- How you can help your teen
- Effective therapy approaches
- Adolescent trauma recovery programs
- How to find professional support
Understanding Complex PTSD in Adolescents
Complex PTSD (CPTSD) is a mental health condition that can cause issues with self-esteem, emotional regulation, and forming healthy relationships.
It’s not known exactly how many teens experience CPTSD, but the Department of Veterans Affairs suggests that just under four in every hundred U.S. adults experience it. However, a recent study in teenagers estimates the figure to be just under six in every hundred.1,2 Let’s take a look at how CPTSD develops and the differences between it and traditional PTSD.
Causes of CPTSD
CPTSD is listed in the International Classification of Diseases (ICD-11) and develops from prolonged, repeated exposure to trauma, often during childhood.3 This trauma could result from abuse, neglect, or exposure to violence, from which there is no easy escape.
CPTSD vs. Post-Traumatic Stress Disorder
CPTSD is a completely separate condition and diagnosis from post-traumatic stress disorder (PTSD). The main differences between the two can be summed up as follows:4
PTSD: Results from a single or short-term traumatic experience. For example, being involved in a serious car accident or an earthquake.
CPTSD: Caused by chronic long-term trauma. For instance, sustained abuse, neglect, or domestic violence.
What Is Attachment Trauma?
Attachment trauma happens when a child’s relationship with their caregivers is considerably disrupted during their early years. At a time when they need safety and comfort, they may instead be presented with inconsistency, neglect, or even abuse. To understand attachment trauma, it’s useful to know the basics of attachment theory.
Attachment Theory
Attachment theory was developed by a psychologist and psychoanalyst called John Bowlby. It explains how an infant’s early relationships with caregivers significantly impact their ability to regulate their emotions and form emotional bonds with others in the future. To break it down, attachments (also referred to as connections or bonds) form based on how well an infant’s needs are met.
If a baby is distressed, they will reach out to their caregiver for support by crying or clinging to them. The way the caregiver responds essentially sets the tone for future connection patterns.5 For instance, if the child’s cues for reassurance are met safely and consistently, they will likely form a secure attachment. If, on the other hand, a child doesn’t feel like their needs are being reliably met, they can develop an insecure attachment style and attachment trauma.
Attachment Issues and Chronic Trauma
Chronic trauma, sometimes known as complex trauma, is the term used to describe the psychological and emotional wounds that come from prolonged, repeated exposure to traumatic events. For example, if a child has experienced long-term abuse, neglect, inconsistent caregiving, bullying, or has been exposed to violence regularly. These experiences can impact the emotional bonds a child forms with their caregiver. This is how a child or teen may develop an insecure attachment caused by complex trauma.
Additionally, when someone has an insecure attachment, if they don’t encounter healing experiences, they are more likely to have difficulties forming healthy relationships with others. They may also struggle with managing their own emotions.5
What Is the CPTSD and Attachment Trauma Link?
Complex PTSD and attachment trauma are very closely linked. As discussed, complex and attachment trauma occurs during childhood over a prolonged period. This type of trauma naturally disrupts crucial early emotional bonds, affecting a child’s sense of safety and trust. As a result, an insecure attachment can form, leading to struggles with self-esteem, managing emotions, and forming healthy relationships. These struggles, in turn, can contribute to the mental health condition CPTSD: the stress response to complex traumatic experiences.
If someone has an insecure attachment style, their trust in others and their own self-worth is shaken, and they may experience emotional dysregulation. Therefore, their ability to process trauma and find healthy ways to deal with stress is interrupted. And so, this starts a vicious cycle of struggling with emotional health but not seeking help, which puts more stress and strain on their well-being.
Although it may sound like a loop with no escape, it is possible to heal from both attachment trauma and CPTSD. With the right support, a teen can recover, build confidence, form healthy connections, and feel safe and secure in the world. The first step in recovery is recognizing the signs of CPTSD and attachment issues.
Recognizing the Signs of CPTSD in Teens With Attachment Issues
If you’re concerned that your teen may have attachment trauma or CPTSD, knowing the red flags to watch for can be the difference between them getting help or struggling alone. The following sections break down the warning signs for each condition separately, so that you can get them the professional support they need and deserve.
