Complex Trauma
How We Adapt to Repetitive and Relational Trauma
Complex Trauma refers to trauma that occurs during developmental years (childhood), may be life threatening (big T trauma) or highly impactful without being life threatening (little t trauma). Little t traumas may include sexual abuse, verbal abuse, or growing up in households with extreme poverty, addiction, or mental health issues, where both emotional and basic needs have not been met on a consistent basis. Attachment issues, how we connect to and relate with others, can develop as a result of complex trauma. Problematic adult attachment styles include insecure attachment and disorganized attachment, where individuals have difficulty regulating upsetting feelings that can be triggered during relationships. In short, complex trauma can lead to years of struggling in adult relationships.
Some people have difficulty recognizing their childhood trauma. By acknowledging our pain we have to acknowledge that a loved one is a perpetrator, abuser, or a less than good parent. Sometimes, part of the abuse is the requirement for loyalty, shielding the loved one from the consequences and responsibilities of their own actions. Sometimes, the loved one was a genuinely good person who was struggling with issues or circumstances that detracted them from their parenting responsibilities. This is not an impeachment of parents. This is about understanding how certain events may have influenced your development. If you experienced some adverse childhood events but think “I don’t want to complain, because other kids had it much worse than me”, don’t let that keep you from making a better life for yourself and your kids. Suffering isn’t a competition, and no one should have to suffer whether it is mild or extreme.
Neglect and Absue
Abuse is what was done to you and neglect is what was not done for you. The presence of one does not guarantee the presence of the other. You can have a middle-class household where basic needs are provided, but the caretakers are physically or emotionally abusive. You can have a low-income household where there is no abuse by the caretaker, but there is a lack of food, clothing, nurturing, and protection.
Neglect can be physical or emotional. Physical neglect can include failing to properly feed, clothe, or bathe a child; failing to ensure the environment is safe, meaning weapons, drugs, tools, or other things laying around that curious kids can be hurt by; failing to get medical help when the child is injured or ill; or failing to protect a child who is being physically or sexually abused. Emotional neglect can include failing to provide nurturing or guidance, ignoring cries for help, not soothing, not providing basic toys, not facilitating learning, or treating the child as invisible. Neglect could stem from a single parent being absent due to working multiple jobs or parents struggling with mental illness or addiction. Often, neglect leaves a child vulnerable to predators and abusers inside and outside the home.
Abuse comes in many forms: verbal, emotional, physical, or sexual. Examples of verbal abuse include name calling, yelling, berating, or humiliating. Emotional abuse can include manipulation, gaslighting, laughing at a child who is hurt or upset, or parentifying (giving a child the responsibilities of an adult). Physical abuse can include hitting or slapping (with or without objects), pulling by the hair, choking, throwing or breaking objects, or locking a child in a closet. Child sexual abuse includes exposing children to sexually inappropriate things such as pornography, sexually explicit conversations, or exposing one’s genitals to the child. It also includes sexual contact such as fondling, manipulating a child into touching an older person’s genitals, or an older person manipulating or coercing a child to have oral, vaginal, or anal sex.
I say “older person”, because sometimes pre-teens or teenagers are perpetrators. The general consensus is to call it sexual abuse of a child when there is an age difference of 5 or more years. While two six-year-old children showing, touching, or talking about genitals isn’t necessarily unusual, it would depend on the context. Are they sharing what seems like age appropriate information they may have learned from children’s books about their bodies? (Six is the approximate age when children get curious about their bodies.) Or, are they using adult slang terms for body parts and describing things that could only have come from exposure to pornography or sexual contact? When the latter is the case, caretakers should want to find out, in a calm and curious manner, where the child learned this information and respond appropriately.
How Children Respond and Adapt
The adaptive responses of the Reptilian Brain were previously discussed in the blog post on the Triune Brain. Here, we will go into more detail about the three hard-wired responses to threats from the mammalian brain. These are more relationship based and help children survive chronically stressful environments.
