“We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present. Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think.” - Bessel van der Kolk
What is Trauma?
Psychological trauma occurs when the sense of threat to a person’s survival exceeds their capacity to cope with that sense of threat.
WHAT exceeds a person’s capacity to cope is not always obvious. For a young child, having an impaired or dysfunctional caregiver represents a significant threat to their survival because a competent caregiver is necessary for a child to survive. Children are dependent on their parents to provide for their basic needs, such as shelter, food and emotional comfort; a child who lives with a parent or care-giver who cannot, for whatever reason, provide those things, may develop a trauma response.
Trauma can occur as a result of exposure to a single traumatic event, such as involvement in a natural disaster, sudden death of a family member, or witnessing terrorist attack.
Trauma can also occur from exposure to multiple traumatic events of the same type over a period of time. Traumatic events can include things such as emotional abuse or neglect, being left repeatedly alone as a child, or physical abuse or neglect. Repeated experiences such as these accumulate so that a person develops a complex trauma response.
What does complex trauma look like?
Trauma manifests in numerous ways. These can include:
Behavioural Difficulties
When triggered, traumatised people may respond to others with physical violence, or shout and scream and break things. They may also be overly perfectionistic, appear to be ‘shut down’ and disconnected, or cry easily. Some people may engage in risk-taking behaviours such as unsafe sexual activity, substance misuse, or deliberately placing themselves in unsafe situations.
Cognitive/Learning Difficulties
Traumatised people typically have compromised memory systems: They may struggle to recall details of their lives, to remember when/where/or with who an event took place, and to remember things that have just occurred. For traumatised people, following the state of play in team sports can be very difficult, as can following group conversations and discussions. Trauma-impacted people may struggle with reading, writing, verbal communication, and math. Traumatised people also often have difficulty concentrating and may appear to be easily distracted.
Difficulties Regulating Emotional Responses in Social Interactions
Traumatised people may react to seemingly innocuous comments and situations with extreme emotional responses. Being asked to attend a performance review may trigger a screaming match; being faced with an unexpected change may result in complete shut-down or literally running away.
Socially, traumatised people often find it difficult to connect to others and can be described as being ‘weird’, ‘annoying’, ‘aloof’ or sometimes ‘scary’. Traumatised people may be acutely aware of what others are feeling but unable to understand their own feelings. They may struggle to recognise, name and tolerate their own feelings - especially feelings of shame, anger, sadness and fear.
Physical Health and Body
Traumatised people often experience autoimmune disease and gut-based health issues, such as IBS. Trauma significantly impacts on our immune systems, so trauma-impacted people are often chronically unwell. Because trauma also impacts on physical growth and development, people who experienced trauma during the developmental period are often also physically smaller than their peers.
Traumatised people may experience insomnia, nightmares and flashbacks, chronic pain and headaches, hypervigilance, emotional numbing, and muscular-skeletal issues.
Sense of Self
Traumatised people struggle with developing a positive self-image or self-esteem. They typically feel fundamentally ‘broken’ or ‘irreparably damaged’ in some way, and have a strong sense of hopelessness; they often feel guilty, ashamed and personally responsible for the abuse and/or neglect they suffered.
Adverse Childhood Experiences (ACEs)
Experiences in childhood shape our lives. Research has shown that traumatic, or stressful events in childhood injure a child’s brain, impairing the brain’s physical development and function.
As adults, these experiences don’t go away. Multiple stressful events in childhood may resurface in adulthood. The ACE Study found a link between multiple stressful events in childhood (ACEs) and chronic diseases, as well as social, emotional and behavioural problems. These included heart disease, lung cancer, diabetes and many autoimmune diseases, as well as depression, mental illness, suicide, and being a victim of violence.
Each type of trauma counts as one. At least 70% of our population has an ACE score of at least one. As your ACE score increases, so does the risk of disease, and social and emotional problems.
There are 10 types of stressful events in the ACE study* :
Emotional abuse.
Physical abuse.
Sexual abuse.
Emotional neglect.
Physical neglect.
Absence of a parent through divorce, death or abandonment.
A mother or stepmother who was treated violently.
A household member who abused alcohol or drugs.
A household member who was diagnosed with a mental illness.
A household member who went to prison.
*Note: Of course, there are many other types of stressful childhood events — watching a sibling or pet being abused, losing a loving caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident or experiencing a natural disaster, etc. The ACE Study includes the 10 most common stressful childhood events experienced by the 17,000 participants in the Kaiser ACE Study. These 10 stressful childhood events have been well studied in research literature. Your ACE score is meant to be a guideline. If you experienced other types of toxic stress as a child, over months or years, these events would likely increase your risk of disease, social and emotional problems in adulthood.
If you have experienced 2 or more of the stressful events noted in the ACE study during your childhood, you may wish to explore the impact these might have had on your current functioning.
If you recognise some of the manifestations of complex trauma as being relevant to you, you may wish to explore whether you are trauma-impacted and how this affects your current functioning.