Complex PTSD and Trauma

What is Complex PTSD?

Complex Trauma occurs when someone undergoes physical abuse, sexual abuse, emotional, verbal abuse and neglect repetitively over months, years and decades. While what happened TO you is significant it is what happens inside of you as a result that matters most. The daily exposure to not having secure and safe connections with your caretakers leave with you an emotional imprint that for many can become problematic in adult life. It may be important to make a distinction between PTSD and Complex PTSD. PTSD can typically be confined to 1 or 2 acute traumatic events, while complex trauma points to repetitive exposure to neglect, emotional abuse, verbal abuse, sexual abuse and otherwise disconnected caretakers.. Complex PTSD includes some combination of emotional flashbacks, toxic shame, self abandonment, a vicious inner critic and social anxiety.

 

What are the symptoms of Complex Trauma?

• Emotional Dysregulation: Difficulty managing emotions. Sometimes this can look like sadness, mood swings or anger.

• Flashbacks and Intrusive Memories: Recurrent, involuntary, and intrusive distressing memories of the traumatic events. Oftentimes complex trauma involves emotional flashbacks, which can feel in the moment as though they have nothing to do with the traumatic event itself.

• Avoidance: Deliberate avoidance of thoughts, feelings, conversations, or places that remind the individual of the trauma.

• Negative Self-Perception: Pervasive feelings of shame, guilt, or a distorted sense of self-blame or worthlessness. This is what we mean when we say "toxic shame" and sometimes refer to this as the "inner critic".

• Difficulty with Relationships: Problems in forming or sustaining relationships; may include difficulty in trusting others and a tendency to seek out or stay in abusive relationships.

• Dissociation: Feelings of detachment from the self (depersonalization) or the world (derealization), or amnesic episodes.

• Hypervigilance: Exaggerated startle response, increased anxiety, and heightened awareness of potential threats.

• Difficulty with Concentration: Problems focusing on tasks. This can sometimes look like ADHD symptoms, or having a hard time in work or school.

• Sense of Foreshortened Future: A bleak and hopeless outlook on the future, such as not expecting to have a normal lifespan, career, marriage, or children.

• Somatic Symptoms: Physical symptoms without a medical cause, which may include headaches, dizziness, chest pains, or stomachaches.

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What are the Four "F" types?

The F-types are trauma responses that were developed in response to experiencing traumatic events. They are as follows:

1. Fight: This response involves confronting the threat aggressively. Individuals who predominantly use the fight response may display assertive, controlling, or even aggressive behaviors when feeling threatened or stressed. They may have difficulty with anger management and may be quick to react defensively.

2. Flight: Those who adopt the flight response tend to evade the threat by running away, either physically or mentally. This can manifest as hyperactivity, busy-ness, compulsive working, or intellectualization. It's essentially an attempt to escape painful feelings or memories through distraction or avoidance.

3. Freeze: The freeze response is characterized by a kind of mental and physical shutdown. People who freeze might feel stuck or paralyzed and find it hard to take action or make decisions when they feel threatened. This response might manifest as dissociation, daydreaming, or feeling numb and detached from reality. We often see addictions in this category.

4. Fawn: The fawn response involves trying to please or appease others to avoid conflict, criticism, or rejection. Individuals who fawn often have a high need for approval and may struggle with boundaries in relationships. They might go to great lengths to take care of others' needs at the expense of their own well-being.​​​​​​

*Often times fawn types will present with symptoms of codependency. Codependency is always a response to complex trauma.*

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Treatment Approaches

We take an attachment-based approach to healing complex trauma, where we focus on building a relationship with clients and a safe space to explore traumatic events that led to the present-day, maladaptive patterns. We also use EMDR which is an evidence-based treatment approach to trauma (you can learn more here). In addition to these treatment approaches, we suggest a holistic approach that focuses on overall health and wellness and social support.

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Can I Get Better?

Absolutely. Therapy is meant to provide you with a safe container to experience everything that you experience in a supportive and accepting environment. You will always be in the driver seat during sessions with your therapist as a helpful guide when needed. Sometimes you may need your therapist to take the lead and that is perfectly ok too. Often just by showing up and further developing your relationship with your therapist you are well on your way to getting and feeling better.  The healing path here requires patience and practice all of which you are more than capable of. RIght now you have a story of your life and who you are and we will work together to re author that story in a way that provides you with a renewed sense of dignity, strength and inner connection.

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One tool that may be useful is to take the ACES (Adverse Childhood Experiences) Quiz. You can do so here.