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Making Sense of Complex Relational Trauma

Addressing stress-generated maladaptive coping skills.

Key points

  • Complex relational trauma experiences closely resemble PTSD but are different in other ways, too.
  • Complex relational trauma happens in the context of close attachment relationships, usually when there is an imbalance of power.
  • Although the effects of these experiences can be significant, they can also be overcome.

What is complex relational trauma? First, let's be clear that complex relational trauma is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (the DSM, the clinical guidebook for mental health).

Complex relational trauma and its attendant symptoms do, however, most closely resemble post-traumatic stress disorder (PTSD), which is in the DSM. (However, complex relational trauma could and sometimes is also interchanged with terms and descriptions such as complex PTSD, developmental trauma, and interpersonal trauma.)

Complex relational trauma is interpersonal in nature, and it happens in the context of close attachment relationships, usually when there is an imbalance of power. It can happen in our primary relationships with parents, caregivers, guardians, or those with authority and great control over us (for example, the head of a boarding school or director of an orphanage) where there is accessibility to the child or teen, and a level of dependency from the victim to the abuser.

What Contributes to This Kind of Trauma?

This trauma is protracted, not isolated, meaning it happens more than once and usually over a period of time, making it also, usually, cumulative.

For example, this type of trauma doesn’t have to end in childhood; there can be the same or different perpetrators, such as your father being the abuser to having a string of abusive relationships with men.

This trauma undermines, demeans, or erodes the dignity, safety, and well-being of the individual.

Examples of events that can lead to complex relational trauma can include the following:

  • Experiences with caregivers or guardians that are fundamentally chaotic, unstable, unsafe, inconsistent, unpredictable, and overwhelming;
  • Exposure to domestic violence;
  • Experiences with neglectful, apathetic, or emotionally unavailable caretakers;
  • Experiences with caregivers who betray you or fail to advocate for you and your needs;
  • Experiences with caregivers with mental illness (like being parented by a narcissist) or addictions.

The bottom line: When children experience this type of stress, it is not necessarily the experience itself that becomes the problem.

If a child has securely attached, attuned, loving, consistent caregivers who can support them in metabolizing the stress, organizing it, and making sense of it, the child can more or less move through these stressors functionally.

However, if the trauma or stressor is happening within the attachment relationship with the parent or guardian, the child cannot usually rely on the adult to help them integrate and process the stress.

Or, if the trauma or stress happens outside of the attachment relationship but the caregiving adult still fails to support the child in managing, healing, or recovering from it, a child may develop maladaptive and compensatory responses to organize their experience simply because, as children, they do not have the resources and coping skills to do much else.

Maladaptive responses are numerous and varied. But, essentially, if left unaddressed and untreated, they can lead the child to become an adult who has ineffective behaviors and beliefs about themselves, others, and the world.

What, specifically, can these maladaptive beliefs and behaviors look like?

Impacts of Experiences

The impact can be wide, varied, and unique to the individual who experiences it. There is no one-size-fits-all description.

It’s absolutely possible that two children growing up in the same household where the stressors took place will have wildly different responses due to many factors including but not limited to the child’s temperament and resources, the length and intensity of exposure to the stressor, the type of experience, and any support in managing it.

While there is no one recipe for what the impact of the trauma may be on an individual, there is, according to the symptomology of the DSM diagnosis of PTSD, and what I have experienced and understood clinically, a list of possible and probable outcomes:

  • Attachment wounds and development of an attachment style that is other than secure
  • Cognitive distortions (erroneous or unconstructive beliefs about self, others, and the world) and or intrusive thoughts
  • Avoidance behaviors to minimize contact or re-creation of the events or scenarios that caused the distress
  • Dissociation, inability to recall the traumas or to stay mentally present when reflecting on and discussing them
  • Somatic impacts such as a hyperaroused nervous system, muscle tightness, trouble sleeping, or other uncomfortable bodily sensations
  • Interpersonal difficulties in romantic relationships, at work, with friends, with neighbors, and with the family of origin, and feeling detached and separate from others
  • Comorbid (co-occurring) disorders such as eating disorders, substance disorders, compulsive behavioral patterns, self-harming behaviors such as cutting or promiscuity, and possible development of a personality disorder or mood disorder
  • Emotional distress and dysregulation challenges (either too much access or too little access to emotion and difficulties appropriately expressing this emotion)
  • Life-task impairments such as holding down a job, creating stable housing, managing money well, and achieving relational, academic, and professional developmental milestones

And, while this list is not exhaustive, you can see that the impact of this can impair nearly every major life area. However, they can also be overcome. If you would like help healing, Psychology Today is a wonderful resource to find a therapist near you.

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