Complex Trauma
Written By: Marissa Halstead
In my previous blog, I covered the difference between acute and chronic trauma. So if you haven’t read that one yet, I encourage you to start there. This post is dedicated to explaining what complex trauma is and what’s happening in the brain and body of someone who has experienced it.
Complex trauma is the result of experiencing repeated, ongoing, and long-term traumatic events. Usually involving a lack of control or an inability to escape—rather than a single isolated incident. It often leads to Complex Post-Traumatic Stress Disorder (C-PTSD), which can profoundly affect a person’s emotions, sense of self, relationships, and overall well-being.
C-PTSD
Although C-PTSD is not currently recognized as a separate diagnosis in the DSM-5, many clinicians and researchers, myself included, believe it is likely to be included in a future edition. While complex trauma does not injure the brain in the same way a traumatic brain injury (TBI) does, prolonged exposure to trauma—especially during childhood and adolescence—can significantly affect how the brain develops and functions. In many ways, it can feel as though the brain has been “injured” by years of living in survival mode.
Three key areas of the brain are particularly affected by complex trauma: the amygdala, hippocampus, and prefrontal cortex.
The amygdala can become hyperactive, keeping the brain in survival mode and constantly scanning for threats. The hippocampus may shrink over time, affecting memory, emotional processing, and a sense of safety. Meanwhile, reduced prefrontal cortex activity can make it harder to regulate emotions, think clearly under stress, and make thoughtful decisions.
Healing from complex trauma is a gradual process. Experiences that are deeply painful—and sometimes unimaginable—take time to process and untangle. For someone living with C-PTSD, there is often no deep, internal sense of safety in the world or even within their own body. That is why the first step in healing is creating safety. People cannot heal in environments that are unsafe, whether physically, emotionally, or psychologically.
One of my favorite quotes comes from Dr. Diane Langberg:
“In a survivor’s healing, victims of abuse need to tell their story. They may be afraid, slow to speak, uncertain of their words. But as we listen, and bear witness to their trauma, we grant them dignity, safety, and comfort. Doing so is a reversal of the experience of trauma.”
Every therapist has different passions and areas of expertise. Understanding trauma, its effects on human beings, and the process of healing is one of my greatest professional passions. Helping someone begin healing from profound suffering and move toward hope and light is an incredible privilege—one I consider sacred.
There is so much more that could be said about complex trauma, but I’ll leave it here for now. If you’ve found yourself wondering whether you might be living with C-PTSD, I want you to know this: you deserve to be seen, heard, and supported. Healing is possible, and you do not have to walk that journey alone.
