How can Complex PTSD (CPTSD) and attachment trauma be treated? What are the differences between Sensorimotor Psychotherapy, Relational Psychoanalysis, Emotionally Focused Therapy (EFT), Internal Family Systems (IFS), and Eye Movement Desensitization and Reprocessing (EMDR)? In this article, I use a fictional CPTSD consultation scenario to compare how five trauma-informed approaches work through the body, emotion, internal parts, the therapeutic relationship, and traumatic memory. I also answer common questions about CPTSD treatment, intergenerational trauma in parenting, and uncertainty about whether to have children.
Reading time: about 10 minutes
1. Fictional therapy scenario - Parenting
2. Sensorimotor Psychotherapy for Attachment Trauma in Parenting
3. Relational Psychoanalysis for Attachment Trauma in Parenting
4. Emotionally Focused Therapy (EFT) for Attachment Trauma in Parenting
5. Internal Family Systems (IFS) for Attachment Trauma in Parenting
6. EMDR for Attachment Trauma in Parenting
7. Why flexibility and safety matter
8. Common questions about CPTSD and parenting
CPTSD treatment comparison, part 2: IFS vs. EMDR Therapy vs. Sensorimotor Psychotherapy
CPTSD treatment comparison, part 3: How IFS helps heal CPTSD and dissociation
This case is fictional. I have tried to avoid overlap with real client material or actual consultations. Any resemblance is coincidental.
Client: A 39-year-old woman, an only child, and the adoptive mother of a 3-year-old girl. She deeply wants to become “a more loving mother than my own mother was,” but recently she has been having angry outbursts when her daughter becomes “too clingy” or “deliberately challenging.” Afterward, she feels intense guilt and often lies awake at night. She remembers growing up in a home that alternated between warmth and coldness. Her mother often used silence and emotional neglect to control her. Lately she keeps thinking, “Maybe I’m not meant to be a mother.” She has already completed 20 therapy sessions and has developed a fairly strong level of trust with the therapist.
Below, I sketch how a Sensorimotor Psychotherapy, Relational Psychoanalysis, Emotionally Focused Therapy, Internal Family Systems, or EMDR session might unfold in a case like this. These examples are entirely fictional and are offered only as a general reference point. I also welcome discussion with other therapists. What follows is broad and simplified. In actual therapy, progress is often slower and less linear. It is also very common not to know how to respond when a therapist asks what you feel or think. That is one reason an integrative approach can be helpful. Different clients respond to different therapeutic entry points with different levels of readiness and sensitivity.
The core idea in Sensorimotor Psychotherapy is that trauma is stored not only in memory, but also in the body, including muscle tension, breathing patterns, posture, and defensive habits. When trauma has not been processed, the nervous system can remain stuck in fight, flight, or freeze. Rather than rushing the client to retell the story, the therapist helps the client notice present-moment bodily experience so the nervous system can begin to thaw. Frozen defensive actions can gradually complete themselves, allowing the body to regain safety and choice. This dialogue shows how a client might move from a frozen physical state toward a bodily sense of willingness and connection.
Client:
When she cries and wants me to hold her, I get irritated. I know I should hold her, but my body just freezes. I already promised myself I would love her. Why do I still feel this way? Does this mean I’m not fit to be her mother?
Therapist:
When you say you “freeze,” do you notice anywhere in your arms, chest, or legs that feels especially tight or cold?
Client:
My shoulders lift a little. My back tightens too. It feels like I’m bracing for something.
Therapist:
Let’s try giving your body a signal: “Right now, I am safe.” You can gently press your feet into the floor and notice the support underneath you. Let your body know it does not need to stay prepared. You have time. You can land slowly.
Client:
I notice that every time she cries, my breathing catches. I want to disappear.
Therapist:
Your body’s reaction feels very familiar, as though it belongs to an earlier situation. Let’s spend a little time with the part of you that wants to disappear. I can see your body wanting to curl forward a little.
Client:
When I was little, I really did curl up under the table when my mother ignored me.
Therapist:
Your body remembers her coldness. Let’s see if your shoulders can open outward just a little. Not by force. Just a slow stretch that gives you a little more space and presence. See what happens.
Client:
My shoulders feel a little softer now, but there is still a voice inside saying, “You can’t be this selfish.”
Therapist:
Let’s invite that voice forward for a moment. Could you ask what it is trying to help you do?
Client:
That part is telling me I have to hold my daughter, because I do want to. I want to hold her, but not in the “I must” way. I want to hold her because I want to.
