What is Complex Trauma?

Complex Trauma refers to the interconnectedness between exposure to certain forms of traumatic experiences and the multifaceted and evolving consequences of these experiences. Extensive research in the fields of neuroscience, public health, pediatrics, child development, psychiatry, psychology, criminology and traumatology has conclusively demonstrated that exposure to childhood trauma can have wide-ranging effects on mind, body, behavior, achievement and social functioning.

Unresolved childhood trauma can result in lifelong difficulties, including health problems and high-risk coping behaviors that dramatically increase the likelihood of school failure, unemployment, substance use, homelessness, revictimization, incarceration and early death.

Early-onset exposure to abuse, neglect, impaired caregiving, placement disruption, family violence, or community violence that is chronic, recurrent or severe has been shown to alter the anatomical structure and processes of the developing brain, setting off a chain of survival-based adaptations that are increasingly likely to evolve over time into increasingly troubling forms of maladaptation, including psychopathology, substance abuse, cognitive and behavioral disturbances, relationship difficulties, inability to care for self or others, aggression, and suicidality or self-harm. Such consequences set the stage for legacies of complex trauma to be repeated, passed down through families in intergenerational cycles.

Complex trauma intersects with forms of systemic trauma such a racism, sexism, homophobia, transphobia, xenophobia, and religious intolerance that increase a person, family or community’s likelihood to experience and be disproportionately affected by trauma and life adversity, reduce access to preventive and intervention services, and perpetuate poverty, inequality and injustice. Many of these forms of social oppression are the direct legacy of ancestral and historical trauma that devastated entire nations, communities and peoples.

Research Reframes Complex Trauma Treatment and Intervention

Given the inherent complexities of complex trauma, treatment and intervention for impacted individuals, families and communities needs to be reframed. Traditional trauma therapies have primarily focused on reducing the symptoms of one psychiatric disorder, PTSD. Extensive clinical research on trauma-exposed children and adults has definitively shown the following:

1. 1. PTSD is not the most prevalent diagnosis for children or adults exposed to trauma. Children or adults who do meet criteria for PTSD are highly likely to meet criteria for 3 or more additional psychiatric disorders.
   2. Developmental Trauma Disorder (DTD) and Complex PTSD (CPTSD) are diagnostic constructs that encapsulate many facets of complex trauma adaptation not covered by other psychiatric diagnoses.
   3. The effects of complex trauma exposure go well beyond psychiatric symptoms and disorders: they alter the way a person views themselves, others and the world; the impact a person’s capacity for self-regulation of emotions, thinking, behavior and impulses; they take root in the body and express themselves through numerous somatic problems and impairments.
   4. Effective intervention for complex trauma needs to be client-tailored, strengths-based, and capacity building.
   5. The source of complex trauma survivors’ resiliency is often entangled with their behavioral problems, problematic relationship choices, aggression, self-harm, or high-risk coping strategies. Therefore, intervention needs to
      • honor a person’s efforts to survive
      • seek to understand the function of societally maladaptive behaviors
      • recognize valid underlying needs, and
      • partner with clients to develop alternate ways to meet these needs
   6. Complex trauma can impact entire families, systems and communities. Effective intervention often needs to be undertaken across all these levels, concurrently or sequentially.