Trauma-Informed Care

Chronic trauma refers to the emotional, psychological, and sometimes physical responses to prolonged or repeated exposure to highly stressful or harmful situations. Unlike acute trauma, which stems from a single, sudden event, chronic trauma develops over time due to ongoing or recurring traumatic experiences. These can include long-term abuse (physical, emotional, or sexual), domestic violence, severe neglect, living in war zones, or growing up in environments marked by persistent instability or danger.

Complex trauma is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature. The profound and long-lasting emotional and psychological harm that results from repeated, chronic exposure to traumatic experiences, often starting in childhood. These traumatic events are typically interpersonal in nature, involving harm or neglect from trusted individuals or caregivers, such as ongoing physical, emotional, or sexual abuse, severe neglect, domestic violence, or living in a persistently unsafe environment.

What distinguishes complex trauma from other forms of trauma is not just the severity of the events but also their cumulative impact on a person’s sense of self, relationships, and overall ability to function. People with complex trauma often struggle with regulating emotions, maintaining healthy relationships, and may develop feelings of deep shame, distrust, and worthlessness. They may also experience dissociation, difficulty with memory, and heightened sensitivity to stress or triggers.

Complex trauma can lead to the development of complex post-traumatic stress disorder (C-PTSD), which includes many of the same symptoms as PTSD but also involves disturbances in self-identity, emotional regulation, and interpersonal relationships. Treatment often requires long-term, trauma-informed therapy that addresses both the traumatic experiences and the associated impact on a person’s self-concept and relationships.

he symptoms of post-traumatic stress disorder (PTSD) can vary but generally fall into four main categories: intrusive thoughts, avoidance, negative changes in mood and thinking, and alterations in arousal and reactivity. These symptoms typically develop after experiencing or witnessing a traumatic event and can significantly affect a person’s daily life. Here’s a breakdown of the common symptoms:

1. Intrusive Thoughts

   • Flashbacks: Reliving the traumatic event as if it’s happening again.
   • Nightmares: Disturbing dreams about the event or related themes.
   • Distressing memories: Unwanted and recurring thoughts about the trauma.
   • Severe emotional or physical reactions (e.g., heart racing, sweating) when reminded of the event.

2. Avoidance

   • Avoiding places, people, activities, or situations that remind you of the trauma.
   • Refusing to discuss the event or think about it, pushing memories of the trauma out of your mind.

3. Negative Changes in Mood and Thinking

   • Feelings of hopelessness or pessimism.
   • Difficulty remembering important details of the trauma.
   • Negative beliefs about oneself or the world (e.g., “I am worthless,” “The world is unsafe”).
   • Feelings of detachment or estrangement from others.
   • Loss of interest in activities once enjoyed.
   • Emotional numbness or feeling unable to experience positive emotions.

4. Changes in Arousal and Reactivity

   • Hypervigilance: Constantly feeling “on edge” or easily startled.
   • Irritability or angry outbursts, sometimes with little provocation.
   • Difficulty sleeping or concentrating.
   • Self-destructive behavior (e.g., reckless driving, substance abuse).

These symptoms must last for at least one month and cause significant distress or impairment in social, occupational, or other important areas of functioning to be considered PTSD. Effective treatment typically involves therapy, such as trauma-focused cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR), and sometimes medication to manage symptoms.