What is Trauma?


"Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives. Psychologists can help these individuals find constructive ways of managing their emotions."   ~American Psychological Association 



What is PTSD?


Trauma can result in prolonged distress, known as Post-Traumatic Stress Disorder (PTSD).

According to the DSM-5, components of PTSD include:


- Exposure (direct or indirect) to actual or threatened death, serious injury, or sexual violence

- Re-experiencing of the trauma (e.g., traumatic nightmares, intrusive memories, flashbacks, triggers)

- Avoidance of trauma-related thoughts, feelings, or external reminders 

- Reactivity (staying on alert, easily startled, or displaying irritability, self-destructiveness, sleep or concentration problems)

- Negative changes in thoughts or mood

- Symptoms that last for at least 1 month and cause problems with functioning (e.g, at work or in other social situations)



What is Complex PTSD?


While the DSM-5 only recognizes PTSD, leading experts in the field of trauma recognize that there is also something called "Complex PTSD." When exposure to trauma is repeated and chronic, it can cause far-reaching symptoms across multiple domains that extend beyond PTSD:


Impairment in Children:

1. Attachment

2. Biology

3. Affect Regulation

4. Dissociation

5. Behavioral Control

6. Cognition

7. Self- Concept


Impairment in Adults:

1. Relationship to others

2. Somatization/medical problems

3. Regulation of affective impulses

4. Attention and consciousness

5. Perceptions of the perpetrator

6. Symptoms of meaning

7. Self-perception


Complex Trauma defined:

"Children's experiences of multiple traumatic events that occur within the caregiving system--the social environment that is supposed to be the source of support and safety in a child's life. Typically complex trauma exposure refers to the simultaneous or sequential occurrences of child maltreatment--including emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence--that are chronic and begin in early childhood."

   White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force



The aftermath of complex trauma is quite devastating and far-reaching. Because the DSM-5 does not formally recognize Complex PTSD as a diagnosis, children and adults often end up receiving multiple diagnoses due to the many areas of impairment that complex trauma contributes to, such as: 


- Self-regulation, attachment, anxiety, and affective disorders 

- Addictions, aggression, social helplessness and eating disorders

- Dissociative, somataform, cardiovascular, metabolic, and immunological disorders

- Sexual disorders in adolescence and adulthood

- Borderline personality disorder







Photo of diagnostic and statistical manual of mental disorders (DSM-5).
Reaching HOPE Logo