Defining complex trauma
Complex trauma (also often referred to as ‘relational trauma’ or ‘betrayal trauma’) is the exposure to repeated, prolonged, and severe traumatic experiences, often beginning in childhood and occurring within relationships that are meant to be protective.
Complex trauma is interpersonal, ongoing, and can involve being or feeling trapped; and it may sometimes also be premeditated and extreme. This can include experiences such as ongoing abuse, neglect, domestic violence, or living in chronically unsafe environments.
Complex trauma is surprisingly common yet it is often not recognised as a major contributing factor in someone’s difficulties with life. Estimated to affect 1 in 4 Australian adults, it is substantially different from single-incident trauma such as natural disasters, motor vehicle accidents, or physical assault.
Complex trauma and developmental impact
Complex trauma often arises from repeated experiences of physical, sexual, or emotional abuse, as well as neglect, particularly during childhood. When such trauma occurs during critical periods of brain development, it can profoundly alter the structural growth of neural networks and disrupt the biochemistry of neuroendocrine systems. These changes can significantly impact emotional regulation, cognitive function, and overall mental health.
Prolonged effects of complex trauma
The long-term consequences of complex trauma include a strong and often co-occurring relationship with numerous physical health and mental health problems, as well as economic, social, and behavioral issues throughout people’s lives. These issues are not usually thought of as related to earlier abuse or neglect, and people do not grow out of it. Links between complex trauma and conditions such as heart disease, cancer, chronic pain, and more are now well-established; and the cost to society is enormous.
Understanding the difference between Complex Trauma and PTSD
Complex trauma and Post-Traumatic Stress Disorder (PTSD) are often confused as being the same, but they are distinct conditions that require different treatments. PTSD typically arises from a single traumatic event, such as a car accident, while complex trauma develops from prolonged exposure to neglect or abuse, often beginning in childhood and involving close relationships. Complex trauma impacts a person’s sense of self and their ability to form secure attachments and tend to occur in relationships with caregivers.
Although Complex PTSD is not yet recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it will be included in the upcoming International Classification of Diseases (ICD-11), reflecting its acceptance as a unique condition by international experts.
A helpful definition of complex trauma comes from a newsletter by School District 622 in the United States:
“The term complex trauma describes both children’s exposure to multiple traumatic events, often of an invasive, interpersonal nature, and the wide-ranging, long-term impact of this exposure. These events are severe and pervasive; such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the child’s development and the very formation of a self. Since they often occur in the context of the child’s relationship with a caregiver, they interfere with the child’s ability to form a secure attachment bond. Many aspects of a child’s healthy physical and mental development rely on this primary source of safety and stability.
Whereas, simple trauma, refers to ONE traumatic event that is definable, such as an assault..”
Complex trauma often leads to more widespread, long-term difficulties, helping to explain the struggles faced by those who have experienced it. Understanding these distinctions can guide caregivers and loved ones in providing the right kind of support. For more professional resources and ideas, visit our resources section for clinically vetted websites.