Trauma is often thought of as a single, life-altering event, but for many people, it is an ongoing experience that shapes their entire sense of self and the world around them. Complex trauma develops from prolonged exposure to distressing events, often in relationships where there is an expectation of safety and care, such as in the home or with caregivers. Unlike single-incident trauma, which may result from a car accident or a natural disaster, complex trauma is deeply woven into a person’s development and disrupts emotional regulation, trust, and a person’s sense of self. Understanding complex trauma is essential, both for those who experience it and for those who support them on the path to healing.
The Impact of Complex Trauma
The effects of complex trauma extend beyond emotional distress, influencing cognitive functions, physical health, and interpersonal relationships.
Emotionally, individuals may struggle with intense mood swings, difficulty regulating emotions, and persistent anxiety or depression. Many people with complex trauma experience chronic feelings of emptiness, shame, or guilt, often engaging in self-destructive behaviors such as substance abuse or self-harm as a way to cope.
Cognitively, trauma can impair concentration, memory, and decision-making. Many individuals report experiencing intrusive thoughts or flashbacks and develop a negative self-perception, feeling inherently flawed or unworthy of love. These thought patterns often lead to overgeneralized fear responses, where a person expects harm even in safe situations.
Physically, the body carries the weight of trauma, manifesting in symptoms such as chronic fatigue, muscle tension, gastrointestinal issues, and an overactive stress response. Sleep disturbances, including nightmares and insomnia, are also common. The nervous system remains on high alert, leading to hypervigilance and difficulty relaxing, even in non-threatening environments.
Complex PTSD (C-PTSD) vs. PTSD
When the trauma experiences cause significant psychological distress, then an individual will likely be diagnosed with post-traumatic stress disorder (PTSD).
While both PTSD and Complex PTSD (C-PTSD) result from trauma, they differ in key ways. PTSD typically develops after a single, identifiable traumatic event and is characterized by flashbacks, nightmares, and heightened arousal. In contrast, C-PTSD emerges from repeated trauma over time and therefore makes emotional dysregulation, a distorted self-image, and chronic difficulties in relationships more likely.
Although C-PTSD is not yet formally recognized as a separate distinct diagnosis in all diagnostic systems, it is widely acknowledged in trauma-informed care and therapeutic settings.
Dr. Erica Tatham, Ph.D., C. Psych., is a psychologist and neuropsychologist at the Centre for Interpersonal Relationships (CFIR). Dr. Tatham provides psychological services to individual adults and seniors experiencing a wide range of psychological and relationship difficulties. She typically works with individuals experiencing mood and anxiety disorders, complex and situational trauma, neurodevelopmental disorders (e.g., ADHD and ASD), and interpersonal conflict. She takes an integrative approach to therapy and utilizes emotion focused therapy (EFT), object relations and self-psychology, and cognitive behavioural therapy (CBT).
References:
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., & Van der Kolk, B. (2005). Complex trauma. Psychiatric annals, 35(5), 390-398.
Maercker, A., Cloitre, M., Bachem, R., Schlumpf, Y. R., Khoury, B., Hitchcock, C., … & Bohus, M. (2022). Complex post-traumatic stress disorder. The lancet, 400(10345), 60-72.
