The trauma went on for years rather than happening in one single identifiable moment
Larchmont, NY • In-Person & Online Across NY, NJ & PA
Complex PTSD Therapy
Therapy for C-PTSD, the pattern that follows repeated or prolonged trauma rather than one single event, in Larchmont and online.
Talia DiPietro, LCSW
What Is Complex PTSD?
Complex PTSD describes what can develop after trauma that was repeated or prolonged, most often within a relationship there was no easy way to leave. Childhood abuse, long-term neglect, and controlling adult relationships are common origins.
It carries the core PTSD symptoms and adds three more: difficulty regulating emotions, a persistently negative sense of yourself, and ongoing trouble feeling close to other people. That last cluster is usually what makes daily life hardest.
C-PTSD is a recognized diagnosis in the World Health Organization’s ICD-11. It is not a separate diagnosis in the DSM-5-TR used across much of United States practice, which is why some clinicians use the term and others do not.
a personal note
Complex Trauma Is Where I Work
I’m Talia DiPietro, a Licensed Clinical Social Worker in Larchmont, New York, and complex trauma and relational trauma are the core of my practice.
Clients often tell me they spent years being treated for anxiety or depression without acknowledging the impact of their history. Framing matters. Getting the right one helps you understand yourself and your symptoms differently, and changes what the work is able to do.
what we work on
Has This Been Going On Longer Than You Can Remember?
- Emotions arrive at full intensity and take hours to come back down
- You carry a background belief that there is something wrong with you
- Closeness feels unsafe, so you keep people at a manageable distance
- You go numb or disconnected when things get to be too much
- You have been treated for anxiety or depression with limited effect
- You cannot point to one event, because it was simply how life was
how it works
How I Approach Complex PTSD
Regulation before excavation. The first work is on managing emotional intensity, because processing anything at all is harder when your baseline is already overwhelmed.
Distress tolerance skills. I bring in DBT skills for the moments when feelings spike faster than thought can catch them, so you have something usable in real time.
The self-concept gets attention. The belief that you are fundamentally defective is a symptom of prolonged trauma, and it gets treated as one rather than as a settled fact.
Relationships are part of treatment. Since the injury happened inside a relationship, the patterns showing up in how you relate now are working material — consistent, positive relating here is one of the ways we can heal past injury.
No single-event requirement. You do not need one clear story in order to do this work. We start from the pattern you are living inside now and trace it back from there.
what we work on
What I Help With
Emotional flashbacks. Sudden returns to an old emotional state with no clear image attached to it, and practical skills for coming out of them.
Emotion regulation. Work on feelings that spike up to full intensity very fast and then take a long time to settle back down again.
Negative self-concept. The persistent background sense of being defective or fundamentally unworthy that prolonged trauma tends to install.
Difficulty with closeness. Support when intimacy registers as a risk and keeping distance has become the safer but much lonelier default.
Dissociation and numbing. Understanding why you disconnect under pressure, and building some other options for those same difficult moments.
Hypervigilance and exhaustion. The genuine cost of scanning for threat without a break, and practical work on lowering that baseline over time.
is this a fit?
Complex PTSD Therapy Is for You, If:
Treatment for anxiety or depression alone has not touched the underlying pattern
You want a therapist whose main body of work is complex and relational trauma care
Getting started is simple
How to Get Started
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01
Book a Free Consultation
Use the contact form or call 929-400-7783 to set up a free 20-minute phone or video consultation.
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02
Talk It Through
We go over what brought you here and whether I am the right fit. If so, I send consent forms and we schedule.
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03
Begin the Work
We map out what is driving the pattern, agree together on where to start, and work at a pace you set.
Common questions
Frequently Asked Questions
What is complex PTSD, and what causes it?
It is the pattern that can follow repeated or prolonged trauma, usually inside a relationship that is hard to escape. Alongside standard PTSD symptoms it involves difficulty regulating emotion, a negative sense of self, and trouble feeling close to people. It is treatable.
What is the difference between PTSD and C-PTSD?
PTSD typically follows a discrete event and centres on intrusion, avoidance, and arousal. C-PTSD follows trauma that is repeated over time and adds problems with emotion regulation, self-concept, and relationships. The added cluster is often what affects daily life most.
Is complex PTSD a real and recognized diagnosis?
It is a formal diagnosis in the ICD-11, the World Health Organization’s classification. It is not listed separately in the DSM-5-TR, which is what most United States clinicians and insurers work from. Both are true, so the term is recognized here without being universal.
What are the symptoms of complex PTSD in adults?
Emotional flashbacks, feelings that spike and take hours to settle, a persistent belief that you are defective, dissociation under pressure, hypervigilance, and difficulty tolerating closeness. Many adults also carry a chronic exhaustion built up over years of staying alert.
Can complex PTSD be treated, and how long does it take?
It responds to therapy, though the timeline is generally longer than for single-event trauma. Progress is uneven. Most of the early work goes into regulation and skills rather than the history itself. I can describe the process honestly, but I cannot promise you a particular result.
Do you take insurance, and how do I get started?
I am out of network and do not bill insurance directly, though I provide superbills you can submit for reimbursement. My fee is $275 and I offer 5-session packages based on sliding scale needs. To start, call or use the contact form. I respond within 24 to 48 hours.
Ready when you are
Ready to start complex PTSD therapy?
Reach out for a free 20-minute consultation — no pressure, just a conversation.
If you are in crisis or thinking about harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911. Therapy is not an emergency service.