Symptoms Of Complex Trauma.
Our previous article on trauma talks about the risk factors, the protective factors and the causes of complex trauma. Here, we are going to try and understand the symptoms and the survival strategies individuals living with complex trauma develop. Complex trauma was first described by Judith Herman in the 1990s. According to her, “Psychological Trauma is an affiliation of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection and meaning”. The concept of complex trauma is one of the biggest contributions made by Herman. Complex trauma can occur due to many reason, some of them being – chronic neglect, abuse of any kind, being exposed to domestic violence, bullying, discrimination or communal violence.
Individuals going through trauma experience strong feelings of guilt, like somehow they were responsible for the situation(s) or event(s),even when they are not. The sense of shame felt is crippling, leaving them feeling isolated and hopeless like they are not in control of themselves or anything around them. The psychological, as well as the developmental, effects of complex trauma are often more severe than a single traumatic event or experience, especially at a young age. The conditioned or the typical response to injustice or abuse is to turn a blind eye, banish them. But they find a way of coming out, in the form of sweating, chest tightening, racing heart, fogginess, dizziness, nausea or overwhelm. This is the way of our body saying that it is feeling scared or anxious. There may be times where you are reading or watching something that you might resonate with which can activate these reactions.
Since Complex Trauma is a relatively recent concept, and due to its changeable nature, mental health professionals may misdiagnose it as post traumatic stress disorder (PTSD) instead of complex trauma. Even in DSM-5 the criteria for complex trauma should include all of the core symptoms of PTSD, along with re-experiencing, avoidance and hyperarousal.
Symptoms of PTSD:
In order to be diagnosed with PTSD, an individual needs to meet the following criterias:
Criteria A (Stressor):- Being exposed to death, serious injury or sexual violence in the following ways:
- You experienced it directly
- You had witness the event happening to someone else in person
- You learned that a close friend or relative had experienced an actual or threatened violent or accidental death
- You have had repeated indirect exposure to upsetting details of the event(s)
Criteria B (Intrusion Symptoms):- The traumatic event is constantly or perpetually re-experienced in the following ways:
Memories that are repetitive, involuntary and intrusive
Having traumatic nightmares or distressing dreams with the content related to the event(s)
Experiencing flashbacks, or dissociative reactions, where it feels like the individual is experiencing the event again
Experiencing extreme or prolonged distress after being exposed to traumatic reminders
Criteria C (Avoidance):- Trying to persistently and arduously avoid distressing trauma related reminders after the event(s) evident by the following:
Avoiding trauma related thoughts, feelings or emotions
Avoiding external trauma related factors or reminders like people, places, objects or activities
Criteria D (Negative Alterations In Mood):- Negative changes in mood and cognition which are evident or visible after the traumatic event, such as:
Failing to recall important or key characteristics of the traumatic event(s) which could be the result of dissociative amnesia and not head injury or drugs or alcohol
Constantly having distorted negative beliefs and expectations about yourself and the world
Constantly blaming yourself or others for the traumatic event or for the resulting consequences
Feeling negative emotions or feelings nonstop like fear, anger, guilt or shame
Losing interest in activities that used to interest you once
Experiencing detachment or alienation from others
Inability to feel positive emotions or feelings perpetually like joy or love
Criteria E (Alterations In Arousal And Reactivity):- Changes in arousal and awareness or reactivity which are trauma related and started or worsened after a traumatic event, including the following:
Disturbed sleep or having trouble with your sleep cycle
Having trouble concentrating
Constantly having the feeling of being on alert or hypervigilance
Careless or thoughtless or self harming behaviour
Easily startled or have an exaggerated startle response
Displaying aggressive or grumpy behaviour
According to Criteria F, which is Duration, the individual must display persistent symptoms from Criteria B, C, D and E for more than a month.
According to Criteria G, which is Functional Significance, where symptoms create distress or functional impairment, like social or occupational.
According to Criteria H, which is Exclusion, symptoms are not due to medication, substance abuse or other illness.
Symptoms of Complex Trauma:
In addition to the aforementioned symptoms, individuals with Complex Trauma might also display the following symptoms:
Disconnection from the traumatic event. The individual might feel disconnected from themselves, depersonalization, and the world around them, derealization.
Having relationship issues, difficulty with relationships
Losing a sense of self and the system of meanings, losing one’s core beliefs, values or hopes.
Having a negative self view, where the individual constantly feels helpless, guilty or ashamed.
Experience difficulty when trying to control one’s emotions or feelings. Losing control over emotions which can come out as explosive anger, persistent sadness, depression or suicidal thoughts.
Have a hard time trusting anyone, even themselves.
Feel isolated or of being totally different from other people.
Becoming obsessed with revenge.
Alcoholism and/or substance abuse.
Experiencing flashbacks.
Symptoms of trauma can be immediate or delayed. Just like each symptom is unique for every individual, similarly there is no accurate timeline for when the signs of complex trauma may appear. All of the above mentioned symptoms can have a life altering effect, and may cause impairments in personal, social, educational, occupational or other important areas of life. Complex trauma being a fairly recent concept, has not really been provided with a specific diagnosis. It is treated using many of the same strategies as PTSD like:
Psychotherapy: This form of treatment focuses on identifying memories and negative thought processes and replacing them with more realistic and positive ones. It can be a one-on-one activity/session or it can be a group session. Therapy might help focus on stabilizing the individual so that they can acknowledge and address their feelings, better their connections with others and be able to deal or handle their anxiety.
EMDR (Eye Movement Desensitization and Reprocessing): Here eye movements guided by a therapist are used to process and reframe traumatic memories, which helps in reducing the negative feelings that are linked with the traumatic memory over time.
Mindfulness: It is a way of paying attention to something in a particular manner, on purpose, in a non-judgemental present manner. Practicing mindfulness can help anyone in reducing their anxiety, depression, sleep difficulties, anger issues, chronic pain and other chronic medical conditions.
At Pause for Perspective we do not believe Complex Trauma to be some kind of a disorder that needs to be fixed. We believe that everyone deserves spaces where they can be themselves. No one should feel helpless or hopeless. There are people and communities ready to help and support each other in any way they can. Don’t allow yourself to be exposed to traumatic experiences which trigger your thoughts or emotions or feelings associated with trauma. Seeking a recovery process that is manageable, therapeutic and effective is okay, seeking out help should be normalised. It is never too late to find help to help you through trauma. Here at Pause, we have trained therapists who can help you through your tough time. Our ideology is that the individual is not the issue here but the system that we live in, they are simply just responding to the situation they are placed in.
Written by Insha Fatima.