Symptoms of CPTSD in Teens
According to the ICD-11, CPTSD symptoms include:3
- PTSD Symptoms:
- Flashbacks, nightmares, or intrusive memories
- Being hyper-aware of danger
- Avoiding people, events, and triggers of trauma
- Additional Symptoms:
- Emotional dysregulation
- Depression
- Feeling ashamed, guilty, or worthless
- Risk-taking behaviors
- Difficulty creating and maintaining healthy relationships
- Suicidal thoughts
Signs of Attachment Trauma in Teens
The following behaviors are indicators of underlying attachment trauma. It’s good to be aware that, if your teen has attachment issues, depending on which attachment dimension they fall on, they may show one spectrum of behaviors more than another.6,7
- Switching between wanting and fearing emotional closeness
- Boundary issues in relationships
- Negative self-view
- Acting defiantly toward caregivers
- Freezing when a parent or caregiver approaches them
- Fear of rejection or abandonment
- Dissociation
- Lack of empathy
- Feeling anxious, stressed, or scared
- Being fiercely independent
- Trust issues
- Feeling lonely
- Emotional dysregulation
- Impulsivity
If you recognize some of these in your teen, they may be struggling with attachment trauma or CPTSD. Although their behavior may seem confusing or upsetting at times, remember that effective treatment is available. We’ll look at some ways you can support your teen at home before diving in to the treatments options available.
How to Support Your Teen at Home
When your child is struggling, all you probably want to do is give them love and support. However, we know this can be tricky, especially if they seem to be pushing you away. Teenagers with attachment issues need support, patience, consistency, and a lot of understanding. If you’re looking for ways to help your teen, whether it’s through coping strategies for attachment trauma or emotional regulation for CPTSD teens, the tips below may help.
Create a Safe Home Environment
Attachment trauma and CPTSD can result from feeling unsafe or experiencing inconsistency during childhood. Because of this, making home a safe place is vital, along with introducing routines. Try to reduce sources of stress or anxiety, and establish routines to create a sense of predictability. This doesn’t mean you have to say “yes” to everything – boundaries are also an important element of consistency.
Encourage Open Communication
When your teenager opens up to you, listen to their feelings and concerns without judging them, even if you find it challenging. You don’t have to agree with their actions or thoughts, but you absolutely can acknowledge how they feel, and validate that their feelings are real.
Work on Your Parent-Teen Bond
It’s never too late to build a stronger connection with your child. You could engage in hobbies that you both enjoy together, such as attending sports matches or playing board games. Be there for them emotionally. If they seem to be having a hard time, you could offer them a hug or squeeze their hand to let them know you are there for them. Remember that consistency is key – be a reliable source of emotional support.
Therapy for CPTSD and Attachment Disorder
If you think your teen may be struggling with trauma, know that professional help and treatment are available. Psychotherapy, more commonly known as “talking therapy,” is an effective way to treat and heal teens experiencing CTPSD or attachment trauma. The following sections explore the options available.
Trauma Therapy for Adolescents
CPTSD is a relatively new mental health disorder. This means that the most effective mental health treatment for CPTSD in youth has not yet been determined. However, from the research available, a trauma-focused approach can significantly improve the symptoms of CPTSD.6 Specifically, two types of trauma therapy are recommended: trauma-focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing therapy (EMDR).8
- TF-CBT enables teens to understand how they react to stress and trauma, and how to manage their symptoms. It also helps them identify any unhelpful thoughts and begin to reframe them with healthier alternatives.
- EMDR is a trauma-focused therapy, but doesn’t require deep conversations about the trauma. Instead, guided eye movements are used to allow teens to reprocess traumatic memories and reprogram how their brain deals with stress.
DBT and CBT for Complex Trauma in Teens
In addition to trauma-focused therapy, other therapeutic approaches can bring relief to those with attachment trauma and CPTSD. These are dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).9,10
- DBT teaches people how to manage or “regulate” their emotions, which is an area that those with attachment trauma or CPTSD often struggle with. It helps teens learn coping techniques to allow them to deal with distress, anxiety, and stress more easily and improve their relationship skills.