Therapist:
Can your arms make that movement? Not toward anyone else, just as your body expressing the posture of “I’m willing.”
Client:
I can try. It feels strange and familiar at the same time. I think I could hold my daughter in that posture too, not for the sake of doing it right, but for connection. I really do want to hold her.
Therapist:
Exactly. Moving from a stress response into voluntary action is part of how the body rebuilds trust. You are no longer the child who had to cope with a cold mother. You can choose how to respond to closeness now.
Client:
My body feels warmer, and I also want to cry. It feels like I’m saying goodbye to something.
Therapist:
It sounds as though your body is saying goodbye to the self that had to stay suppressed in the past. You can cry. This is no longer danger. It is release.
Client:
I never thought I could connect with her through my body instead of constantly forcing myself in my head to do the right thing.
Therapist:
You are no longer relying only on cognition to control yourself. Your body is helping you become a mother. That is a deeper kind of truth.
Client:
I feel like I can love her. It feels as if that love is coming out of my body, not from what I “should” do, but from a deep willingness.
Therapist:
Yes. You found that path yourself, step by step, from “I should hold her” to “I want to hold her.” Not a perfect mother, but a living person with a body, with choice, and with presence.
(Sensorimotor work often pairs well with grounding practices. Here are six grounding exercises that can help you reconnect with your body and stabilize overwhelming emotion.)
Complete collection of grounding techniques for CPTSD, anxiety, and dissociation
The core idea in Relational Psychoanalysis is that trauma does not remain only in the past. It comes alive again in present relationships, especially in the therapeutic relationship. The therapist does not only interpret the client’s reaction as transference. The focus is also on what is happening between client and therapist in the room, here and now. The therapeutic relationship becomes a place where repair can happen. The client can begin to experience, perhaps for the first time, that they can be understood and accepted in relationship, and that the old internal script is not the only possible one.
Client:
When she cries and wants me to hold her, I get irritated. I know I should hold her, but my body just freezes. I already promised myself I would love her. Why do I still feel this way? Does this mean I’m not fit to be her mother?
Therapist:
It sounds as though becoming a “good enough mother” brings up a lot of confusion for you, and maybe grief and shame too, especially when it feels like you cannot carry out what you decided. I’m curious when you have felt this same frozen feeling in other relationships.
Client:
My mother used to hate it when I cried. She said I was being dramatic. Then she would go cold and ignore me for days. Once she even left me alone on the street. I truly didn’t know what to do.
Therapist:
Being abandoned by a parent is every child’s nightmare. It is about survival. Maybe from very early on, you learned that expressing need would be met with rejection and a harder blow afterward.
Client:
I’m terrified that I’ll become like my mother. The more I try not to be like her, the more out of control I feel.
Therapist:
That sounds like a familiar entanglement. You try to get away from it, but keep circling back to it.
Client:
I think my father didn’t understand me either. He would say, “She’s not even your biological child. Don’t be so emotional.”
Therapist:
Do you feel emotionally unanswered, as if no one is there to meet you? That loneliness can bring you back to the child who was always misunderstood. I also wonder whether you worry that I might misunderstand you as a terrible mother.
Client:
Yes. Even saying this out loud makes me nervous. I’m afraid you’ll think I’m hopeless too.
Therapist:
That is what is happening between us right now. You are testing whether I will pull away, judge you, or disconnect, the way your mother did. But we are still here. That is a new experience. You can be heard without being perfect.
Client:
When you said that, I suddenly wanted to cry. I think I’ve been performing the role of a very composed adult for a long time.
Therapist:
You may finally be able to stop performing for a moment and try being yourself, and that self may be more real and more grounded.
Client:
I suddenly wonder whether the harshness I bring to my daughter is also a way of punishing the child in me who was never good enough.
Therapist:
That is a significant insight. What you demand from her may be an internalized judgment you direct at yourself. It also sounds as though you are beginning to distinguish what belongs to history and what belongs to the present.
Client:
Back then I kept wanting my mother to turn around and look at me. I thought if I were good enough, she would pick me up.
Therapist:
That image is painful. You were already good enough, and she still did not turn back. Maybe what you longed for was not obedience, but a sense that you were worthy. I can also see that you are not relating to your daughter in exactly the same way.
Client:
I hear a voice inside now saying that I can try to become a different kind of mother. Yes, I really am different from my mother.
Therapist:
Yes. You are not imitating someone else. In relationship and in experience, you are becoming the mother you want to be.
