For Your Own Protection: How Complex Trauma Changes a Person

young child with hair up in pigtails looks off to the side in dimly lit room with a serious expressionAlthough it remains explicitly absent from the Diagnostic and Statistical Manual of Mental Disorders, complex posttraumatic stress (C-PTSD) is a condition that has gained broad acceptance in the mental health community. The symptoms and features of C-PTSD may be similar to borderline personality and posttraumatic stress (PTSD) and are most commonly associated with experiences of chronic child abuse or neglect, though any uneven power dynamic exploited over a prolonged period—such as kidnapping/hostage situations, indentured servitude, cults, or even intimate partner violence—can be the basis for complex trauma.

Complex trauma’s chief distinction is its prolonged nature. It’s not that your caregiver assaulted you that one time; it’s that your experience as a child was filled with recurring maltreatment, resulting in symptoms that are often diagnosed as attention-deficit hyperactivity (ADHD), depression, and anxiety. While these diagnoses may be accurate, they do not address the origination of the problem.

How a parent interacts with their child can have a huge impact on the child’s emotional development. If a child is not properly attuned, attended to, or acknowledged as an infant or in early childhood, a lifetime of damage may result. Generally, no visible scars or marks offer clues that anything damaging has occurred. When the person becomes an adult, they may experience serious relationship problems or struggle with addictions and other issues without understanding why. This, too, is complex trauma.

In fact, when someone has been chronically maltreated during any portion of life as a result of any type of abuse or emotional neglect, they may develop an inner propensity to manifest a variety of external symptoms. These tend to include but are not limited to “airheadedness,” anxiety, somatic symptoms (migraines, stomachaches, etc.), dissociation, and depression.

People who experience trauma from an early age must protect themselves in some way in order to cope. One means of protection is to “split off” the part of themselves that is experiencing the trauma. This results in the traumatized person having a fragmented psyche. Fragmentation is really a protective strategy. It serves a person well during traumatic experiences, but tends to be problematic once no longer needed for survival.

This splitting cannot be seen under a microscope or in a brain scan. Rather, it is as if the person develops different, developmentally stunted personas that are frozen in time deep within one’s unconscious memory. Each “persona” or “mode” is rigidly committed to a lack of growth and causes a level of stunted emotional development.

Schemas and Modes

During a child’s upbringing, various inner working models about life are developed. These can result in internalized “schemas.” Schemas develop in all people at an early age; some are adaptive and some are maladaptive. They are comprised of emotions and deeply ingrained beliefs about self, others, and relationships. Schemas are neurologically held as experiential or implicit memories, and are experienced viscerally. For example, one type of schema could leave an internal felt message of, “I know I am not worthy of love; I just know it. I feel it in my being.”

Modes are developed internally in response to schemas and are comprised of the personas created during traumatic or otherwise emotionally dysregulating experiences. Modes are compensatory and are created mainly as protectors. Some protectors are over-compensatory, such as in the case of narcissistic and antisocial personalities. Others are in the form of avoidance, denial, being overly friendly, etc.

Modes are akin to personalities. The necessary personality shows up as needed in response to the trigger at hand.

Everyone operates in modes. Some people with minimal traumatic experiences in childhood have relatively “normal” modes, where triggers aren’t as devastating as in the case of those who come from extremely emotionally deprived childhoods. When particularly strong modes of relating are present, personality conditions may develop.

Dissociative identity (DID) is the clinical term for a person with distinct and separate personas developed as a result of childhood trauma.

Triggers

Triggers usually have a connotation of something negative, but can also occur when a person has been conditioned to experience something positive. For the purposes of this article, I am referring to those triggers that cause a person to maladaptively regress emotionally to an earlier time in life.

Triggering occurs when a person experiences something that reminds them unconsciously of a past traumatic or emotionally upsetting experience. A schema is what is triggered, and a mode is what comes into play to protect the underlying, unbearable emotional pain.

Personas

When threatened by a negative emotional experience, subconsciously a schema is triggered and a mode comes to the rescue to protect the individual from the underlying emotional discomfort. The threatened unbearable emotions may include anger, shame, humiliation, desperation, fear, and emptiness.

Challenging the underlying maladaptive beliefs helps a person who experienced complex trauma begin to assess the damage caused during their childhood. The goal of therapy is integration of the different personas into a cohesive, adaptive, pro-social whole.

For people with personality conditions, a common threat is the potential for warmth, nurturance, or closeness. Such individuals may display personas to stop healthy interpersonal connection from happening.

Why is this? The hope for love may be threatening to a person with a personality condition. The “protector” shows up to stop this threat from becoming a reality. For a person with a personality condition, the hope for attachment may bring up the emotions of vulnerability, neediness, helplessness, powerlessness, and subjugation. These feelings may be too threatening to experience consciously.

If, as a child, a person did not experience consistent nurturance and reassurance when feeling helpless, needy, or vulnerable, but instead experienced abandonment and abuse, then dissociation and over-compensatory measures may have been created. Over-compensatory measures may occur in the form of another personality, such as The Entitled, The Superior One, The Rager, or The Detached Observer. These modes are protective.

