Complex trauma. What it is and how to heal.
Trauma means “any experience that causes the child unbearable psychic pain or anxiety”
- Donald Kalsched, The Inner World of Trauma, pg. 1
Understanding complex trauma (C-PTSD) vs. PTSD
PTSD
While PTSD may have similar symptoms to C-PTSD, the primary distinction between the two is PTSD is typically a response to a single-incident event, such as a car accident. When symptoms of PTSD manifest after an event, even though they may share similar characteristics as C-PTSD, they tend to be less enduring or extreme as those related to C-PTSD.
Source: https://www.medicalnewstoday.com/articles/322886#what-is-complex-ptsd
Complex trauma
(Complex Post Traumatic Stress Disorder or C-PTSD)
Traumatic events that occur in childhood are called abuse events when children are threatened or harmed by those charged with their care or who are in a position of power or authority over them.
Such persons include family members such as parents, stepparents, and older siblings. Guardians or persons in authority also include teachers, coaches, religious leaders, police officers, and judges. Child abuse can occur in many contexts including homes, schools, churches, foster care, justice systems, and workplaces.
Source:
https://istss.org/public-resources/trauma-basics/what-is-childhood-trauma
A key distinction of C-PTSD is that it occurs within the context of our earliest relationships.
Because a child doesn’t yet have the developmental foundation to be able to reconcile the conflicts and emotional distress associated with trauma, it proceeds to overwhelm their system.
Within this compromised state, a child must find a way to manage what is essentially intolerable, in order to survive.
What causes the child’s system to be overcome by unbearable pain?
Types of complex trauma
Emotional abuse
Psychological abuse
Physical abuse
Sexual abuse
Neglect or an absent parent
Emotional neglect
A caregiver who struggled with alcohol, substances or had personality disorders (Narcissism, Borderline Personality Disorder) or mental illness.
While many clients may have heard of these types of trauma they may not always recognize or believe their situation would be considered trauma.
Some clients may have experienced some of the above difficulties but they may think “it just wasn’t that bad”.
Here is a some additional information if you want to understand if you have been abused and what to consider:
Effects of complex trauma
Emotional and Memory flashbacks
Tyrannical Inner and Outer Critic
Toxic Shame
Self-Abandonment/Suppressing your authentic self
Social Anxiety
Abject feelings of loneliness and abandonment
Low self-esteem or negative self-perception
Attachments issues and/or disorders
Relationship difficulties
Maybe you are unsure if what you experienced in your childhood was actually “traumatic”.
For some clients, there can be a lot of confusion about whether what they have experienced in childhood results in trauma.
While you know that you may have had adversity when you were growing up, you may also have good memories of your parents or loved ones, in which you felt they loved and cared for you.
Reconciling this confusion is often part of the work towards healing.
While there may be reasons that a parent or caregiver was abusive, it’s very important to understand the singular impact it has had on you and how it has affected your life, your sense of self, your beliefs, behaviors and relationships.
Trauma / Complex Trauma
The link below provides a clinical definition of complex trauma according to the International Classification of Diseases. The mental health equivalent, the Diagnostic and Statistical Manual of Mental Disorders, does not yet have a formal diagnostic criteria for complex trauma.
https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/585833559
ACE test
The Adverse Childhood Experience (ACE) test is based upon an investigation of childhood abuse and neglect and household challenges and later-life health and well-being.
It doesn’t include all experiences that someone may experience, nor is it predictive of challenges in later life.
It is a screening tool to assess the risks for developing mental and physical health challenges over the life span. You should always discuss any concerns about your mental or physical health with a trauma-informed mental health clinician and/or your doctor.
Hair-triggered fight/flight responses
Significant overwhelm in stressful situations
Suicidal thoughts/actions
Difficulty regulating emotions
Hyperarousal, or being “on alert”
Dissociation or lapses in memory
sleep disturbances or nightmares
struggling in interpersonal relationships
avoiding people, places, or scenarios that upset you
Source: Pete Walker, Complex PTSD: From Surviving to Thriving, pg. 7
Our psyche twists itself into knots in order to
cope with problems in our family.
Problematic Interpersonal Relationship
We first learn how to relate to others and the world in our primary relationships with our parents and caregivers. If those relationships were dysfunctional, if we couldn’t comfortably express our needs, or if there were conflicts that were not resolved and repaired, children will modify their behaviors in order to cope with the dysfunction.
Becoming the parent
Children of parents who are abusive, absent or struggle with chronic alcoholism or mental illness often have to take on a parental role in the family, either with the parent themselves, or for their siblings.
They may become the emotional support for the adults or others in the family.
When a child becomes parentified, they have to set themselves, their needs, wants, sense of fun, and creative play aside to keep the family environment stable.
The child’s psyche adapts in order to protect it’s fragile and emerging self
In order to survive, the psyche shifts, adapts, even fragments, forming a protective structure so the child can relate to the world.
Adapting to a traumatic environment can create long-term patterns in relationships lasting into adulthood, including emotional suppression and denial, becoming a people pleaser, projecting anger and fear onto others.
It can have a devastating effect on your identity and causing you to endure unending doubt and shame, and living without purpose and meaning.
Voids, Aloneness, Lack of Safety, and Powerlessness
Loss of meaning or purpose
Inability to fully experience joy or a sense of freedom because something always feels missing in your life.
Paralysis when faced with making decisions or always referring to others for validation and affirmation that you are okay or are doing the right thing.
A sense that you are different from others, or feeling utter aloneness and that no one else can understand you.
Source: Partially taken from Judith Herman, Trauma and Recovery, pg. 121
What you need to heal from trauma
“The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivors and the creation of new connections.”
- Judith Herman, Trauma and Recovery, pg. 133
What you need to promote healing
Safety
Resourcing
Grounding
Soothing
Coping tools
Support
Understanding and insight
Reconnecting with your body
What happens to the psyche as you heal?
You move away from a false self
You move towards your true Self
You move towards an authentic life
You move towards trust and love
You learn how to regulate and process your emotions
You have a reduction of somatic symptoms
There is an integration of your inner and outer worlds aligned with the Self
“In order to become whole we must try, in a long process, to discover our own personal truth, a truth that may cause pain before giving us a new sphere of freedom”
- Alice Miller, Drama of Gifted Child, pg 1
Get support on your path towards healing
What does trauma-informed treatment look like?
“It is very important to get a clinical assessment by a trauma-informed therapist to know if your symptoms represent a diagnosis of C-PTSD. Many of us experience a variety of adverse effects throughout our lives, but how our psyche responds to these events is an essential component of understanding if an individual is suffering from a long-term issue.”
How Does Trauma-Focused Therapy Work?
“The point of trauma-focused therapy is not to make people remember all the disturbing things that ever happened to them. People do not need to remember every detail in order to heal.
Rather, the goal of psychotherapy is to help people gain authority over their trauma-related memories and feelings so that they can get on with their lives. To do this, people often have to talk in detail about their past experiences. Through talking, they are able to acknowledge the trauma—remember it, feel it, think about it, share it and put it in perspective.
At the same time, to prevent the past from continuing to influence the present negatively, it is vital to focus on the present, since the goal of treatment is to help individuals live healthier, more functional lives in the here and now.”
Ways to take care of yourself if you have had childhood trauma
Ways to cope in various aspects daily life as you work towards healing:
https://istss.org/public-resources/trauma-basics/what-is-childhood-trauma/public-resources