Client:
She is my daughter, and I am her mother. It’s not that I “should” love her. I choose to love her.
Therapist:
I can see your sense of self strengthening. Loving her is no longer a maternal task imposed on you. It is your own willing response.
The core idea in Emotionally Focused Therapy (EFT) is that emotion itself is the primary medium of change. The therapist helps the client move from secondary emotions such as irritation or anger into primary emotions such as sadness, fear, and loneliness. Through techniques such as two-chair dialogue, the client can create movement between different emotional positions, soften self-criticism, and transform maladaptive emotional patterns. This dialogue shows how a client might move from surface irritation into fear of abandonment and longing for connection.
Client:
When she cries and wants me to hold her, I get irritated. I know I should hold her, but my body just freezes. I already promised myself I would love her. Why do I still feel this way? Does this mean I’m not fit to be her mother?
Therapist:
I hear you say “irritated,” but I also notice your voice shaking as you say it. If we slow this down and feel underneath the irritation, what else is there? Fear? Sadness?
Client:
Fear. When she cries, I feel afraid, as if something is about to spin out of control.
Therapist:
So irritation is what sits on the surface, and underneath it is fear. Can you stay with that fear a little longer? Where do you feel it in your body? How old does it feel?
Client:
In my chest. Curled up into a ball. Very small, maybe five or six years old. When my mother was upset, she would ignore me, no matter how much I called for her.
Therapist:
So when your daughter cries and wants you to hold her, the five- or six-year-old girl inside you is crying too. She is carrying the fear from back then: “Mom is going to disappear again.” Can you feel that child’s fear right now?
Client:
She is so scared. She thinks she must have done something wrong for her mother not to want her.
Therapist:
I want to invite you to try something. If you feel ready, imagine that five-year-old version of you sitting in this chair, and sit in the chair across from her. What would you want to say to her?
Client:
It wasn’t your fault. It wasn’t your fault. She didn’t know how to love you.
Therapist:
When you say that, how does the little girl respond?
Client:
She seems relieved, as if someone finally saw her.
Therapist:
Can that feeling of being seen also enter the relationship with your daughter? The next time she cries for you, instead of “I should hold her,” could the child inside you remember that someone who is crying needs to be seen?
Client:
I think I suddenly understand that I’m not angry at her. I’m angry that no one did this for me when I was little.
Therapist:
That sentence matters. You are beginning to distinguish past pain from present fault. That distinction itself can help you become a different kind of mother.
Client:
I want to hold her. This time I really want to, not because I should, but because I want to.
Therapist:
Can you notice the difference in your body between “should” and “want to”?
Client:
“Should” is tight. It feels like a command. “Want to” is warm. It feels like it comes out of my chest.
Therapist:
That is your body telling you something true. You do not need to force yourself with “should” in order to be a good mother. The capacity to love her is already there. It has just been held down by childhood fear, and now it is starting to move again.
The core idea in Internal Family Systems (IFS) is that the mind is made up of different parts. Some are protectors, including Managers and Firefighters. Others are Exiles that carry traumatic memory and vulnerable emotion. Each person also has a core Self with qualities such as calm, clarity, curiosity, and compassion. The therapist helps the client build dialogue with these parts, understand their protective intentions, and allow Self to care for wounded parts. This dialogue shows how a client might identify a critical maternal part, a frozen protector, and a wounded child part, and begin letting Self take the lead.
Client:
When she cries and wants me to hold her, I get irritated. I know I should hold her, but my body just freezes. I already promised myself I would love her. Why do I still feel this way? Does this mean I’m not fit to be her mother?
Therapist:
I hear you say that you froze. I want to invite you to slow down and notice whether a part of you is speaking right now. Maybe there is an irritated part. Maybe there is a self-critical part. Which part most wants to speak first?
Client:
There’s a voice that keeps saying, “You can’t do this. You don’t know how to be a mother.”
Therapist:
Where do you feel that voice in your body?
Client:
At the back of my head, like a tightening band.
Therapist:
If we call that voice the critical part, how do you feel toward it? Do you hate it, or are you at least a little curious about it?
Client:
I hate it. It keeps telling me I’m not good enough.
Therapist:
That makes sense. I also want to invite you to try something. See whether the part that hates it can step back a little, so you can ask with some curiosity, “What are you trying to help me do? What are you protecting me from?”
Client:
It says, “Don’t hold her. If you do, you’ll get hurt, just like when you reached for your mother and got pushed away.”
