How Some People Unknowingly Live with Complex PTSD
As a New York City therapist, clients reach out to me because of anxiety, self-esteem, avoidance, lack of boundaries or the inability to be vulnerable and open with who they are. After the first few sessions, I notice signs of developmental (complex) childhood trauma present. When I name this to my clients, sometimes there’s confusion about what “complex” trauma is, which sounds intense (and often understood as extreme abuse or neglect). Clients occasionally share their experiences are common among friends and others. Sometimes, when one hears the word trauma, there is a visceral reaction of “I didn’t have it that bad” or downplaying experiences because of one’s own privileges.
In this article, I’ll share why complex trauma can go unnoticed, the symptoms and treatment options.
What is complex trauma?
We categorize complex trauma as having recurring traumatic or life-adverse events happen for an extended period. This is not exclusive to an individual’s experience at home but also relationships, local communities and culture, societal and global/collective.
The events may vary in severity but are consistent, often beginning at a young age. From an individual level, complex trauma may involve a childhood void of consistent support from a reliable and available adult. This could be related to abuse, neglect, or lack of emotional or physical availability for any reason. It may feel like a lack of belonging with friends or others on a relational level. Within local communities, trauma might manifest as not fitting into the acceptable norms, such as religion, gender or sexuality (to name a few). In contrast, global stressors are larger-scale issues such as war, pandemic, climate change, natural disasters, etc.
Symptoms of complex trauma show up as
Difficulty managing emotions
Low self-esteem
Shame
Experiencing anger or envy towards others or the world
Lack of boundaries
Inability to be vulnerable
Dissociation
Physical symptoms such as headaches, sleep issues and chronic pain
Why do complex trauma and complex PTSD go unnoticed?
Normalization surrounding parents’ or caregivers’ unavailability or mis-attunement
As human beings, we are wired to connect to our caretakers. Something especially true for babies and kids who depend on their parents or caretakers for survival (food, shelter), self-regulation, soothing, and safety. A baby or child picks up on the nervous systems of the adult they are physically closest to. If the child turns to an adult under constant stress, that child will also pick up on that stress response, internalizing it and causing emotional reactivity to emerge.
On the other hand, if the child is stressed and turns to an adult (who can manage their own emotional state) for comfort, then the child will have a model and absorb the healthy nervous system as their equilibrium.
This is also true for infants in utero; research shows that how the mother’s life is during the infant’s stages of pregnancy affects their nervous system development.
Many of us often acknowledge that our parents did the best they could with the resources they had. After all, we made it here, didn’t we? These parents may be emotionally or physically unavailable, working most days, or unsure how to comfort a child in emotional pain. In many households, it’s normalized as “the way it is,” often reflecting cultural norms surrounding parenting and their specific generation. It’s great that one can hold understanding and compassion for their parents. However, it’s also important to acknowledge its impact on our development because that is often the root of some of our emotional and internal distress getting played out as adults.
Normalization surrounding sociocultural expectations
We live in a capitalistic society with systems that reward certain attributes, identities and abilities while disowning others. As children, we grow up with a lot of messaging from cultural and societal values being pushed on us. Society often presents things in a binary between good and bad or right and wrong. There is a strict structure to follow, which can cause undue stress (especially if you choose to deviate from that path). Going to school, getting a good job and following the markers of what is deemed successful can create a lot of pressure on a young person, reinforcing internalized anxieties surrounding self-worth and what is valuable under capitalism. We also can’t forget living and developing under white supremacy, patriarchy, heteronormativity and so much more that restricts access to equality and authentic self-expression. Folks often have to assimilate as a survival response, creating a distrust of self and who they are.
Psychological defenses (coping) in daily life
Trauma can go unnoticed, particularly for those who minimize their adverse experiences. Many psychological defenses exist within the human psyche, and below are some pulled from Psych Central that I’d like to highlight:
Repression: Blocking out memories or emotions associated with traumatic or adverse memories.
Denial: Not being able to accept the weight of reality, often protecting you from feeling completely overwhelmed.
Displacement: Placing an aggressive impulse or charged emotion onto something safer option instead of the object or person who hurt you.
Projection: Placing blame or insecurities you carry towards yourself onto another person.
Other common behavioral defenses include:
Keeping a busy work and social life
Minimizing (sometimes even laughing at) hard memories and emotions when talking to friends
Substance use
Identifying trauma as part of your history is scary!
Psychological defenses exist because going back and fully processing the trauma can be painful and alter your experience and sense of self. Sometimes it’s easier to focus on present-day surface-level things that keep us stuck rather than acknowledge how we got there in the first place, which can be rooted in deep emotional wounds.
Treatment of complex PTSD
Somatic Therapy
Somatic therapy is an evidenced-based, body-centered therapy modality that helps treat the physiological symptoms of people who have experienced trauma or adverse life situations.
Somatic therapy is based on the belief that trauma or stress can cause dysfunction in the nervous system and prevent people from fully processing their experiences. This creates the feeling of being stuck in an activation or stress response. Examples of how people can experience an activation response are:
Experiencing hypervigilance
Loss of focus
Chronic stress
Experiencing self-judgment, shame, blurry boundaries, and intrusive thoughts
Somatic therapy helps create a mind-body connection where folks can find self-regulation through the body and release the trauma or stress response by completing it with the therapist they did not have access to when the trauma occurred.
Eye Movement Desensitization Reprocessing (EMDR)
EMDR is an evidenced-based structured therapy where clients are asked to focus on the traumatic memory while simultaneously experiencing bilateral stimulation, often with eye movements, intending to reduce the vividness, emotion, and trigger associated with the memory. Sometimes a traumatic experience can resolve on its own, while other times, it can linger in the brain, which creates the feeling of being stuck in the past when one experiences triggers.
Click here to learn more about complex trauma and PTSD therapy.
Also feel free to contact me and learn more about my approach to trauma recovery.