Think of the concept of a person having part of their personality stuck in an early developmental stage, such as age 3. Now, think of a person with narcissism having a “rage attack.” The image you conjure may resemble the temper tantrum of a 3-year-old.

This is an example of a trigger leading to an emotional regression. The rage attack is akin to the “protection” for the person. While it may be maladaptive, it is effective in protecting the person from feelings of vulnerability and helplessness.

Treating Complex Trauma

One of the most helpful first steps in treating complex trauma is to identify the various modes within a person’s psyche. Some people have a few distinct personas, such as the ones mentioned above. Others include personas with attributes fitting titles such as The Rebel, The Fighter, The Victim, The Seducer, The Liar, The Party Girl, and so on. These labels are self-descriptive; the corresponding personas may show up when particular schemas are triggered as a result of threats being sensed in the environment.

Some of these personas act “normal” and can be masterful at concealing dysfunction. Protective in nature, these modes are usually the ones that present to the world and can be likened to a mask. For healing to occur, it is helpful to identify all modes—the “normal” ones as well as the socially maladaptive ones.

A good therapist can help a person struggling with complex trauma identify their schemas, modes, triggers, and personas, and can help the person learn to integrate these parts into a cohesive whole. Keep in mind it is not the goal of therapy to eliminate a person’s protectors, but to embrace them and incorporate them into the person’s sense of oneness.

Integration succeeds differentiation. Once the different parts are identified, the therapist can help the person ascertain the primary underlying threatening schemas residing in their psyche. Once these underlying schemas are pinpointed, the triggers make sense. Challenging the underlying maladaptive beliefs helps a person who experienced complex trauma begin to assess the damage caused during their childhood. The goal of therapy is integration of the different personas into a cohesive, adaptive, pro-social whole.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Sharie Stines, PsyD, therapist in La Mirada, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 23 comments
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  • Amy

    Amy

    July 24th, 2017 at 10:38 AM

    Much more awareness and understanding of this has to be unlocked. This is not anything that will reveal itself in one or two instances; most cases I suspect would be very slow burn in nature and you start to learn things in small bits at a time because really who can process much more than that at once when they have been subjected to this for a lifetime.

  • samuel

    samuel

    July 24th, 2017 at 2:43 PM

    There will come a moment when something that seems so benign will trigger something deep inside of you, and you know that there has to be something underlying causing that reaction but you may still be unsure exactly what that is.
    That is the moment when you have to start that process of looking inward, looking to find what that trigger is and why it is effecting you in such a way.

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 25th, 2017 at 11:27 AM

    A reference to the White Paper on Complex Trauma (aka Developmental Trauma Disorder. Note C-PTSD is not a term generally used) by the National Child Traumatic Stress Network and to their material on treatment might have been useful. I’d recommend the works by John Briere, such as Principles of Trauma Therapy, and Treating Complex Trauma in Children and Their Families.

  • Vanessa

    Vanessa

    July 25th, 2017 at 3:30 PM

    wow…thanks for the info…It made things much clearer than I have been able to understand what is going on with me and my responses to triggers.

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 25th, 2017 at 5:26 PM

    Glad I could be of assistance.
    Best regards,

  • Jdhers

    Jdhers

    July 26th, 2017 at 4:31 PM

    Interesting read, truthful information. It also leads me to realize I am screwed and will never be able to create a lasting relationship. Too many triggers.

  • Cara

    Cara

    July 27th, 2017 at 11:18 AM

    Very helpful information!

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 27th, 2017 at 11:53 AM

    I’m glad you found it helpful.

  • Amanda

    Amanda

    July 27th, 2017 at 5:43 PM

    This information is very interesting as I have CPTSD and show all of the symptoms described. I would say dissasociation is my worst fear as some of the time I can feel myself going in to a trance like state however more recently I can’t and don’t know until someone brings me out of it. It is just like I have passed out. I endured rape and sexual abuse from the age of four daily for 12-13 years by my adoptive Father who was convicted last year and sentenced to Nine years in prison. Since this my disassociation has become worse and I am now under a Psychiatrist and a Counsellor as in times of extra stress I also hear voices. I find information like this valuable as it enables me to have a greater insight in to what is actually going on in my head and to help me learn to accept it Thankyou for publishing.

  • justin

    justin

    June 10th, 2019 at 1:08 PM

    Hi.i also have cptsd. Neglected and sick all my childhood.i am now 53,and have breathing problems from past smoking,and multiple health issues.i went to several professionals that were no help.
    So I tried intensive meditation .
    Which was excellent,although there are entities out there that will try and harm.
    I am now Christian,and would like to slip off to heaven soon.

  • Chaney B.

    Chaney B.