Therapist:
So this critical voice is actually a protector. It criticizes you to stop you from holding your daughter because it fears you will relive that childhood pain. Can you see its good intention, even if the method hurts you?
Client:
Yes. I think I can. It’s trying to protect me.
Therapist:
What changes in your feeling toward it when you see that?
Client:
I don’t hate it as much. It must be tired, guarding my mind all the time.
Therapist:
Would you be willing to say something to it? Maybe: “I see that you’re protecting me. Thank you for working so hard. I can also see that you’re tired. You can rest a little now. I’m grown now, and I can face this differently.”
Client:
I see that you’re protecting me. Thank you for working so hard. I can also see that you’re tired. You can rest a little now. I’m grown now, and I can face this differently.
Therapist:
How does that part respond when it hears you say that?
Client:
It feels much better. Like it is calming down and loosening.
Therapist:
Let’s stay with that calmness and thank that part for telling us what it knows. Now I want to ask whether any other part is present in your body as you notice this.
Client:
There’s a very small part in my chest. Heavy. Painful. She’s crying.
Therapist:
If you’d like, can you move a little closer to that part? How old is she?
Client:
Very little, maybe three or four. She got pushed away and was left standing there alone, not knowing what to do.
Therapist:
Can you gently ask that three- or four-year-old part what she needs?
Client:
She says she needs someone to walk toward her, kneel down, and hold her.
Therapist:
Can you, from the calmer and stronger place in you, move toward her now, kneel down, hold her, and tell her, “I’m here. I won’t leave you standing there alone anymore”?
Client:
I’m moving toward her. I’m kneeling down and holding her. I want to say, “Your older sister is here. I’ll stay with you. You won’t be alone.”
Therapist:
What expression does the little girl have now?
Client:
She’s holding me. She’s crying, but it doesn’t hurt as much.
Therapist:
Let’s stay with that embrace. I can see you smiling.
Client:
I feel like I can hold her now. Not because I should, but because there is someone to hold me, and there is someone to hold her too.
The core idea in Eye Movement Desensitization and Reprocessing (EMDR) is based on the Adaptive Information Processing model. Traumatic memories continue to bring pain because they have not been fully processed. Instead, they remain frozen in the nervous system in fragmented form, carrying the original images, bodily sensations, emotions, and negative beliefs. When the client activates a target memory while receiving bilateral stimulation such as eye movements, tapping, or tones, the brain enters a state of information processing that resembles REM sleep. The client’s task is not to control or analyze, but simply to notice. The brain continues the work it is built to do. This dialogue shows part of that process after earlier preparation, including safety, stabilization skills, and identifying the target memory.
Client:
When she cries and wants me to hold her, I get irritated. I know I should hold her, but my body just freezes. I already promised myself I would love her. Why do I still feel this way? Does this mean I’m not fit to be her mother?
Therapist:
I hear you say you froze. In earlier sessions, you already practiced some stabilization skills, and we agreed to start working with the most central memory. I want to invite you back to the earliest scene that carries this frozen feeling. Would you be willing to describe it?
Client:
Yes. I was three years old. My mother left me on the street and walked away. I stood there crying and calling for her, and she never turned back.
Therapist:
As you picture that scene, which part feels the hardest right now?
Client:
Her back as she walked away. And me standing there surrounded by strangers. I felt like no one in the world wanted me.
Therapist:
What negative belief about yourself goes with that image? Something like “I’m not good enough” or “It was my fault.”
Client:
“I’m not good enough. I’m not worthy of love.” That’s the sentence. When she walked away, I felt sure she left because I wasn’t good enough.
Therapist:
If there were a positive belief about yourself that you would rather be able to believe, what would it be?
Client:
“I am worthy of love.” But when I say it, it feels very far away.
Therapist:
On a scale from 1 to 7, where 1 feels completely false and 7 feels completely true, how true does “I am worthy of love” feel right now?
Client:
1. Maybe not even 1.
Therapist:
All right. Now go back to the image. You are standing there, and your mother is walking away. On a scale from 0 to 10, where 0 is completely calm and 10 is the worst distress you can imagine, how disturbing does it feel right now?
Client:
10.
Therapist:
Where in your body do you feel the disturbance most strongly?
Client:
In my chest. It feels as though something is pressing down on it and I can’t breathe.
Therapist:
Good. Hold the image, the thought “I am not worthy of love,” and the sensation in your chest. Then follow my fingers with your eyes. You do not need to force anything. Just let your brain do its work. We’ll begin.