The first is cry out. Infants need to be able to notify their parents when they are in pain, hungry, or threatened. Crying infants and children usually elicit empathy responses from adults. But what if the care takers are abusive or neglectful? Children will still cry out to abusive caretakers. They are unaware of what is right or wrong parenting, normal or abnormal. They simply know these are their caretakers, and their survival is tied to them. Depending on the patterns that evolve in an abusive household, this adaptive response can be shaped into a number of adult behaviors such as being very clingy and needy, or learning that no one will come, never asking for help, and not trusting help when offered. This makes for difficult adult relationships.
The second is fawning. Southerners call this “pettin’ and pattin’ someone” to sooth them or keep them calm. In a household with an explosively abusive person, you can commonly find the partner and children fawning over the abuser in an effort to prevent an outburst. This could be tip-toeing around, staying quiet or invisible, or not expressing needs (i.e. making demands of an obviously stressed parent). Kids adapt to such households by being on constant alert and are tense all the time, anticipating the next outburst. They learn their needs don’t matter and that nowhere is safe. They might learn to be a clown to keep the abuser calm and entertained, or a chameleon who becomes what the abuser wants. Some kids even learn to parent their younger siblings, never knowing what it’s like to play and have fun. Not knowing any other way of being, these kids take these adaptations with them into their adult lives where they don’t trust, over react, have trouble setting boundaries, are over-responsible, or struggle to relate to others with emotional or physical intimacy.
The third is collapse. This one is severely misunderstood. First, lets understand how it is different from the freeze response. A mammal in the freeze response will be hyper-aroused (a very high state of physiological arousal). The muscles will be tense and full of energy. There is increased heart rate and blood pressure. Their eyes are wide open. The body is ready and waiting to shift to fight or flight at the appropriate time. While collapse can look similar to freeze, something very different is going on inside the brain and body. The mammal is hypo-aroused (a very low state of physiological arousal). Heart rate and blood pressure are decreased. Sensory information isn’t taken in and endorphins are released to numb pain (dissociation, detachment, or numbing). There is less awareness of the internal and external world.
In a human, the thought process associated with freeze is “I’m going to stay still, watching and waiting until the right time to run or fight.” In collapse, the thought process is “I can’t win a fight or get away, and will probably get more injured or killed if I try. I submit to my fate.” The goal is to endure and survive. In that state of submission, dissociation, detaching from the body, and feeling numb are hard-wired forms of protecting oneself from the emotional and/or physical pain of the experience. Most people can understand how a rape survivor might go into this state during the assault. But some struggle to understand how a teen or adult stays in such an environment when they have access to phones and other people. Someone who lives with their perpetrator or who’s brain developed in this environment has become conditioned, and may stay in such a state for long period of time. For this person, the collapse state can become easily triggered and long lasting, and the belief that there is safety anywhere is non-existent. Many don’t have the resources to “just leave” making the notion of escape even less plausible. A person with such adaptations will likely have many struggles in adult relationships, such as mentally staying in the present moment, setting boundaries, expressing needs, low self worth, and tolerating maltreatment from others.
It is challenging to whittle down all of the information about Complex Trauma into a single article, but I hope you have enough to answer some basic questions or point you into the direction you need. Children adapt to abusive situations in many ways, and while many take those adaptations into adulthood, not all will have problems later in life. However, there are indications that Adverse Childhood Events (ACE) can be predictive of medical and mental health issues later in life. You can learn more, or take the ACE Questionnaire here. Finally, please know there are many mental health professionals who understand and work with Complex Trauma every day. You don’t have to have survived something extreme to justify working toward the life you want. You just have to want to make changes. And if you did survive something extreme, a new normal is possible.
Sunny Street
Licensed Clinical Mental Health Counselor, North Carolina
Licensed Proferssional Counselor, South Carolina
Licensed Mental Health Counselor, Florida