Complex Trauma and PTSD

Posttraumatic Stress Disorder (PTSD) refers to long-term symptoms that result from severe physical and/or psychological shock and injury. Feeling shaken and on edge after a traumatic event is normal, in that almost everyone feels that way after being seriously hurt. With good social support and the ability to process the experience, most people eventually recover from the event. Sometimes, people find themselves stuck and unable to recover, experiencing varying levels of depression, guilt, self-blame, fear, anxiety, jumpiness, hypervigilance, inability to concentrate, and sleep problems for years or decades afterwards. The good news is PTSD is highly treatable, and there is a lot of research evidence that sitting with the discomfort of the traumatic memories and processing them with a trained professional can relieve the heightened tensions associated with the trauma.

Complex PTSD, or complex trauma, is, as you guessed, more complicated. Complex trauma results from chronic, inescapable, interpersonal abuse as opposed to trauma that has a beginning and an end, like an accident, war, or natural disaster. As social creatures, humans depend on each other to have our backs, as it were. When the people who are supposed to have our backs (such as parents, romantic partners, or other trusted figures) are the very people who cause the injuries, over and over again, children and adolescents learn to feel helpless and stuck, ashamed, guilty, worthless, and broken. Over time, they learn hyper-independence, to distrust others, to feel unsafe in relationships, and to never rely on anyone but themselves. They can’t trust themselves either, wondering if they are over-reacting when they feel hurt, if they are going to pick the wrong person again, and if hoping for a relationship that is reliable and respects their needs is simply unrealistic. Having learned to protect themselves by prioritizing other people’s needs first, they learn over-responsibility for the feelings and welfare of others to the point of sacrificing their own needs and dreams. They often do not know or remember who they really are because they have had to ignore their own happiness for so long. Complex trauma can also include the symptom of dissociation, depersonalization, and derealization, which blocks off painful experiences so that it seems like it is happening to someone else.

Treatment for complex trauma generally involves helping you accept and sit with intense emotions when they flare up, learn to nurture your own needs for protection and safety, figure out and embrace who you are and what lights up your soul, develop a strong experience of self-worth and self-compassion, and learn to set both physical and emotional boundaries for the care of yourself and others. In addition, therapy can help you recognize patterns in your strategies to protect yourself, understand why you learned to protect yourself in those ways, and move towards developing new habits that build you up instead of tearing you down.