In Part 1 of this blog, we explored how complex trauma affects a person emotionally, cognitively, and physically, often leading to complex post-traumatic stress disorder (C-PTSD). In this next section, we’ll focus on the long-term effects of complex trauma and discuss ways to begin the healing process.

Complex trauma refers to prolonged, repeated exposure to traumatic events, often occurring within interpersonal relationships or early in life. Unlike single-incident trauma, complex trauma shapes a person’s sense of identity, safety, trust in themselves and the world, and general attachment to others. Understanding these impacts is the first step toward compassionate, effective care and meaningful recovery.

The Long-Term Impact of Complex Trauma

Without intervention, complex trauma can shape a person’s personality, behaviors, and overall mental health. Many individuals develop anxiety disorders, depression, or dissociative disorders as a result of their experiences. They may struggle to maintain stable jobs, relationships, and a sense of purpose in life. Self-destructive behaviors, including substance abuse, disordered eating, or reckless decision-making, can become coping mechanisms for the unresolved pain/hurt. Additionally, chronic feelings of emptiness, emotional detachment, and difficulty trusting others can make it challenging to build a fulfilling life. However, despite these challenges, healing is possible with the right support and strategies.

Healing from Complex Trauma

Recovery from complex trauma is a gradual process that requires patience, support, and intentional effort. When beginning the journey, it is important to establish a sense of safety and stability in your life. Before deep healing can occur, individuals must feel physically and emotionally secure in their environment. This includes developing healthy routines, learning self-soothing techniques, and building supportive relationships. 

Psychotherapy can also be helpful in determining the specific messaging that led to the complex trauma. After having a better understanding of the ways we were hurt, we then have the opportunity to develop new, more helpful narratives about ourselves and the world around us that makes us feel safe and secure. Additionally, psychotherapy can also be a space where you learn to recognize triggers, establish boundaries, and emotionally regulate when feeling heightened. 

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.

Ford, J. D., & Courtois, C. A. (Eds.). (2020). Treating complex traumatic stress disorders in adults (2nd ed.): Scientific foundations and therapeutic models. New York: The Guilford Press.

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.