What is Complex Trauma and What Causes it?

Most of us won’t get through life without our own fair share of stress and heartache. But some people experience not just stress, sadness or grief, but actual trauma. There are two categories of trauma commonly referred to as: Big “”T trauma and Little “t” trauma (also known as complex trauma). 

Big “T” Trauma

Big “T” traumas are isolated incidents such as, being involved in a bad car accident, an isolated rape incident, a natural disaster, or war. The result of experiencing big “T” trauma events is called post-traumatic stress disorder (PTSD), a condition where the mind is unable to process the event as it processes ordinary life events. The result is a brain that misfires information, causing the person to live much of their life distressed, as if the event were still happening to them. 

 

Little “t” trauma

Little “t” traumas (Complex-Trauma) are when someone is repeatedly exposed to extremely threatening events from which they are unable to escape such as, prolonged bullying or harrassment, prolonged emotional, physical, or sexual abuse, prolonged captivity, prolonged domestic violence, prolonged discrimination, or being a refuge. Although little “t” traumas may seem less significant because they are not as life threatening as big “T” traumas, the reality is sometimes little “t” traumas can cause more emotional harm than big “T” traumas. The result of little “t” traumas is Complex-Post Traumatic Stress Disorder (C-PTSD). C-PTSD can also develop from traumas experienced during a child’s developmental years such as, childhood sexual abuse, physical abuse, neglect, exposure to domestic violence, having a parent with an untreated mental illness, and having a parent who abuses alcohol or other substances. 

 

Symptoms of PTSD (results of Big “T” traumas):

• Nightmares

• Flashbacks

• Psychological and physiological distress at reminders

• Avoidance of internal and external reminders

• Dissociative amnesia

• Negative beliefs about oneself and the world

• Distorted blaming of oneself

• Negative persistent emotional states

• Loss of interests

• Detachment from loved ones

• Hyper vigilance

• Exaggerated startle response

• Difficulty concentrating

• Difficulty sleeping

• Irritability or outbursts of anger

• Self-destructive or reckless behavior

 

Symptoms of C-PTSD (results of Little “t” traumas)":

Includes all the same symptoms of PTSD in addition to any of the following:

  • Re-experiencing Symptoms:

    • Flashbacks, such as vivid images, overwhelming emotions, or disturbing sensations

    • Nightmares or wake up in a fright

    • Thinking about the traumatic events at an inconvenient time

    • Reliving traumatic events

    • Feeling triggered in a way that leaves you feeling overwhelmed, shaky, anxious, shutdown, helpless, and/or collapsed

  • Avoidance Symptoms:

    • Staying away from people or places that remind you of traumatic events

    • Tendency to withdraw or isolate yourself

    • Relying on alcohol, substances, nicotine, or food to avoid feeling your pain

    • Spending hours watching T.V. or playing video games

    • Difficulty admitting to yourself that you were abused or neglected

    • Spending so much time caring for others that you ignore yourself

    • Perfectionist or highly critical of yourself and others

    • Focusing so much on work so you don’t have to feel or think about the past

  • Persistent Perceptions of Current Threat:

    • Feeling hyper aware or on guard

    • Startled easily 

    • Finding yourself constantly checking your environment for signs of threats

    • Always needing an escape plan

    • Tend to expect the worst

    • Highly sensitive to subtle changes in other people’s body language and facial expressions

  • Affect Dysregulation

    • You tend to cry uncontrollably, even after a minor, everyday challenge

    • Taking you a long time to feel better after a stressful event

    • Frequently feeling angry or irritable

    • Having a hard time controlling your anger

    • Tend to feel anxious or panicky

    • Often feel hopeless or depressed

    • Times when you feel you would be better off dead or you think about suicide

    • Sometimes you feel the urge to harmself

    • You tend to spend time with people or in places that are dangerous

    • You tend to feel numb and cut off from your emotions

    • Feeling incapable of feeling joy or pleasure

  • Negative Self-Concept

    • Feeling like you have little control over your life no matter what you do 

    • Often feeling ineffective or powerless

    • Feeling like a failure

    • Believing that you are damaged 

    • Having little hope for your future

    • Often feeling ashamed, guilty, or unworthy

    • Feeling as though something is wrong with you

    • Difficulty finding a sense of purpose or meaning to your life 

  • Interpersonal Disturbances

    • Feeling disconnected from other people

    • Tendency to avoid spending time with other people

    • Difficulty trusting other people or knowing who you can trust

    • Difficulty doing things on your own or feeling that you rely to heavily on other people

    • Terrified of being left or abandoned by others

    • Finding it difficult to hear other people’s viewpoints or perspectives

    • Tendencies to avoid conflict 

  • Dissociative Symptoms: 

    • Sometimes finding yourself staring into space or realize that you have been daydreaming for long periods of time

    • Difficulty paying attention or getting distracted easily 

    • Suddenly getting tired, feeling far away, or as if you’re looking at the world through a fog

    • Are there times when people, objects, or the world feels unreal

    • Sometimes feeling disconnected from your body or emotionally numb

    • Feeling like you are different people in different situations

    • Sometimes feeling, acting, or talking like a younger person

    • Difficulty remembering broad periods of your life

    • Sometimes arriving at places and don’t know how you got there, or find things that you have bought but don’t remember buying them

 

How Can Complex Trauma be Treated?

One of the most effective forms of treatment for C-PTSD is something called an integrative, mind-body approach. This kind of therapy involves meeting with a trauma therapist over a number of sessions to learn techniques that will reduce symptoms of C-PTSD, re-processing traumatic memories, and finding emotional freedom. Beyond finding a trained therapist, it’s important to find one you feel comfortable with, so make sure to interview a few candidates to see who might help you on your journey to healing.

If you or a loved one are suffering from C-PTSD and would like to explore treatment options, please be in touch. I would be more than happy to see how I may be able to help.

 

SOURCES

The Complex PTSD Treatment Manual: An Integrative, Mind-Body Approach to Trauma Recovery by Arielle Schwartz, PhD

https://psychcentral.com/disorders/ptsd/posttraumatic-stress-disorder-ptsd-causes/

https://www.psychologytoday.com/us/basics/trauma

https://journeypureriver.com/big-t-little-t-trauma/