- CBT is a structured therapy that allows adolescents to recognize and rewrite negative thought and behavior patterns. They can gain healthy coping skills and a better understanding of why they feel the way they feel.
Family Therapy for CPTSD and Attachment Repair
Attachment-based family therapy is a structured and evidence-based approach based on attachment theory. Sessions focus on repairing disrupted early emotional bonds within the family unit by working on trust, connection, security, and open communication.11,12
Adolescent Trauma Recovery Programs
Sometimes, outpatient therapy just isn’t enough to completely heal the emotional scars that teens may have. This is where residential programs for complex trauma teens enter the conversation.
Here at Mission Prep, our residential programs offer a safe and supportive environment for teens to heal from their trauma. We take a trauma-informed approach to mental health treatment, considering the impact of trauma on teens and their development to help them recover. In our care, teens are given the time and space to learn about their condition, benefit from therapy, and find new coping skills with the support of our mental health experts.
We also understand the importance of family involvement in a teenager’s recovery and strive to keep loved ones informed and involved in their treatment. This may include attending family sessions, as described earlier, to allow your teen to heal.
Healing CPTSD and Attachment Trauma With Mission Prep
Complex PTSD and attachment trauma can feel overwhelming. But healing is absolutely possible with the right support. Whether your teen struggles to trust others, regulate their emotions, or feel safe, they don’t have to figure things out alone. And neither do you.
At Mission Prep, we specialize in treating teens through our outpatient therapy and residential treatment programs. Combining clinical expertise with evidence-based approaches, empathy, and trauma-informed care, we’re here to help your teen heal.
If you’re ready to take the next step, our team can talk you through treatment options. Reach out today for a confidential consultation.
References
- Larsen, S. (n.d.). Complex PTSD. U.S. Department of Veterans Affairs, National Center for PTSD. Retrieved August 5, 2025, from https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp
- Chiu, H. T. S., Alberici, A., Claxton, J., & Meiser-Stedman, R. (2023). The prevalence, latent structure and psychosocial and cognitive correlates of complex post-traumatic stress disorder in an adolescent community sample. Journal of Affective Disorders, 340, 482–489. https://doi.org/10.1016/j.jad.2023.08.033
- World Health Organization . (2018). International classification of diseases 11th Revision (ICD-11). WHO. https://icd.who.int/browse11/l-m/en
- Cleveland Clinic. (2025, July 15). CPTSD (Complex PTSD). https://my.clevelandclinic.org/health/diseases/24881-cptsd-complex-ptsd
- McGarvie, S., PhD. (2025, March 27). Attachment Theory, Bowlby’s Stages & Attachment Styles. PositivePsychology.com. https://positivepsychology.com/attachment-theory/
- Lahousen, T., Unterrainer, H. F., & Kapfhammer, H. (2019). Psychobiology of Attachment and Trauma—Some general remarks from a clinical perspective. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00914
- Moore, M. (2023, August 21). Understanding disorganized attachment. Psych Central. https://psychcentral.com/health/disorganized-attachment
- National Health Service (NHS) (2022, August 1). Complex PTSD – Post-traumatic stress disorder. https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/com
- De Arellano, M. a. R., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-Focused Cognitive-Behavioral therapy for Children and Adolescents: Assessing the evidence. Psychiatric Services, 65(5), 591–602. https://doi.org/10.1176/appi.ps.201300255
- Geddes, K., Dziurawiec, S., & Lee, C. W. (2013). Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adolescent Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service. Psychiatry Journal, 2013, 1–10. https://doi.org/10.1155/2013/145219
- Ewing, E. S. K., Diamond, G., & Levy, S. (2015). Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support. Attachment & Human Development, 17(2), 136–156. https://doi.org/10.1080/14616734.2015.1006384
- Diamond, G., Siqueland, L., & Diamond, G. M. (2003). Attachment-based family therapy for depressed adolescents: programmatic treatment development. Clinical Child and Family Psychology Review, 6(2), 107–127. https://doi.org/10.1023/a:1023782510786
