I first came to hear the term Complex Trauma many years ago when I was trained in Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), a group model for teens living in chronic stress. Prior to that most of my training in traumatic stress had been around Post-Traumatic Stress Disorder, or PTSD. There are distinctive differences between the conditions and Complex Trauma really seemed to capture the experiences of the majority of kids and young adults I was working with at the time. These people were living in chronically stressful environments with many adversities, both within their homes and in society at large, as well as having endured multiple, and often ongoing, traumatic experiences throughout their lifetimes. Experiences such as sexual, physical, verbal abuse, neglect, growing up with an impaired caregiver through addiction or mental illness, experiencing domestic violence, being abandoned by a parent, having a family member in jail, community violence, etc. With the swift advance of neurobiological research over the past few years we now know the very real consequences of these kinds of life experiences on the developing brains of children. Rather than spending resources on learning, the brain shifts resources to survival. Our needs for survival involve the more primitive parts of our brain, the parts of the brain that make it so we can more likely survive an attack by a wild animal, for instance. The only aim is survival, so the more complex areas of our brain that help us organize information and use judgment to make the best decisions are not really involved. The impact of this over time and through critical developmental phases is that the learning brain gets more connected with the processes of the survival brain, meaning the person is more focused on survival rather than higher level processes of learning and organizing information. It also means an ongoing surge of stress hormones. Hormones that are meant to only be activated during the fight or flight response, the response linked to our survival in life or death situations. When this response is always turned on a person is essentially flooded with these stress hormones, creating significant risk for chronic mental and physical health problems across their lifetime.
How might a kid come across who has grown up in a chronically traumatic and stressful environment? You might see a lack of ability to regulate impulses and mood, perhaps someone who gets easily triggered, loses it over seemingly little things, participates in risky and self-destructive activities. You might see problems with attention and consciousness, forgetfulness, not feeling connected with self or what is going on in the present. You might see a negative self-perception, a person who sees themselves as permanently damaged with deep feelings of guilt and shame, disconnected from others. You might see a disruption with relationships, not able to trust or relate to others, continuing to be victimized by others. You might see problems with somatization such as chronic pain and physical symptoms that are worsened by stress. And finally, you might see a person who doesn’t have a sense of purpose or meaning in life, pessimistic, hopeless, with negative beliefs about the world. More than likely you will see multiple combinations of these ways of being in the world. With difficulties in these areas you inevitably will see someone who adopts unhealthy coping strategies as they grow and mature. Coping strategies such as alcohol and drug abuse, smoking, promiscuity, overeating, lack of physical activity, self-harm. These coping strategies lead to significant health risks and ultimately can result in early death. The ACE Study is a compelling study that clearly lays out the relationship between the number of adverse childhood experiences (ACEs) a person has and the increased risk of early death. Click here for an infographic highlighting the connections made with this study.
This is a complicated and significant issue, but there is good news. We now know way more than we ever have about the impact of chronic and traumatic stress on kids and many interventions have been developed that can help mitigate some of the complications. SPARCS, the model I am trained in and also a trainer of, has a great curriculum for helping kids learn to cope more effectively in the moment, connect with others, cultivate awareness, and create meaning in their lives, all areas that are disrupted when a person lives in a chronically stressful environment. We are also getting more and more firm research data of the overall physical and mental health benefits of the practice of mindfulness, a practice SPARCS infuses throughout the curriculum. The National Child Traumatic Stress Network, a great resource for anyone interested in child trauma, has just released a new resource guide on Complex Trauma for young people, “What is Complex Trauma?”. This guide explores the issue and is designed for youth and others to help them make better sense of Complex Trauma and have a better understanding of what they need to do begin to heal. Many therapeutic interventions for Complex Trauma, including SPARCS, are noted in this guide. There are also many more efforts focused on prevention strategies designed to protect children from being chronically victimized in the first place. Though that is a tall order, the more people know and understand, the better.
The impact of Complex Trauma highlights the importance of the phrase used often in the child trauma field, “Don’t ask what’s wrong with me, ask what happened to me.” So many of the kids I worked with several years ago were funneled into the juvenile justice system, a pipeline to the adult corrections system, setting the stage for a lifetime of difficulty, and perhaps incarceration. Most of these youth did not belong in the justice system. And had the knowledge we have now been there then, I suspect many of these kids would have had a better chance. I’m so saddened to know that as I still remember so many of those kids and the unfair circumstances and obstacles they had to face. But I am as determined as ever to raise awareness about Complex Trauma and how no child should ever be written off. Every human being is a miracle and has potential to do great things or just be a good person. We have an obligation to give all children a chance.