What is complex trauma and how is it treated?

Complex trauma refers to prolonged, repeated exposure to traumatic experiences, typically interpersonal, occurring primarily in childhood or over extended periods (Courtois & Ford, 2009). Unlike single-incident trauma, complex trauma profoundly impacts emotional regulation, identity formation, relationship skills, and overall psychological stability (van der Kolk, 2005). Individuals suffering from complex trauma often experience chronic emotional distress, difficulties in interpersonal relationships, persistent negative self-perceptions, and pervasive feelings of shame or helplessness (Herman, 1992).

Effective treatment of complex trauma typically requires an integrated, phased therapeutic approach, comprising three stages: stabilization, trauma processing, and integration or reconnection (Courtois & Ford, 2009). Treatment modalities frequently employed include:

  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Internal Family Systems Therapy (IFS)
  • Somatic Experiencing (SE)
  • Neurofeedback
  • Sensorimotor Psychotherapy

These treatments prioritize restoring emotional and physical regulation, fostering secure relationships, and helping individuals reconstruct a coherent sense of identity and meaning (Ogden, Minton, & Pain, 2006; Levine, 2015).

Not Recommended Modalities for Complex Trauma: Cognitive Behavioral Therapy (CBT) and Exposure Therapy are generally not recommended for complex trauma due to potential risks of retraumatization and insufficient focus on emotional regulation and attachment repair, which are essential in complex trauma recovery.

References:

  • Courtois, C. A., & Ford, J. D. (Eds.). (2009). Treating complex traumatic stress disorders: An evidence-based guide. Guilford Press.
  • Herman, J. L. (1992). Trauma and recovery: The aftermath of violence–from domestic abuse to political terror. Basic Books.
  • Levine, P. (2015). Trauma and memory: Brain and body in a search for the living past. North Atlantic Books.
  • Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton & Company.
  • van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.