When most people think of trauma, is a single distressing event an accident, assault, or natural disaster. But for many, trauma isn’t about one incident. It’s about what happens repeatedly, over time, often within relationships that were supposed to provide safety. This is known as Complex Trauma.
What is Complex Trauma?
Complex trauma refers to exposure to chronic, repeated traumatic experiences, often beginning in childhood. These experiences usually occur in the context of interpersonal relationships for instance, physical, emotional, or sexual abuse; neglect; domestic violence; or growing up in an environment of fear, instability, or invalidation.
Unlike single-incident trauma (such as a road accident), complex trauma affects not only how one responds to threat, but how one experiences themselves, others, and the world.
In 2018, the World Health Organization formally recognized Complex Post-Traumatic Stress Disorder (C-PTSD) in the ICD-11 as distinct from PTSD, characterized by additional difficulties in self-organization, including:
- Problems in emotion regulation
- Negative self-concept or identity
- Difficulties in relationships and trust
How Complex Trauma Shapes the Mind and Body
Early or repeated trauma can disrupt normal development of the brain’s stress response systems and attachment processes. Over time, these changes can shape how individuals experience emotions, relationships, and safety.
People with complex trauma may experience:
- Emotional dysregulation, intense emotions, sudden shifts, or numbness
- Chronic guilt, shame, or self-blame
- Difficulty trusting others or feeling close in relationships
- Feeling "different," empty, or disconnected from self
- Hypervigilance or emotional shutdown
- Somatic symptoms such as headaches, fatigue, or pain without clear medical cause
These responses are not “overreactions.” They are adaptations, ways the mind and body learned to survive overwhelming experiences.
Complex Trauma and Relationships
Because complex trauma often occurs in relationships where there was supposed to be care or safety, survivors may struggle with connection. They may fear intimacy yet crave it, feel unsafe being vulnerable, or expect rejection or harm.
Attachment difficulties are common, individuals may unconsciously repeat old patterns, find themselves drawn to unsafe dynamics, or struggle with boundaries. Healing, therefore, often involves rebuilding a sense of safety in relationships, including the therapeutic one.
Therapy and Healing
Healing from complex trauma is not about “forgetting the past” it’s about learning to feel safe now.
Effective therapy focuses on three broad phases (adapted from Judith Herman, 1992):
1. Safety and Stabilization:
- Building a sense of physical and emotional safety
- Learning grounding, relaxation, and self-regulation skills
- Understanding trauma responses as adaptations
2. Processing Traumatic Memories:
- Gently revisiting traumatic memories in a controlled, safe way
- Using evidence-based approaches such as Trauma-Focused CBT, EMDR, or Prolonged Exposure Therapy
3. Reconnection and Integration:
- Developing healthier relationships
- Rebuilding self-worth, trust, and purpose
- Fostering compassion toward self
Therapies like Schema Therapy, Internal Family Systems (IFS), Dialectical Behavior Therapy (DBT), and Somatic approaches can also be deeply helpful in working with long-standing relational and emotional difficulties linked to complex trauma.
The Role of a Trauma-Informed Therapist
A trauma-informed approach is not just about “techniques.” It’s about how therapy is done. A trauma-informed therapist emphasizes:
- Safety: both emotional and physical
- Choice and control: empowering the client to set pace and boundaries
- Collaboration: working together rather than diagnosing or directing
- Compassion and trustworthiness: recognizing the courage it takes to heal
At Aayaas Counselling Center, our work with complex trauma integrates evidence-based therapies with a compassionate, individualized approach — recognizing that healing takes effort, time, and the right support.
Hope and Recovery
Recovery from complex trauma is possible. Healing does not mean the past disappears; it means its grip loosens. Survivors learn to recognize their strength, reclaim their voice, and reconnect with life.
Therapy offers a space to make sense of what happened and to rediscover safety, trust, and self-worth.
As one survivor said, “I used to think therapy will help me forget my past, but I know now, its to process it better, and becoming who I was meant to be.”
References:
- Courtois, C. A., & Ford, J. D. (Eds.). (2013). Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach. Guilford Press.
- Herman, J. L. (1992). Trauma and Recovery. Basic Books..
- Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
- World Health Organization. (2018). International Classification of Diseases 11th Revision (ICD-11).