(The therapist begins a set of bilateral eye movements and stops after about 20 to 30 passes.)
Therapist:
Take a breath. What do you notice now?
Client:
I can see that I reached my hand out when she left. I always thought I was just standing there crying, but I reached out.
Therapist:
Good. Let’s continue from there.
(Second set of eye movements.)
Therapist:
Take a breath. What do you notice now?
Client:
She turned around. No, she didn’t. I just kept hoping she would turn around. I kept waiting for something that was never going to happen.
Therapist:
You can see the waiting itself. Let’s keep going from there.
(Third set of eye movements.)
Therapist:
Take a breath. And now?
Client:
I suddenly see that there were other people on the street. A woman stopped. I think she was looking at me. I never noticed her before. Someone did see me.
Therapist:
Stay with that image.
(Fourth set of eye movements.)
Therapist:
Take a breath. Has the image changed now?
Client:
That woman is walking toward me. She kneels down and asks, “What’s wrong?” I never remembered this part. I was always staring at my mother’s back. I never saw her.
Therapist:
What do you notice now?
Client:
She wasn’t my mother, but she didn’t walk away. So I wasn’t completely alone on that street after all.
Therapist:
Go back to the image now. Your mother is walking away. You are standing there. From 0 to 10, how disturbing does it feel now?
Client:
7. My chest is still heavy, but not as much.
Therapist:
Let’s continue from there.
(More sets of eye movements continue. In a case like this, it may take many sessions or hours of therapy for the distress level to come down further.)
Client:
I think I can breathe now. The pressure has eased a little. Maybe the disturbance is around a 2.
Therapist:
And how true does “I am worthy of love” feel now, from 1 to 7?
Client:
4. Maybe 5. It no longer feels completely impossible.
Therapist:
Good. Now scan your body from head to toe. Is there any discomfort left, any residual tightness, heaviness, or strain?
Client:
My shoulders are still tight, as if they are still preparing for something.
Therapist:
Let’s place attention on the shoulders and notice that sense of preparing. Then continue from there.
(Final set of eye movements, focused on the shoulder tension.)
Therapist:
Take a breath. And now?
Client:
My shoulders let go. My whole body sinks into the chair. Not light, but steady.
Therapist:
Now when you go back to the image, what is the disturbance level?
Client:
2. It’s still there, but now it feels like a memory, like looking at an old photograph.
Therapist:
And how true does “I am worthy of love” feel now?
Client:
6. I think it may be true. I’m not sure I fully believe it yet, but it no longer feels like a lie.
Therapist:
We did a great deal today. Before we finish, I want to help you return to a safe and steady state. You can close your eyes and imagine the place we discussed before, the place where you feel safe. Bring in as much sensory detail as you can and settle into it.
All right. Now slowly bring your attention back to this room. Feel the chair beneath you and the ground under your feet. When you are ready, you can open your eyes.
Client:
I can feel that the three-year-old girl was not alone. I always thought that once she was left on the street, no one saw her again. But today I could see someone walking toward her. That woman was not my mother, but she did see her.
Sensorimotor techniques help the body regain resources so trauma does not remain trapped in thought alone. The body begins to experience what life could feel like if trauma were no longer driving the whole system.
Emotionally Focused Therapy helps us see that beneath irritation there may be fear, and beneath shame there may be a self that has never been fully held.
Internal Family Systems invites us to turn toward each part inside. The critical voice is not an enemy. It is an exhausted protector. The one curled up in the corner is not weakness. It is an exiled part carrying pain.
Relational Psychoanalysis brings repair into the space between you and another person. The past is not the only possibility. A new relationship can support a new internal script.
EMDR uses bilateral stimulation to help frozen fragments of memory begin moving again, so what happened can become part of the past rather than something that keeps happening in the present.
Sensorimotor Psychotherapy enters through the body. Emotionally Focused Therapy enters through emotion. Internal Family Systems enters through the internal system. Relational Psychoanalysis enters through the interpersonal field. EMDR enters through the neural encoding of memory. These approaches reach the same core pain through different entry points. In practice, they can often be integrated rather than treated as competing schools. Depending on your state in the moment, a therapist may begin by stabilizing the body, staying with emotion, speaking with internal parts, using the therapeutic relationship as a site of repair, or supporting the brain’s ongoing integration of traumatic material.
These approaches do not cancel each other out. In many cases, they can work together and help you move from isolation toward connection and more stable self-leadership.
