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  • Katie Lawliss

What is Complex Trauma? And Expanding What We Think of As Trauma

Understanding what trauma is can be important for healing oneself and is important to help cultivate empathy and compassion for others. This article may be triggering to some as it gives examples of trauma and discusses trauma and Posttraumatic Stress Disorder (PTSD).

The APA Definition

The American Psychological Association defines trauma as:

1. any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning. Traumatic events include those caused by human behavior (e.g., rape, war, industrial accidents) as well as by nature (e.g., earthquakes) and often challenge an individual’s view of the world as a just, safe, and predictable place.

2. any serious physical injury, such as a widespread burn or a blow to the head. —traumatic adj.

Some examples of trauma include being physically abused by a parent, having a terminal medical illness, being sexually assaulted, witnessing COVID-19 deaths as a nurse in the ICU, finding out a friend has died by suicide, feeling unsafe by the actions of a physician while in their care, being in an emotionally abusive relationship, having a miscarriage, being accosted for your sexual orientation or race, and more. 

No type of trauma is easier or harder than others. Our brains experience all trauma as “SOS we/they are in danger”. Two people can experience the same trauma and react differently to the experience, but it does not mean the trauma is less valid. 

Trauma can also be acute or complex, meaning not acute. For example, being in an ongoing abusive relationship is considered complex because there is not one singular event that is traumatic, trauma occurs on an ongoing basis and many times. Another example of complex trauma is having a progressive chronic illness in which each flare of symptoms may mean you will not get that level of functioning back again, or each exacerbation of infection means you are closer to a lung transplant, or you know you will die younger than your peers and you are aware of this fate at all times. These are just two examples but they demonstrate the term "complex trauma".

What is Posttraumatic Stress Disorder?

Trauma does not always lead to PTSD but trauma is required for the diagnosis of PTSD. Oftentimes when we hear the term PTSD, short for Posttraumatic Stress Disorder, we think of veterans of war. However, PTSD can happen from any type of trauma and what fits the definition of trauma is quite broad. 

The diagnostic criteria for PTSD from the DSM-5-TR states that a person must have exposure to an actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways including directly experiencing the traumatic event, witnessing (in person) the events that occurred to others, learning that the traumatic event occurred to a close family member or close friend, and/or experiencing repeated or extreme exposure to aversive details of the traumatic event. This definition focuses on an acute traumatic event.  However, trauma can also be living in a constant state of stress or constantly experiencing frightening events. 

Effects of Trauma

Oftentimes, new clients present to therapy and are asked “Have you had any trauma in your life”. Many dismiss their personal experiences as not traumatic because they feel it is “not that bad” or may not have an understanding of what trauma can be. Maybe they have only heard of it related to veterans. However, whether the person considers their experience as traumatic or not, oftentimes their body and mind hold onto trauma responses that impact their wellbeing both physically and mentally. For example, there may be irrational beliefs that are strengthened by a traumatic experience or created by one. For example, someone may think, “I can’t trust others” or “The worst things always happens to me” as a result of experiencing trauma. Those beliefs impact your health and wellbeing. Perhaps your heart races when you smell a certain scent or have a stomach ache every time you walk into your parents’ house, your body is likely having a reaction to the past trauma. A person does not need to meet criteria for PTSD in order to discuss and process their trauma history. 

"If I give attention to it, won't it be making a bigger deal of it?"

Labeling your experiences as trauma does not give it more power, in fact, it has the opposite effect. Trauma is often nagging us in the back of our mind even if we don't realize it. When you do not not give it attention and space, the effects of trauma come in strong and seemingly randomly. You have to give your trauma attention to be able to manage it. This attention can help you take the reins in your healing journey and change your relationship to your experiences in a positive way. If you are interested in learning more about how trauma responses can manifest, I recommend the book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk M.D. I also recommend exploring your history with a therapist to reflect on how past experiences may be impacting your functioning today, even if you previously did not label those experiences as traumatic. Please reach out to via my contact form if you are interested in beginning therapy to explore your own traumas and find effective ways to cope with them. 

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