Complex Trauma

Trauma is not a psychological effect to be taken lightly. 

It can leave one feeling vulnerable, mistrusting, and even disoriented in their own identity, causing a myriad of emotional effects in their life. Trauma can be described as a psychological effect caused by deeply distressing or disturbing incidents in one’s life. These incidents or events are usually exposure to a grotesque or violent incident, or a situation where death or serious harm has been threatened leaving the psyche in a state of overwhelm, hindering the ability to cope with the situation (APA 2013).  To understand better the different categories of trauma, there are two main types, type I, and type II.  

Type I is a single-incident of trauma exposure, meaning a one-time or short-term event that profoundly affects an individual.  This could be a natural disaster, terrorist attack, an episode of abuse, rape, or other highly violating assault threatening the individual.  Type I is usually the less difficult type of trauma to recover from as the single incident hasn’t complicated the person's belief system as deeply as type II.  Type II is a repetitive type exposure where one is subjected to physical, sexual, or emotional abuse, violence, neglect, terrorism, torture, wars and even genocide for many years at a time.

These different forms of ongoing maltreatment cause complex beliefs to form as a strategy to cope with the trauma, especially in that of young children where exposure to the abuse or maltreatment gets enmeshed in their development and beliefs about relationships, themselves and the world they live in (Courtois & Ford 2013).  


Within these two types of trauma, the most difficult for victims to make sense from is when the maltreatment has been carried out by a person who was in the primary caregiver role for the child.  

When this fundamental and developmental relationship has been violated, it undermines the child’s ability to cope healthily and develop healthy core beliefs.  Children can grow up functioning on a psychological survival mode because that is all they know. This functioning also leaves them vulnerable to retraumatization (Courtois & Ford 2013).

There are three core domains of complex traumatic stress reactions, the first being emotion dysregulation, the second is the loss of self-integrity, and the third is the disturbance in the ability to relate and maintain healthy relationships with others.  Emotion dysregulation is a lack of ability to regulate emotions because the skills to do so were not learned. This can look like the functioning in a all or nothing type mindset, or too preoccupied with others therefore not having healthy boundaries for themselves.  The loss of self-integrity can cause the person to dissociate from parts of themselves as a way to numb emotions in protection of challenging their own self-worth. The core existential questions the trauma caused have not been answered, such as “why did this happen to me?” or “why did someone who was supposed to love me do this?”.  When these questions have no sensible answer, the person will block or dissociate from emotions that bring this existential question to the forefront as they are not able to make sense of it causing emotional dissociation.  And lastly complex trauma can cause compromised relationships with others as a healthy or secure attachment was not developed in childhood, instead their victimization may have created an insecure and disorganized attachment. This type of attachment makes it difficult to develop trusting relationships, and causes one to isolate themselves and either take on the role of being highly self-sufficient; not needing anyone, or being an overly involved caretaker as a way to control the peace and relationship at the same time disregarding self-care and emotional boundaries for themselves (Courtois & Ford 2013).


People have an innate ability to overcome even the most difficult of circumstances so there is hope in healing from complex trauma.  

In fact many with even type II histories,  display a high capacity for resilience, develop a sense of morality, spirituality, perseverance, empathy for others, and are able to create a strong capacity for survival.  I actually fit into the type II category as I grew up from the age of 5 years old until 11, under a physically, emotionally and sexually abusive home. I lived with a very disturbed step-father who we had to “walk on eggshells” around so he didn’t hit us, but not matter what, he always found something to be angry about with my brother and I, so we would get hit, smacked, choked and even kicked. Then he devised a nightly routine of sexually molestation until I was the age of 11 when I finally had the realization that what he was doing “might” be wrong, so I was brave and told my mother and my biological father.  They immediately put a stop to it and I spent many years in self-esteem therapy as I gained a grasp on my resilience and the answers to those existential questions. In fact it was when I was 21 years old that a lady from my church looked into my eyes like she knew my pain, and said that sometimes God sends the most valiant spirits to difficult homes because He knows they can stop the abuse cycle and are strong enough to remember who they truly are.  

Trauma is complex, and no two people generally have the same circumstances to compare successes or failures. In fact even my brother and I who grew up in the same household have coped very differently with our trauma. The key for me was developing a sense of innate worth and believing in that worth as it guided me to work through years of negative conditioning.  

With one step at a time, the fog does begin to lift revealing the sun brightening the future ahead.







References


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Washington, DC: Author.
Courtois, C. & Ford, J. (2013) Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach. Guilford Publications, Inc. New York, NY.