    July 27th, 2017 at 8:26 PM

    Reading this was very emotional for me as I recognized myself more and more as I read it. Having been in and out of therapy since my early 20’s and hospitalized five times after suicidal episodes, I was diagnosed as bipolar in 1995 at age 49. That never rang true to me internally but it seemed a convenient place to sort of “hang my hat” when working with a therapist. Bipolar meds were all problematic for me as I went through them all with varying debilitating side effects. My current psychiatrist has me on vistaril for anciety and temazepam in order to get any REM sleep and that has been working much better. The last time I was hospitalized (eight years ago after the death of my only sister, who was 6 1/2 years older than me), the doctor in charge of our therapy did not talk in the terms explained here, but he did identify me as having both victim and rebel personas. I have been out of therapy for about 1 1/2 years because in addition to the cost (I had to retire two years ago after finally being diagnosed with R.A. and fibro so I am now on Medicare), I felt we were spinning my wheels since my therapist told me at each visit how great it was that I had retained so much of what I guess I would call “good vibes.” But I didn’t feel that way at all but somehow I was never able to convey that to her. If there are therapists trained to treat complex PTSD, should I just ask if they treat that condition?

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 28th, 2017 at 6:20 AM

    I am glad that you found some comfort in the article and material. Best regards

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 28th, 2017 at 9:13 AM

    You could look at the list of therapists on this site, and on my website, center4familydevelop.com, to find a therapist who is trained in the areas you describe.

  • Cynthia

    Cynthia

    July 30th, 2017 at 1:00 PM

    Finding a therapist who is proficient in C-PTSD is like finding a needle in a haystack. Plenty of therapists say they are -CPTSD trained and they are not and re-traumatize the client. As to the information….it is VERY helpful, but It could use more definitions and detailed explanation on schemas, modes, triggers, personas and so forth so one can just fill in the banks and map it.

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 31st, 2017 at 5:35 AM

    Well, one clue that the therapist may not be current on assessment and treatment is if the person uses the term C-PTSD, which is not a term currently used. PTSD is a DSM-V diagnosis. Complex Trauma is a clinical formulation and the term used by the National Child Traumatic Stress Network and all competent and knowledgeable therapists and researchers.
    For the more detailed information you are wanting, take a look at the NCTSN’s White Paper on Complex Trauma and you may also find some helpful material on my website, which is Center4FamilyDevelop.com

  • Joe

    Joe

    August 8th, 2017 at 9:16 AM

    any thoughts on complex trauma stemming from childhood illnesses… ??

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    August 8th, 2017 at 10:25 AM

    If the illness is severe and long-term requiring frequent and painful medical interventions at a young age, then, yes that can cause Complex Trauma since the child may experience the parent repeatedly bringing the child for those procedures as “abusive.”

  • Holli

    Holli

    March 22nd, 2018 at 8:48 AM

    Arthur Becker-Weidman, why are you responding to everyone’s comments on here like you’re the author of the article? Nobody was talking to you.
    I mean, to be fair, the author wasn’t responding, but still. Not your place or your business to answer for them. I googled you; I can’t find any association between you and this website. Am I missing something?

  • Suzie M.

    Suzie M.

    July 27th, 2018 at 2:27 AM

    iam in theraphy at the moment being treated for CPTSD, I DIDNT realize that i was suffering from complex trauma but have had emotional abuse from birth , i am not conscious of any other abuse but remember my sisters being abused, how long will it take for my unconscious take to release more information so i can work through it with my very nice therapist that i have been seeing for a year now . thankyou

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 29th, 2018 at 6:17 AM

    Assuming that you are receiving an evidence-based and empirically validated treatment for Complex Trauma, such as Dyadic Developmental Psychotherapy, you can expect to BEGIN to see symptom improvements within about ninety days.

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 29th, 2018 at 6:15 AM

    Assuming that your therapist is using an evidence-based empirically validated treatment for Complex Trauma, such as Dyadic Developmental Psychotherapy, you can expect to BEGIN making progress within about three months and see the beginnings of symptom improvement.

  • Suzie

    Suzie

    July 30th, 2018 at 2:55 AM

    Thankyou for your reply .I have been seeing my therapist irregularly for 9 months but started regular weekly sessions 5 months ago, I do feel the world getting more friendly and I am making new friends , however it took such a long time to trust my current therapist as years ago when I had a nervous breakdown my then therapist was retired from the NHS as she had a drink problem ! whilst treating me on a 1-1 basis, I can’t tell you the mess we got into with counter transference , very very painful for me? Ato cut a long story short she ended up staying at my house as she had nowhere to live but she ended up going into rehab. I found it so hard to get over her but 20 years on I am in theraphy again, privately this time , and it is so different and professional than the first time, however it’s taken me so long to trust my current therapist but I have a good alliance with her now, I don’t know what treatment she is giving me except it is for CPTSD from birth , my problem now is although I am doing very well with her and working hard , is that I feel like a little child with her and this makes it very painful between sessions, I just hope time with this good therapist will work things out ? How will I grow away from her in time as at the moment the thought terrifies me ???
    Thankyou
    Suzie

  • Arthur Becker-Weidman, PhD

    Arthur Becker-Weidman, PhD

    July 30th, 2018 at 11:17 AM

    Best to discuss these concerns directly with your therapist. My experience is that as people grow and improve, ending treatment comes naturally.
    best regards

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