What We Misunderstand About Complex Trauma.
When we hear the word “trauma,” most of us picture a singular catastrophic event. These experiences can indeed leave deep psychological scars, often referred to as Post-Traumatic Stress Disorder (PTSD). But what about the “tiny” traumas – the ones that build up over time? The kind that unfolds over the years, shaping the very foundation of how we see ourselves and the world? Often stemming from relationships or systemic oppression, this is the territory of complex trauma.
What Is Complex Trauma?
Complex trauma stems from prolonged, repeated exposure to distressing or harmful experiences. Unlike PTSD, which typically results from a single incident, complex trauma develops over time. Examples include:
Chronic neglect or abuse in childhood.
Growing up with a caregiver who is emotionally unavailable or volatile.
Experiencing prolonged domestic violence.
Living through systemic oppression or chronic adversity.
PTSD vs. Complex Trauma: What’s the Difference?
While both PTSD and complex trauma involve responses to overwhelming stress, the differences lie in both nature and scope.
Source of Trauma:
PTSD: Often linked to a single, identifiable event.
Complex Trauma: Results from prolonged, repetitive harm, usually in interpersonal contexts.
Symptoms:
PTSD: Symptoms often revolve around intrusive memories, hyperarousal, and avoidance of trauma reminders.
Complex Trauma: Includes these symptoms but extends to difficulties with self-worth, emotional regulation, and forming healthy relationships. Survivors may struggle with pervasive feelings of shame, self-blame, and disconnection.
Impact on Development:
PTSD: While disruptive, it may not fundamentally alter one’s sense of self.
Complex Trauma: Often rooted in early developmental years, it can deeply influence identity, attachment, and a person’s view of the world.
Why Do We Misunderstand Complex Trauma?
One reason is that complex trauma doesn’t always look like “trauma” in the way we’ve been taught to recognize. Survivors may not recall a singular event that caused their pain, leading others—and sometimes even themselves—to downplay the severity of their experiences. Additionally, societal narratives around resilience often pressure individuals to “just get over it,” further obscuring the long-lasting effects of complex trauma.
Complex Trauma and the DSM
Complex trauma is not currently recognized as a separate diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Instead, its symptoms are often lumped under PTSD or other related conditions, such as borderline personality disorder or depressive disorders. This lack of formal recognition means that the distinct challenges faced by survivors of complex trauma are frequently overlooked.
Unlike PTSD, complex trauma involves pervasive issues like emotional regulation difficulties, self-concept struggles, and relationship challenges that stem from long-term harm. Addressing complex trauma requires a different therapeutic approach, focusing on building safety, trust, and connection over time, and trauma-informed care that acknowledges the survivor’s lived experiences and emphasizes holistic healing is crucial.
Common Myths
Myth 1: Trauma is only valid if it’s tied to a single event.
Complex trauma challenges this notion by demonstrating how cumulative harm can be just as devastating as a single shocking incident. The absence of “overt” trauma doesn’t make the pain any less real.
Myth 2: If you’re functioning, you’re fine.
Many survivors of complex trauma become highly functional, often as a survival mechanism. However, beneath the surface, they may wrestle with deep emotional wounds and a fragmented sense of self.
Myth 3: Time heals all wounds.
Time alone doesn’t address the effects of complex trauma. Healing requires intentional work—whether through therapy, safe relationships, or self-guided practices—to rebuild a sense of safety and connection.
It’s not simply a psychological issue. It’s a human one.
Modalities of Healing
Understanding complex trauma fundamentally begins with compassion—both for ourselves and others. Here are some ways survivors can navigate moving through it:
Trauma-Informed Therapy: Modalities like EMDR, somatic experiencing, and Internal Family Systems can address the deep wounds of complex trauma.
Building Safe Relationships: I believe that the human capacity to hurt one another can be met and surpassed by our capacity to heal one another. Healing often happens in connection; trustworthy relationships can provide a reparative experience.
Mind-Body Practices: Yoga, mindfulness, and breathwork can help reconnect survivors to their bodies which are often sites of unresolved tension.
Why This Matters
Complex trauma isn’t just a psychological issue; it’s a human one. It touches relationships, communities, and generations. By expanding our understanding, we can create a culture that supports healing through community and connection.
The work I’m doing examines relationship mapping: a deep dive into the connections that have shaped our lives. Relationships inherently trigger us no matter their nature. They are an incredible place for growth; they can be a place of pain, and also a space for healing. Holistically exploring how these relationships continue to show up for us mentally and physically is a profound experience – one that deserves greater attention in dialogues surrounding trauma healing.
References:
Herman, J. L. Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror. Basic Books, 1997.
Van der Kolk, B. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2015.
Courtois, C. A., and Ford, J. D., editors. Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach. Guilford Press, 2013.
Ford, J. D., and Courtois, C. A., editors. Complex PTSD and Emotion Regulation: A Framework for Assessment and Treatment. Springer, 2020.
Ford, J. D., and Courtois, C. A. “Defining and Understanding Complex Trauma and Complex Traumatic Stress Disorders.” Trauma, Violence, & Abuse, vol. 10, no. 2, 2009, pp. 86-98. doi:10.1177/1524838009337028.
