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Complex Trauma

What is Trauma?

Trauma is an event or series of recurring events that exposes an individual to an actual, perceived, or threatened disruption of felt safety in a person’s life. This may occur through many aspects of their life like physical, emotional, mental, and spiritual wellbeing. There are many categories of trauma; however, the thread through each category is that an outside observer is not able to define something as traumatic for another person; as it is that individual’s experience of an actual, perceived, or threatened disruption of felt safety. What will be traumatic for individual A will not be for individual B. This becomes even more true when we consider what children experience as traumatic in comparison to adults.

For example, if a tiger was to come into the room you are in now, you would have a fear response. If you were not able to get to safety quickly, this would be experienced as a trauma. A toddler who sees a tiger comes into a room would not know to be afraid if there were no adults in that room scared; therefore, this would not be a traumatic experience for the toddler. In reverse, if a toddler’s primary attachment figure leaves with no notice, warning, or alternative attachment figure, the toddler would become panicked, stressed, and experience this as a traumatic event. If your primary (adult) attachment figure were to leave with no notice, warning, or alternative attachment figure, you might be angry, worried, or annoyed, but likely this would not be a traumatic event for you. 

Complex trauma (sometimes referred to as Developmental Trauma) describes both exposures to multiple traumatic events and the long-term effects of this exposure. These events are often severe and penetrating, such as physical, sexual, or emotional abuse and/or profound neglect. These events typically take place early in life and often disrupt the child’s development and the formation of a sense of self. Complex traumatic events often occur with a caregiver, and as a result, they interfere with the child’s ability to form secure attachments.  This primary source of safety and stability impacts many areas of a child’s healthy physical and mental development.

What are the effects of Complex Trauma?

Traumatic childhood experiences have a profound impact on many different areas of functioning in the child’s life. Children who grow up in homes that have not consistently provided safety, comfort, and protection develop ‘hacks’ to help them survive and function day to day. Children may become hyper-sensitive to the emotions, moods, and behaviours of others, always watching to determine what the adults around them are feeling in order to predict how they may behave. They may mask their own emotions, needs, and thoughts from others, never feeling safe or able to reach out for support or help. 

Complex trauma has major impacts on the child’s attachment structure as well. Through healthy relationships with attachment figures, children learn how to trust others, regulate their emotions, thoughts, and behaviours, and interact with the world; they develop a sense of the safety or lack thereof, in the world and develop understanding around their own value/worth as a person. When these attachment relationships are unstable or unpredictable, children extrapolate and believe they cannot trust others to help them. When a primary caregiver exploits and/or abuses a child, the child learns that they and the world are bad.

When a child has been exposed to complex traumatic events, their brain and body develop to be more vulnerable to stress. These children frequently struggle with body dysregulation; as a result, they may over-respond or under-respond to sensory stimuli. For example, they may be hypersensitive to sounds, smells, touch, or light. They often have trouble controlling and expressing emotions and may react violently or inappropriately to situations. A child with a complex trauma history may develop to have challenges in their future romantic relationships, in their relationships with peers, and with authority figures. Children who have experienced complex trauma also often have difficulty identifying, expressing, and managing emotions and may have a limited vocabulary for feeling states. Their emotional responses may be unpredictable or explosive and are often either internalized onto themselves or externalized onto others.

Trauma Reminders

A child may respond to a reminder of a traumatic event with the same or similar physiological responses they displayed in the original event, trembling, anger, sadness, or avoidance. With a complex trauma history, reminders of various traumatic events are often everywhere in the environment and in relationships. As a result, a child may react often, react powerfully, and have difficulty calming down when upset. As a result of the interpersonal nature of complex trauma, even mildly stressful interactions with others may serve as powerful trauma reminders and trigger intense trauma responses.  Children are often hyper-vigilant and on-guarded in their interactions with others and are more likely to perceive situations as stressful or dangerous, having learned from an early age that the world is a dangerous place where even loved ones can’t be trusted. For those children who do not respond in this manner, they may have learned to “tune out” (emotional numbing/dissociation) to threats in their environment, making them vulnerable to revictimization.

Dissociation is a common trauma response. As a result, it has its own information sheet. 

Trauma Symptoms

Every child will have a unique experience and presentation of trauma symptoms. The following are some examples of possible trauma symptoms that children may showcase. 

•           Upsetting thoughts or images about the event popping into the child’s mind without the ability to stop or control them.

•           Having bad dreams or nightmares.

•           Acting or feeling as if the event was happening again.

•           Feeling upset when thinking about or hearing about the event. 

•           Having physiological responses in their body when they think about or hear about the event.

•           Trying to avoid thinking, talking, or feeling about the event. 

•           Trying to avoid activities, people, or places that are reminders of the event.

•           Not being able to remember an important part of the upsetting event. 

•           Having much less interest or doing things the child used to like doing. 

•           Not feeling connected to the people around the child. 

•           Not being able to have strong feelings. 

•           Feelings as if future plans, hopes will not come true. 

•           Difficulty falling or staying asleep.

•           Feeling irritable or having fits of anger. 

•           Having trouble concentrating. 

•           Being overly careful. 

•           Being jumpy or easily startled. 

Risk and Protective Factors

Some factors help lessen the effects of the severity of the traumas that have occurred. Some of these may include: 

•           Type of event and event severity. Was someone or the child injured that they had to go to the hospital? Did someone die? Were they taken or separated from their caregivers? Were they interviewed or questioned by police, social workers, or other professionals? Was it a one-time event or was it multiple happening over a period of time?

•           How close was the child to the event that occurred? Did it happen to them? Did they witness it? Did they hear it behind closed doors? Were they physically there at the time the events occurred? Did they hear someone talking about it? Did they watch it on TV or see it on social media?

•           How the caregiver reacted to the event. Did they show big emotions? Did they believe the child? Did they meet the emotional, social, mental, and physical needs of the child? Did they get help for the whole family?

•           Trauma history. Is there a history of traumatic events in the child’s life? Has this occurred before? How long has this been happening? The more events that occur increases the chances of traumatic symptoms being present.

•           Culture and community support. Did the community and family come together to support the child? Were there cultural events that helped support healing?  Race and ethnicity play a role as well, both positive and negative. 

Resources

Child Trauma Academy

https://www.childtrauma.org

The Diagnostic Criteria from the DSM-5

The National Child Traumatic Stress Network. About child trauma 

https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma

Understanding and helping traumatized children and their caregivers https://kimsgolding.co.uk

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