For a broader overview of CPTSD treatment, you can also read:
A: Yes. Long-term neglect, rejection, unpredictable caregiving, or abuse from a primary caregiver can shape how you later understand yourself, other people, and intimacy. Research shows a significant association between childhood maltreatment and adult attachment anxiety and avoidance. That influence is not destiny. Safe adult relationships and psychotherapy can still help a person develop more secure relational patterns.[1][2]
A: Becoming a parent can reactivate attachment experiences that were never fully processed. A child’s crying, clinginess, refusal, or intense emotion may trigger familiar fear, helplessness, shame, or rejection in the parent. Research has found links between a parent’s own childhood maltreatment history and some negative parenting behaviors, but the association is not inevitable. A trauma history does not mean someone is destined to repeat the previous generation. What matters is whether the person can notice their trauma reactions and work toward repair.[3][4]
A: Trauma reactions do not happen only at the level of rational thought. When a child’s behavior activates an old sense of threat, the first response may be bodily tension, freezing, avoidance, anger, or emotional numbing. Awareness often comes later. That is why “I know what I want to do” and “my body cannot do it yet” can both be true at the same time. Body-based trauma therapies pay close attention to these defensive and arousal responses.[5]
A: PTSD mainly includes re-experiencing, avoidance, and a persistent sense of threat. In ICD-11, Complex Post-Traumatic Stress Disorder (CPTSD) also includes three disturbances in self-organization: affect dysregulation, a persistent negative self-concept, and ongoing interpersonal difficulty. CPTSD is often associated with prolonged, repeated, or relational trauma, such as childhood abuse or long-term domestic violence.[6]
A: There is no single treatment sequence that fits every person with CPTSD. Traditional phase-based treatment often includes stabilization, trauma memory processing, and integration. More recent research suggests the question is still debated. A 2026 systematic review and meta-analysis found no clear difference between phase-based and non-phase-based treatment on many outcomes, though multi-phase treatment may have some advantages for certain PTSD symptoms and emotion regulation difficulties. Even in non-phase-based treatment, the therapist still needs to judge whether the client is ready. At this point, it makes more sense to treat phases as a flexible reference than as a rigid linear rule. The key is to adjust the pace to the person’s symptoms, stability, resources, and readiness.[6][7]
A: Internal Family Systems (IFS) understands inner experience as an interaction among different parts and helps the client build a calmer, more curious, and more compassionate relationship with those parts. Research on IFS for PTSD and multiple childhood traumas is still at an early stage. One pilot study of adults with multiple childhood traumas found improvement after 16 sessions of IFS in PTSD symptoms, dissociation, emotion regulation, and self-concept. Because the study did not include a randomized control group, the findings are still preliminary rather than definitive evidence that IFS is an established standard treatment for CPTSD.[8]
A: Emotionally Focused Therapy (EFT) is built around attachment and emotional connection. It helps couples identify the deeper emotions and attachment needs underneath conflict. In a randomized controlled trial involving female survivors of childhood abuse and their partners, EFT for couples improved relationship functioning and reduced trauma-related distress. EFT can be especially useful when you want to understand patterns such as “Why am I so afraid of rejection?” or “Why do I push someone away most when I most need connection?”[9][10]
A: EMDR has a substantial evidence base for PTSD, and more research is examining its use with prolonged childhood trauma and CPTSD. In complex trauma, treatment often needs to be adjusted to the client’s level of stability, including resourcing, trauma memory processing, and work around rebuilding self and relationship. Research on EMDR specifically for CPTSD remains more limited than the broader PTSD literature, so it is not clinically accurate to assume EMDR works in the same way for every client with CPTSD.[10][11][12]
A: Relational Psychoanalysis looks at how early attachment experience enters current relationships, including how you expect other people to respond, how you protect yourself, and how those patterns appear again in the therapeutic relationship. Therapy is not only a place to talk about the past. It can also become a place to experience a different kind of relationship. For attachment trauma, a safe, consistent, and deeply understood relational experience can itself be therapeutic. Some research also suggests that the therapeutic relationship is one of the strongest factors in treatment outcome across modalities.[2][13]
A: No. Childhood trauma can increase the risk of certain insecure parenting patterns or attachment difficulties, but it does not create an unavoidable cycle. A 2025 meta-analysis found a weak but significant association between parental childhood maltreatment and offspring attachment insecurity, while the association with attachment disorganization was not significant. In other words, having a trauma history does not mean you are destined to become a traumatized parent. Psychotherapy, greater self-awareness, stronger emotion regulation, and more secure parent-child relationships can all help shift that pattern.[3][14]
A: There is no simple line between those two possibilities. Choosing not to have children can be a stable, self-directed decision that fits your values. It does not automatically mean there is trauma underneath it. For people with childhood trauma histories, decisions about parenthood can also become entangled with earlier relational experience, fear of repeating trauma, uncertainty about caregiving capacity, or fear of intimacy. Research suggests that some people with histories of adversity delay or avoid having children because they fear repeating their parents’ patterns, doubt their ability to protect a child, or feel they are not good enough. That still does not mean every person who does not want children is acting from trauma. A more useful question may be this: Is this choice coming from freedom and values, or is it being narrowed by fear, shame, and the past?[15][16]
A: Many people who are re-examining their own childhood trauma ask exactly this. Childhood maltreatment is associated with lower parenting self-efficacy, higher parenting stress, and more self-doubt in the transition to parenthood, but that does not mean a person with trauma cannot become a capable parent.[17][18] In fact, being able to recognize your trauma, worry about repeating the past, and actively seek understanding and change can itself become an important step in interrupting intergenerational patterns. You do not need to be a perfect parent in order to build a safe and stable relationship with a child.
