The idea of complex trauma has been making some buzz in the mental health field in the last few years. The concept is even starting to get into mainstream language. Perhaps you’ve even heard of it but you still aren’t really sure what it is.
I Didn’t Know Either
In 2015, my therapist diagnosed me with PTSD. I didn’t understand. How could I have PTSD?
I hadn’t experienced a significant traumatic event. I didn’t have these intrusive, terrifying flashbacks. I didn’t have nightmares like those who get them every night related somehow to being back in the traumatic event.
Where did my therapist come up with this diagnosis?
Well, it turns out, there’s more than one kind of trauma. We frequently think of trauma as a big, single event. This is the type of trauma we generally think about when we think about precipitating a diagnosis of PTSD. This could be a car accident, a natural disaster, or violence.
Complex trauma, however, doesn’t have to be a specific event. Complex trauma involves smaller and repeated stressors over time. It typically involves harm caused by those who are supposed to be our caregivers.
When these repeated stressors happen during developmental stages in childhood, it is considered developmental complex trauma because it severely impedes the developmental process.
Understanding A Trauma Response
Before I describe complex trauma in more detail, I’d like to back up a bit to briefly describe a trauma response.
When we experience stress that threatens our sense of safety, our bodies respond in all kinds of ways. We go into survival mode, or what is often referred to as “fight, flight, or freeze.” We have physiological and psychological reactions that help us to survive.
When we fear physical or psychological harm, our bodies respond with a physical reaction. Our brains release chemicals that give us the ability to fight, flight, or freeze as a way to survive the situation. We may tense up. Our heart rate may increase and feel like our heart is going to beat out of our chest. We may get sweaty hands. Our breathing can become fast and labored. We may go the other way and freeze, unable to protect ourselves or run away.
In addition to having a physiological response to stressors, we often experience a psychological response as well. The flight response may present as anger or an intense rush of adrenaline helping us stand up or fight for our safety.
The flight response may present as extreme anxiety and fear. We could become hyper vigilant, feeling like danger is all around us and we have to constantly look out for it. We might need to feel the need to escape and run away.
We may even freeze psychologically. We may checkout mentally because it is too hard to process. We could become numb and lose our ability to fight back or run away. Many people describe feeling an “out of body” experience, like they are watching themselves without having the ability to really control their reactions. This is called dissociation.
After The Trauma
It typically takes some time after experiencing the trauma before we calm down and regulate our physiological and psychological responses. Many factors could determine just how long it takes to get back to our “normal.”
The extent of the trauma, our genetics, and how we’ve learned to cope and deal with trauma in the past all contribute to how quickly recover. The number and extent of the traumas we’ve experienced before also makes a big impact on how quickly we get back to our normal. If we haven’t had the time and ability to get back to our normal before we experience an additional trauma makes recovery even more difficult.
When a person experiences the psychological response to stressors beyond a few hours, we call this Acute Stress in they mental health field. A person may be diagnosed with Acute Stress Disorder when they experience the symptoms up to 30 days after the stressor.
If we aren’t able to regulate the psychological symptoms within 30 days, the diagnosis is transitioned from Acute Stress Disorder to Post Traumatic Stress Disorder. The main goal in treatment is helping people to find healthy, sustainable ways to cope with the stress response until the body can regulate.
How Complex Trauma Is Different
Complex trauma really complicates things in a lot of ways. Recovering from complex trauma is incredibly difficult for many reasons, especially when the trauma happened in childhood.
Complex trauma happens when we are exposed to stressors repeatedly and chronically. It almost always involves harm caused by the people who are supposed to be caring for us in childhood.
Complex trauma could be physical, emotional, or sexual abuse. It could also be chronic neglect.
If you experienced neglect but didn’t experience the other forms of abuse, it can be very easy to minimize and dismiss your experiences as “not bad enough.” If that speaks to you, I’d like to take a moment to just pause here to say that your experiences and your response to your experiences are valid. Keep your mind open to this. If you feel like many of the symptoms are described here, then know that this applies to you too.
Because the trauma is ongoing, we don’t have the opportunity to regulate back to our normal. If the stressors started early enough, we may have no idea what it feels like to have regulated emotions. Our normal is being in trauma response all of the time. Learning how to regulate is a giant task because we’ve never known what it is like.
Symptoms of Complex Trauma
Those who have experienced complex trauma have many of the same symptoms that are uniquely different from those who experience a single trauma or trauma later in life.
Complex trauma in childhood deeply impacts our development of self. We develop around the trauma, which means we often believe the bad things that happen are a result of who we are. We think that we are inherently messed up or bad. This is called toxic shame.
Toxic shame leads us to believe we aren’t capable of healing. It leads us to believe we deserve what happens to us. It often leads to us repeating the cycle as we get caught up in playing out our role in the trauma.
Inner Critic & Outer Critic
The toxic shame leads to an inner voice that constantly questions everything we think, feel, say, and do. The voice can feel constant and never ending. Any time we attempt to quiet it, it comes back without notice.
The outer critic can be loud too. It’s a way to protect ourselves from harm. Since most, if not all, of our trauma happened at the hands of those who we were closest to, anyone and everyone can feel dangerous. Our outer critic reminds us of the danger, leading us to judge everyone as unsafe.
We often think of flashbacks the way we see them in the movies. The person hears or sees something that reminds them of the traumatic event and they are suddenly taken back there in a full body experience. The flashback could involve visual and auditory memories.
Emotional flashbacks aren’t as well understood or clear. Emotional flashbacks involve being brought back to past emotions. It isn’t always clear what triggered it. It often isn’t clear of a specific time when the emotion was felt in the past. Most of the time, we just feel bad and we don’t know why, not realizing it is a flashback at all.
Because the trauma happened in childhood, our sense of self is severely damaged. Without a strong sense of self, our ability to connect with others is impaired. Our sense of belonging and role in the world is skewed.
The toxic shame impedes our ability to feel safe building close relationships. We may be avoidant of relationships, or we may cling tightly to anyone who is kind to us. Or we may respond in many other ways.
Need for Survival
Regardless of how we respond, we do so out of our need for survival. In a future blog, I’ll explore how our ways of survival play out in our Trauma Type.
There are many more symptoms that go along with Complex Trauma. These are just a few that stand out as significantly different from standard PTSD. Complex trauma is much more complex than described here, but this gives you the start of an understanding of what it's like for someone who experienced repeated, continuous stressors in childhood.
Questions? Email me at firstname.lastname@example.org.
Hi, I'm Candace Whitman and I'm a Licensed Clinical Professional Counselor. I'm am the owner of Wild Moon Counseling. I help women recover from an unhealthy, abusive, or neglectful childhood. To work with me, you can send me an email at email@example.com to get started.