Thankfully, health care providers have come to recognize and better understand psychological stress and trauma over the past few decades. While we used to reach for terms like shell shock, hysteria, and catatonia to describe mental health symptoms, we now have a more refined understanding of the nervous system and its window of tolerance. Nowadays, we are able to conceptualize more clearly how overwhelming experiences impact individuals and communities.
It is common to associate posttraumatic stress (PTSD) with veterans of wars or with people who have suffered through intense natural disasters. While those exposed to firsthand violence in this way are at high risk of experiencing PTSD, trauma is not always as cut-and-dried as we would like to think. Diagnostically, posttraumatic stress relates to an experience of threatened death or loss. However, it is the reaction less than the event itself that determines whether someone is experiencing posttraumatic stress, and PTSD symptoms can occur in a wide array of circumstances.
You may have heard the term “complex trauma” and wondered what, exactly, that means. Indeed, the terms complex trauma and developmental trauma are becoming more popular in the mental health community. These terms describe a phenomenon that mental health providers are seeing in people who have experienced more than one instance of traumatic experience.
Complex trauma occurs when multiple traumatic experiences occur over time, and it becomes difficult to differentiate the effect of one trauma from another. For example, someone who is born into a low-income family, lives in a violent neighborhood, and experiences physical abuse and loss during key stages of life may develop complex trauma, particularly if there are minimal supports available to cope with these challenges. Alternatively, an adult who experiences a natural disaster, is trapped in rubble, and loses family members can have a much more complex presentation than someone who experienced just one of these horrific challenges.
The first example of complex trauma above would also classify as developmental trauma. Developmental trauma is a term coined by Bessel van der Kolk. In addition to noting that this describes multiple instances of trauma, developmental trauma highlights the importance of these traumas occurring during key developmental stages of life. While a child who experiences multiple instances of violence, neglect, and/or abuse may have PTSD as a result of one or more of these experiences, it can also interfere with the child’s psychological, neurological, social, and emotional development.
Interestingly, mental health professionals often diagnose youth and adults who have experienced developmental trauma with disorders related to attention, mood, and attachment—all which may be accurate descriptors but do not capture the full context of the person’s trauma history and the relevance of his or her symptoms. In addition, symptoms of developmental trauma can impact educational and vocational development, and many people with complex trauma histories feel betrayed by systems that are meant to protect them. This poses an even greater challenge to receiving help.
If you or someone you love grew up in an environment where they were exposed to multiple experiences of trauma, therapy can help. Therapists who understand complex trauma often pull from a tool bag of interventions known to assist in resolving trauma, including hypnosis, eye movement desensitization and reprocessing (EMDR), neurofeedback, yoga, and more. Each of these can reduce symptoms related to trauma and increase the crucial coping skills needed to deal with stress and improve relationships.
If you are struggling with complex traumatic experiences, find a therapist who understands this evolving conceptualization of trauma and is committed to supporting you in your healing.
© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Lisa Danylchuk, MEd, LMFT, E-RYT, therapist in Oakland, California
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