A: Yes, though the more accurate statement is that research has found an association, not that trauma automatically causes someone not to want children. One study of 1,004 Korean university students found that 40.4% reported no intention to have children in the future. After controlling for demographic variables and depressive symptoms, childhood emotional abuse remained one significant predictor of lower desire for marriage and parenthood. Other research suggests that childhood maltreatment may shape attitudes toward parenting through its effects on mental health, intimate relationships, beliefs about caregiving capacity, and fear of becoming a parent.[16][17][19]
A: Current research suggests several overlapping pathways. One is fear of repetition: the fear of unconsciously repeating the parenting style one grew up with. Another is low confidence in one’s caregiving ability: childhood maltreatment is associated with lower parenting self-efficacy and greater self-doubt about caregiving. A third is safety and relational patterning: when early family relationships were shaped by unpredictability, rejection, or harm, becoming a parent may reactivate attachment and caregiving patterns formed in those settings. A fourth is fear of transmitting trauma: some trauma survivors strongly want to become a different kind of parent while also fearing that they may not be able to do so.[16][17][18]
A: First, try to distinguish “my partner does not understand me” from “my partner does not respect me.” Your partner may not have lived through the same childhood conditions you did, so your fear around parenthood may not make immediate intuitive sense to them. It may help to use “I” language, such as: “When I think about having a child, I become afraid that I might repeat parts of what I lived through growing up,” rather than “You just don’t understand me.” You do not need to explain your entire trauma history at once. You can share gradually, within your own window of safety and capacity. It is also important to make room for the possibility that two people may genuinely want different things regarding parenthood. Understanding each other does not require changing your decision. If this is already affecting the relationship, couples therapy may help both of you better understand the emotion, values, and needs underneath the conflict.[20][21]
Li Li, Registered Psychotherapist (Ontario), integrates psychoanalysis, EMDR, IFS, Sensorimotor Psychotherapy, Emotionally Focused Therapy, and other trauma-informed approaches, with a focus on relationship healing and complex trauma. You are welcome to book a free consultation and begin the work of healing with me.
[1] Li, S., Ma, Y., Cao, X., Liu, J., Qi, Y., & Chen, X. (2026). Childhood Maltreatment and Adult Attachment: A Three-Level Meta-Analytic Review. Trauma, Violence, & Abuse.
https://doi.org/10.1177/15248380261455767
[2] Barazzone, N., et al. (2019). The links between adult attachment and post-traumatic stress: A systematic review. Psychology and Psychotherapy: Theory, Research and Practice.
https://doi.org/10.1111/papt.12181
[3] Greene, C. A., Haisley, L., Wallace, C., & Ford, J. D. (2020). Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence. Clinical Psychology Review, 80, 101891.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7476782/
[4] Isobel, S., Foster, K., & Edwards, C. (2019). Preventing intergenerational trauma transmission: A critical interpretive synthesis. Journal of Clinical Nursing.
https://doi.org/10.1111/jocn.14735
[5] Ogden, P., & Minton, K. (2000). Sensorimotor Psychotherapy: One Method for Processing Traumatic Memory. Traumatology, 6(3), 149–173.
https://doi.org/10.1177/153476560000600302
[6] Darby, R. J., Taylor, E. P., & Segovia Cadavid, M. (2023). Phase-based psychological interventions for complex post-traumatic stress disorder: A systematic review. Journal of Affective Disorders Reports, 14, 100628.
