What is Complex Trauma and How Does it Show Up in Our Lives?
Written By: Jamie Dinneen, Counseling Intern
Key Words: Trauma, Complex Trauma, PTSD, C-PTSD
Content Warning: Brief Mentions of Child Abuse, Sexual Assault, and Abusive Relationships
Disclaimer: The information and resources provided in this blog post are simply supplementary information. The recommendations and resources in this post are not a substitute for mental health treatment.
What is Complex Trauma and How Does it Show Up in Our Lives?
In recent years, complex trauma and Complex Post Traumatic Stress Disorder (C-PTSD) have become topics of conversation in both the psychology community and the general population. But, what is complex trauma? What makes it different from what we typically think of as trauma or PTSD?
The Diagnostic and Statistical Manual, 5th Edition (DSM-5)--the guide that clinicians use to diagnose psychological conditions—defines a traumatic event in the context of PTSD as “Exposure to actual or threatened death, serious injury, or sexual violence” either by directly experiencing the event, witnessing it, hearing about the event happing to someone close to you, or experiencing repeated or extreme exposure to details of these events, such as in the case of first responders (American Psychiatric Association, 2013). Due to this definition, many perceive trauma as resulting from a single event, such as a car accident or a single instance of physical or sexual assault. However, complex trauma is different; it occurs when an individual experiences ongoing, repeated, or multiple traumatic events, such as in cases of child abuse and neglect, child sexual abuse, or being in a relationship with an abusive partner (Courtois & Ford, 2012).
When someone experiences complex trauma, even after the events have stopped, they often feel as though they are stuck in “survival mode.” Because the traumatic events persist over a long time, the person who has experienced them will often have learned to adapt to these situations where they feel a constant need to protect themselves (Courtois & Ford, 2012). These behaviors that a person learns to help them survive or endure the trauma often remain long after the traumatic event(s) end. This is because the brain has learned that the best way to survive is to treat every situation as a potential threat, as more often than not, this was the best way to cope with ongoing traumatic events (Van der Kolk, 2014). Once this pattern develops, it can become very difficult to learn when new environments, situations, or relationships are safe, as the person has learned that it is necessary to remain on high alert and will not fully let down their guard (Van der Kolk, 2014). The sensation of never feeling safe can result in feelings of isolation, distrust, shame, and self-loathing. People who have survived complex trauma often feel that they can only depend on themselves (Courtois & Ford, 2012).
It may be difficult for some to unlearn these patterns and behaviors, but it is certainly not impossible! Working with a counselor or therapist can be an important step towards overcoming the unpleasant and, at times, disruptive thoughts and feelings associated with having experienced complex trauma. By exploring these experiences in a safe environment, it is possible to regain feelings of safety, stabilization, trust, and emotional regulation in one’s life (Courtois & Ford, 2012).
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Courtois, C. A., & Ford, J. D. (2012). Treatment of complex trauma: A sequenced, relationship-based approach. Guilford Press.
Van der Kolk, B. A. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.