Abstract

This paper follows from my previous articles ‘What is complex trauma?’ which outlined a the-ory of complex trauma as a chronic condition in which the biological fear system is unable to deactivate, and ‘What is complex trauma? Part 2: Working with the body’, which examined the implications of this theory for working directly with the physical reactions of the body, in addi-tion to traditional ‘talking therapy’ approaches. This current paper reflects further on the issue of complexity and its practical implications for our work as therapists, examining among other things the nature of the organic change which underpins therapy and setbacks and limitations involved in working with complex trauma. It also reflects on the variety of approaches that may be required by this complexity, and the issue of our competence in undertaking this work.