https://doi.org/10.1016/j.jadr.2023.100628
[7] Lee, Y., Park, S., & Cho, Y.-E. (2026). Phase-based versus non-phase-based psychological interventions for complex PTSD: A systematic review and meta-analysis. European Journal of Psychotraumatology.
https://doi.org/10.1080/20008066.2026.2644112
[8] Hodgdon, H. B., Anderson, F. G., Southwell, E., Hrubec, W., & Schwartz, R. (2022). Internal Family Systems (IFS) Therapy for Posttraumatic Stress Disorder (PTSD) among Survivors of Multiple Childhood Trauma: A Pilot Effectiveness Study. Journal of Aggression, Maltreatment & Trauma, 31(1), 22–43.
https://doi.org/10.1080/10926771.2021.2013375
[9] Li Li (2026), Leaf Light Therapy, Toronto Trauma Therapy, Healing CPTSD Modalities Comparison & Integration: IFS vs EMDR Therapy vs Sensorimotor Psychotherapy
[10] Dalton, E. J., Greenman, P. S., Classen, C. C., & Johnson, S. M. (2013). Nurturing Connections in the Aftermath of Childhood Trauma: A Randomized Controlled Trial of Emotionally Focused Couple Therapy for Female Survivors of Childhood Abuse. Couple and Family Psychology: Research and Practice, 2(3), 209–221.
https://doi.org/10.1037/a0033117
[11] Korn, D. L. (2009). EMDR and the Treatment of Complex PTSD: A Review. Journal of EMDR Practice and Research, 3(4), 264–278.
https://doi.org/10.1891/1933-3196.3.4.264
[12] de Jongh, A., Bicanic, I., Matthijssen, S., et al. (2019). The Current Status of EMDR Therapy Involving the Treatment of Complex Posttraumatic Stress Disorder. Journal of EMDR Practice and Research, 13(4), 284–290.
https://doi.org/10.1891/1933-3196.13.4.284
[13] Sette, G., et al. (2015). The transmission of attachment across generations: The state of the art and new theoretical perspectives. Scandinavian Journal of Psychology.
https://doi.org/10.1111/sjop.12212
[14] Sirparanta, A. E., Danner Touati, C., Cyr, C., & Miljkovitch, R. (2025). Parental History of Childhood Maltreatment and Offspring Attachment Insecurity and Disorganization: Two Meta-Analyses. Trauma, Violence, & Abuse.
https://doi.org/10.1177/15248380241282995
[15] Blackstone, A. (2012). Choosing to Be Childfree: Research on the Decision Not to Parent. Sociology Compass, 6(9), 718–727.
https://doi.org/10.1111/j.1751-9020.2012.00496.x
[16] Chamberlain, C., Gee, G., Brown, S. J., et al. (2019). Healing The Past By Nurturing The Future: A qualitative systematic review and meta-synthesis of pregnancy, birth and early postpartum experiences and views of parents with a history of childhood maltreatment. PLoS ONE, 14(10), e0225441.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6910698/
[17] Greene, C. A., Haisley, L., Wallace, C., & Ford, J. D. (2020). Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence. Clinical Psychology Review, 80, 101891.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7476782/
[18] Martin, L. N., Renshaw, K. D., Kelly, A. G., & Goldberg, D. G. (2026). “Desperate not to make the same mistakes”: Couple adjustment to parenthood in the context of childhood maltreatment. Infant Mental Health Journal.
https://doi.org/10.1002/imhj.70106
[19] Lee, J., Kim, S.-G., Youn, H., & Lee, S. I. (2021). Childhood Emotional Abuse Is Associated With the Desire to Get Married and Have Children in Korean Young Adults. Psychiatry Investigation, 18(11), 1117–1124.
https://doi.org/10.30773/pi.2021.0211
[20] Roddy, M. K., Walsh, L. M., Rothman, K., Hatch, S. G., & Doss, B. D. (2020). Meta-analysis of couple therapy: Effects across outcomes, designs, timeframes, and other moderators. Journal of Consulting and Clinical Psychology, 88(7), 583–596.
https://doi.org/10.1037/ccp0000514
[21] Javadivala, Z., Allahverdipour, H., Jafarabadi, M. A., et al. (2021). Improved couple satisfaction and communication with marriage and relationship programs: Are there gender differences?—A systematic review and meta-analysis. Systematic Reviews, 10, 178.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8215832/