Hi there, I'm Gabrielle Kawashima, a licensed therapist and the owner of Even Here Therapy. As a therapist who specializes in helping people heal from trauma, I wanted to explore with you more about what complex trauma is. I know talking about trauma can be a bit daunting, but I'm here to help you understand what it is, how to recognize it, and what the healing process can look like.
What Is Complex Trauma?
So, what is complex trauma? It's a type of trauma that happens when there are repeated threatening incidents or chronic stressors. It can be caused by acute experiences, like domestic violence, chronic discrimination, torture, or genocide. Or through childhood traumas: childhood sexual abuse, physical abuse, emotional neglect, exposure to DV, having a parent who struggles with substances or mental health. While it's not yet recognized as a formal diagnosis in the DSM, we do know that it can have a big impact on a person's mental and emotional well-being.
Signs + Symptoms
Let's take a look at how complex trauma shows up 〰
Re-experiencing symptoms are what they sound like, ways in which we experience what we've lived through over again. These can look like:
Flashbacks
Nightmares
Intrusive thoughts or memories
Images
Strong emotional responses to sensations
These interfere with our ability to feel present, calm, and safe. They are ways that your mind and body show you that you're still carrying these experiences with you presently, even though they happened in the past.
Avoidance symptoms are ways that we avoid reminders of the trauma. This can happen through avoiding external reminders; like people, places, or certain activities. Or through avoiding reminders that come from inside yourself; like thoughts, emotions, or sensations.
We can develop coping strategies that help us avoid, like substance use or over-eating. Sometimes, our avoidance strategies are things that we might actually be receiving praise for. This can happen with over-working or chronic business.
Arousal symptoms are evidence in both our minds and bodies that we are continuously perceiving or preparing for threats. This is something that we do without thinking about it, it's purely a result of survival states.
Hyperarousal or hypervigilance is often experienced as:
Anxiety
Feeling on edge
A hyperawareness of the emotions of others
An over-reactive startle response
Irritability or 'snapping' easily
Difficulty relaxing or sleeping
Essentially, too much activation / energy
Hypoarousal or dissociation is often experienced as:
Fatigue / depression
Emotional numbness
Feeling disconnected from your body
Difficulty thinking clearly or brain fog
Little interest in things that you usually enjoy
Dysregulation symptoms are very much related to arousal symptoms. Our nervous systems are responsible for scanning our inner and outer worlds constantly and are always on the lookout for cues or stimuli associated with safety or danger.
Complex trauma can lead to being overly primed for some cues, as well as incorrectly associating neutral or even safe cues as dangerous. For example, physical touch is something that generally would be neutral or safe if it were happening in the appropriate context. After experiencing frequent physical touch that was not at all safe, all physical touch or even physical closeness may set off some alarms. If you struggle to regulate your nervous system or if you feel completely unable to, that's a sign.
Struggling with a Sense of Self can mean that we have a hard time distinguishing who we are, or how we feel worthy about ourselves, and can even show up as having low self-worth. This can have to do with the meaning that we made from our experiences, and not all of the meaning we make from trauma is done consciously.
We may also notice feelings of:
Guilt
Shame
Worthlessness
Hopelessness
Self-blame
Helplessness
Relationship difficulties are common as relationship wounds are common with complex trauma. As a result of these wounds, it can be difficult to find and form healthy relationships. There may be difficulty trusting, fears of being abandoned or hurt again, or this nagging feeling like betrayal is right around the corner.
Finding a good balance between being overly independent and overly self-reliant may also be difficult. The good news is that developing a safe and trusting relationship with a competent therapist can be one way to start unlearning and relearning.
If you're experiencing any of these things, know that you're not alone and that there is help available.
The Process of Healing
The healing process for complex trauma is unique to each person, but there are several evidence-based treatments that can help, like Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Brainspotting. Think of each of the signs and symptoms as a little marker of where healing needs to happen. Integrative care, or utilizing a few different methods, can be beneficial to make sure that each of these little markers get the kind of care and attention that they need.
In my work with clients, I've found that using a mind-body approach helps to support both the cognitive signs (or the things that we are conscious of) and the somatic signs (the things happening in our body automatically, without our input).
Remember, healing from complex trauma takes time and patience, but it is possible! Establishing safe spaces and safe people can be a big support. If you're struggling, don't hesitate to reach out to a therapist who specializes in trauma work. They can provide the support and guidance you need to begin your healing journey.
Take care out there.
Hi there. I’m Gabrielle Kawashima, a Licensed Clinical Professional Counselor and Brainspotting Therapist. I have a passion for working with childhood and complex trauma, people who've learned to prioritize others over themselves (helpers), and working with emergency and first responders. If you’re interested in working with me, click below to set up a free consultation (:
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