How do you know if you’re suffering from complex trauma

How do you know if you are suffering from complex trauma - Centres For Health and Healing

Long-lasting trauma can have a profound impact on a sufferer’s life.

For example, a catastrophic experience such as being in a war zone, car accident, or natural disaster are all events that can induce severe physical and psychological trauma.

Traumatic events

Traumatic events wreak havoc on an individual’s life, affecting the way they navigate their emotional experience, something that can erode a person’s sense of safety, personal relationships, and overall mental health.

Repeated trauma

The way that mental health professionals diagnose and treat psychological trauma has improved monumentally over recent decades as knowledge around complex post-traumatic stress and more mental health resources increase in capacity.

Complex trauma is often the result of the domino effect; for example, studies conducted in 2012 showed that the financial recession got linked to increased child abuse cases.

Complex PTSD

A war veteran who has complex PTSD might be so traumatized by the events they witnessed during deployment that they can no longer function in the same way they once did back at home.

Such an experience can create the domino effect as other family members suffer from unresolved complex trauma.

Extreme stress

During a traumatic event, our nervous systems become activated as our bodies prepare us for fight or flight mode; this protective part preserves our energy and safety and serves a valuable purpose while in the moment.

However, in most complex trauma cases, the activation button hasn’t switched off, even though the traumatic event has long subsided, resulting in many PTSD symptoms and other forms of mental illness.

What is a complex trauma?

Complex trauma - Centres For Health and Healing

According to trauma expert and psychologist Dr. Christine Courtois, complex trauma ‘is a type of trauma that occurs repeatedly and cumulatively, usually over some time and within specific relationships and contexts.’

Examples of complex trauma

The cumulative trauma that Dr. Courtois refers to involves events such as:

  • Domestic abuse
  • Severe child abuse
  • Multiple military deployments to dangerous locations

Understanding complex trauma

Following up on Dr. Courtois’ work around complex trauma, she summarises difficult, traumatic experiences to be the result of triage of life- stressors that include:

  1. Events that are prolonged, repetitive or cumulative
  2. Events that are usually interpersonal involving harm or maltreatment, such as abandonment or antipathy by parents or caregivers that may include acts of exploitation
  3. Events that occur during developmentally vulnerable times, such as adolescence or childhood. Additionally, such events may occur during later life, such as physical dependency, age, illness or disability.

The diagnostic and statistical manual

The diagnostic and statistical manual (fifth edition) sparked controversy some years ago as mental disorders, such as complex trauma, are not currently included in the diagnostic manual as an official diagnosis.

According to the National Centre for PTSD, there is some overlap with the symptoms between complex PTSD (c-PTSD) and post-traumatic stress disorder.

C- PTSD isn’t included as a separate diagnosis in the DSM-5, with 92% of those with the condition also meeting the criteria for PTSD.

The importance of education around complex trauma

For sufferers of complex trauma, awareness is vital to getting the treatment they require to manage their condition and the severe symptoms.

Educating ourselves on the subject of complex trauma helps the victims and the family and friends of those who are struggling with the disorder.

Predominantly, complex trauma affects multiple systems within a family dynamic where many people with unresolved C-PTSD are at risk of developing mental health disorders such as depression, anxiety and substance abuse, to name just a few.

How complex trauma manifests

For the people impacted by complex trauma, understanding how complex trauma manifests and the symptoms associated with the mental disorder can be the difference between them getting the treatment they need (or not, as the case may be).

Therefore, people need to recognize that their symptoms are coming from somewhere and thus allow space for self-compassion, understanding and recognition.

Symptoms of complex PTSD (trauma)

Dr. Courtois lists several symptoms associated with complex trauma, which involve difficulty regulating affective impulses, such as:

  • Self-destructiveness and anger
  • A pervasive sense of guilt or responsibility
  • Difficulties with trusting people or being intimate
  • Dissociative episodes
  • Hopelessness and despair
  • Other somatic or medical problems

Dissociation and complex trauma

People exposed to repeated trauma over long periods often learn to dissociate from themselves and their surroundings, another effective coping mechanism that gets people through a painful event.

Studies show that children who get abused are more prone to dissociation than adults.

Childhood abuse

Childhood abuse - Centres For Health and Healing

In child abuse, it is very often the case that children depend on the attacker for survival (usually a parent or caregiver).

When the one person responsible for protecting and caring for a child inflicts trauma and deep emotional pain on them, the child’s defence is often to disconnect from their bodies mentally.

According to research from Psychology Today, ‘children with memories of physical, verbal or sexual abuse, sometimes remember the scene as if they’d watched it take place from above as if it wasn’t happening to them’ (Lisa Firestone, Ph.D.).

Firestone further comments that children may experience amnesia or not remember certain painful events at all in some cases.


As mentioned earlier, many people with mental health conditions such as complex trauma experience intense guilt over events in the past.

Whether such incidents took place in a war zone or within a childhood home, guilt is often one of the main symptoms of trauma.

Negative self-perception

Traumatized individuals often experience an altered perception where they suffer from profound feelings of shame.

In addition to the above emotional challenges, people with complex trauma may also experience intense guilt, believing that past events are somehow their fault.

Identifying with the aggressor

In many cases where abuse is a distinct factor for trauma, many victims internalize the aggressor.

For example, trauma victims may begin to identify with the person who hurt them, often taking on their opposing point of view and feeling protective over them.

Critical inner voice

Lisa Firestone Ph.D. discusses the ‘critical inner voice’ used to describe a negative self-perception many of us carry around inside us. 

Many people have a critical inner voice to some degree. However, according to Firestone;

‘Traumatised individuals are profoundly affected by their past and may experience that ”voice” as a deeply destructive and terrifying enemy whose attacks on them can feel crippling and constant and can even lead to life-threatening, self-destructive behaviours’ (Lisa Firestone, Ph.D.).

Unhealthy relationships

Unhealthy relationships - Centres For Health and Healing

When individuals feel hopeless and withdrawn in their suffering, they find it impossible to trust others and may become further traumatized by that critical voice within.

They may continue to operate in a state that is void of all self-compassion and might even make choices that repeat destructive patterns from the past.

For example, a child who got physically abused may repeat the vicious cycle with their children in adulthood.

Differentiating from negative programming

Dr. Courtois states that for people to manage a mental health condition such as complex trauma, they must first address and differentiate from the negative programming they previously received in moments of stress.

To do this, people must cultivate self-compassion and recognize the profound emotional anguish they once endured.

Courtois states that complex trauma requires complex and sequenced treatment when it comes to treatment strategies, the kind that involves multiple components which target a range of symptoms as the person moves towards recovery.

Fortunately, there are many trauma treatments available in today’s current climate. In addition, research is helping to inform the development of pioneering and cutting-edge treatments for trauma victims.

‘People should not feel hopeless in their recovery,’ explains Dr. Courtois, ‘support and help are always available, even to those who have survived the most heinous of circumstances’.

Treatments such as eye movement desensitization reprocessing (EMDR) and cognitive-behavioural therapy (CBT) target specific C-PTSD symptoms and seek to resolve traumatic memories that are life-limiting for the victims of complex trauma.

Whether a person endured childhood neglect or is a victim of natural disaster or domestic abuse, everyone deserves to be guided and supported through the darkest times. 

Trauma-specific treatments are designed to do just that.

Contact us

If you think you might be experiencing symptoms of trauma and would like to speak to a mental health specialist for further advice, please get in touch with a member of our team at Centres for Health and Healing who can help.

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