Why No One Really Understands Complex Trauma
It’s a whole lot bigger than PTSD.
A recent three-day trauma workshop got me thinking.
As part of the clinical material presented, we watched a short video of one of the presenters working with a young woman whose drink had been spiked at a bar.
Gently probing for emotion and trauma memories, the therapist supported and encouraged the client, allowing her to approach the incident without discussing the events.
It was touching and inspiring, but also a bit misleading.
A discrete episode of trauma isn’t really comparable to the effects of chronic relational trauma during childhood.
For most of my complex trauma clients, trauma is embedded in their identity. It’s a big part of who they are.
People who have suffered complex trauma in childhood are “marinated in trauma.”
It’s impossible to say who these survivors might have been without the trauma. Or where and how the trauma has insinuated itself into their personality and experience of self.
Attachment trauma in early childhood is not the same as a car accident or a mugging at thirty. Although the trauma caused by a car accident, disaster or war can be life-changing, it’s not comparable to the developmental effects of chronic attachment trauma.
Trauma at this stage of life becomes a part of how we relate, our spirituality and sense of meaning, our ability to trust and how we handle stress.
Complex Trauma & the Right Brain
Our brain doubles in size during the first three years of life.
Regulation theorist and clinician Allan Schore argues that during this period, our right brain is dominant.
We communicate and attach through emotions and senses — through sound, smell, touch and visual stimuli. Babies are particularly sensitive to facial expression and so will pick up on a parent’s mood, even if the parent is unaware of what they are feeling.
Schore also highlights new research that shows that mothers who try to communicate through left-brain logic might cause anxious ambivalent attachment in their children.
These parents miss the opportunity to bond because they are not speaking a language that their children can understand — the language of the right brain.
Words Are Not Enough
As we develop language, our left brains come to dominate, but the early experiences we have when the right brain is dominant stay with us.
Our attachment experiences in early life have a profound effect on our identity, our relationships and our sense of self.
In order to treat relational trauma, we need to access areas of the brain that are not part of the logical, thinking mind.
Therapy for Complex Trauma Needs to Treat the Whole Person.
The more intrinsic and far-reaching effects of developmental trauma cannot be healed through a cognitive approach, because they are not based in the “thinking brain.”
Good trauma therapy should take a more holistic approach because our emotional, physical, spiritual and relational selves are all implicated in the profound and intimate damage created through complex trauma.
For people with complex trauma, everyday life is an emotional minefield.
CPTSD caused by relational trauma in childhood can trigger extremely painful and overwhelming emotional flashbacks.
The trauma will not be remembered directly but will be experienced as a felt sense of shame, worthlessness and sometimes, physical pain.
Triggers often go unrecognised. The environmental cues that cause emotional flashbacks can be subtle. Because the trauma and the effects of the trauma were not clearcut, symptoms such as flashbacks are very hard for people to disentangle from their “ordinary” experience of self and of life.
People with complex trauma will often think that there is something wrong with them and that they are just naturally out of control, “oversensitive” or reactive.
This can lead to intense self-criticism and shame as their inner critic takes over.
Most people with C-PTSD have an untamed inner critic. The constant barrage of criticism and self-hate that they experience often echoes the voice of a harsh and judgemental parent. For people with complex relational trauma from childhood, the critical and negative parent lives on forever — inside them. These judgemental voices never leave us, contributing to feelings of low self-esteem, shame, and worthlessness.
When trauma is caused by emotional abuse within an attachment relationship, there is no escape. Because the trauma happens at sensitive times in a child’s development, it becomes embedded in who and how they are. Instead of being exploration and learning focused, a young child experiencing chronic trauma will be focused on survival.
This means that their brain will develop in a way that is oriented to anticipating and responding to threat. These early pathways and structures will remain into adulthood, and people with complex trauma will have a much higher stress response and be more sensitive to any environmental triggers which could be interpreted as threatening.
This doesn’t mean just a physical threat.
Emotional or social threats such as abandonment, rejection, and criticism can be triggering for people with this condition.
In response to these threats, they will often get stuck in the feelings which they had as young children. Those around them might think they are “overreacting’, but people with CPTSD are responding in the only way they know-how.
They developed these responses in order to survive.
This is not a conscious process and many people with complex trauma will be at a loss to explain or understand their responses.
Emotional flashbacks are not discrete images or clear memories like the flashbacks of people with PTSD. They are overwhelming emotional states and responses that are very hard to differentiate from an “ordinary” experience of self.
How therapy can help.
Psychotherapy will help you recognise the effects of early trauma on your development. Education around the trauma will help you understand what is going on and why — and that it is not your fault.
For people with CPTSD, a close, non-judgemental and non-shaming relationship will be important for recovery. This special therapeutic relationship is what helps people heal.
As you come to understand yourself better through the prism of a therapeutic relationship, you will be able to see the difference between an “ordinary” response to triggers and a trauma based emotional flashback.
This self-awareness will allow you to keep the “thinking part” of your brain active and help you to make better choices and lead a more enjoyable, less reactive life.
Trauma counselling will help you understand your emotions and manage the ups and downs of life, including potentially triggering situations.
As you heal and grow, you will learn to practice self-compassion.
Over time your inner critic will become less powerful, freeing you to pursue your own goals without the pressure to be perfect.
Learning to understand and have compassion for your reactions and emotional responses will help you live the life you want to live.