Complex Trauma and Dissociation

How a person responds to trauma is dependent on so many things, including how pervasive and prolonged the trauma was, the context in which it took place (family setting, school, work etc) and type of life experiences before and after the trauma was experienced, particularly in regard to the amount of appropriate care and support the person received.

Types of Trauma

Severe traumas (otherwise known as "big-T" traumas) include repeated, prolonged, overt physical and sexual abuse as a child as well as natural disasters, wars and violent crimes. However sometimes a child may have a general perception of neglect, deprivation or lack of appropriate parental care; these experiences are often referred to as "small-T" traumas. Yet both types of trauma, as well as single-incident traumas such as a car accident, can result in severe symptomatology for the person to the extent that the trauma continues to intrude in their life. For example they may experience flashbacks, a sense of reliving the traumatic event, hypervigilance to reminders of the trauma, sleep problems, loss of appetite, irritability, anxiety, nightmares, difficulty concentrating, avoidance of triggers that remind them of the trauma, feeling detached from and not trusting others, anger dyscontrol and other symptoms not mentioned here.

Experiencing a Traumatic Event

When people experience a trauma, they automatically attempt to survive it by using their natural, survival instincts which are body led, rather than conscious decisions made by a 'thinking brain'. What this means is that behaviours during a trauma will be guided by the need to fight, run away (flight) or freeze. However in order to engage these behaviours a part of the brain that controls executive functioning (the 'thinking brain') shuts-down in order to allow the body to respond appropriately; as a consequence although the trauma is survived there will be little or no memory of the event - only body sensations. Thus after the traumatic event is over, people continue to experience frightening, somatic (or body) disturbances such as increased heart rate, rapid breathing, heart palpitations, cold sweating, 'jumpiness' or hypervigilance without knowing the reasons why, or that they are responding to events and feelings from the past. This can then lead to symptoms as described above. If not treated appropriately, long-term experiencing of the somatic disturbance and above symptoms can lead to fatigue, exhaustion, sense of hopelessness and the sensation of constant threat and danger, including the desire to flee or flight when experiencing stressful situations.

Complex Traumas

Where there has been repeated prolonged trauma, we often find that a person has traumatic responses that include more than the typical post trauma symptoms. These complex posttraumatic response patterns are best understood as a spectrum of conditions rather than a single disorder. People with complex posttraumatic responses often have difficulty regulating their emotions, consciousness, systems of meaning, relations with others, and perceptions of the self and perpetrator.

Complex Trauma Therapies

We believe that traditional talk therapies are not able to address the somatic and emotional legacy of trauma. Therefore in our practice we use EMDR (Eye Movement and Desensitisation and Reprocessing) as well as Sensorimotor Psychotherapy to reprocess key elements of traumatic events. There is no requirement when using these therapies to request a full narrative recall of the event. Instead very gentle and empowering techniques, including mindfulness, help the person feel in control of their trauma related body responses, after which time they are helped to rework emotional responses and meaning-making associated with their long-term physical sensations.

Learn more about Complex Trauma and Dissociation

Please get in touch to discuss Complex Trauma and Dissociation. More information on Complex Trauma and Dissociation is available from the European Society for Trauma and Dissociation.