Over the many years I have worked with children and teenagers, and over the last 5 years working in my therapy office I meet so many clients with different backgrounds.
Some have scars on the outside, from domestic violence, self-harm, eating disorders or alcoholism.
Others have scars on the inside from emotional abuse, neglect, domestic violence, narcissism, bullying, grief and loss…..
When we have scars on the outside it is easier for many people to comprehend the sadness and the pain. The medical intervention required means that there is a feasible reason to allow us to make sense of their suffering.
When someone has scars on the inside we can easily forget the level of anguish, pain, self-doubt and suffering they have incurred as it is invisible to the naked eye; but its levels of impact are on an incomprehensible scale.
Wounds heal, but internal scars remain for a long time after the event, in some cases they change behaviours and personalities forever, we’re never quite the same after some of those internal scars. This is not to take away the impact of external scars as they will additionally have their own internal battles, emotional impacts and traumas, however there was once a scar for people to see to understand whilst they still struggle. Other people’s lives go on and they cannot comprehend why we aren’t as happy, balanced or ‘like them’, but perhaps in many cases only those with those internal scars can truly empathise with the long term impact that they have. They require adaptations, changes and additional support because those internal scars alter the way that we think, rationalise or cope with some ‘everyday’ events. This level of complex trauma can feel impossible for others to comprehend, after all, surely if we are no longer in that situation we should be able to just ‘forget about it’?
If you watched my video, or read my previous blog about our brain processing systems (if not read it before you finish this) then you will already acknowledge that I speak about how our brain is a filing cabinet. The everyday events we witness, experience and partake in develop internal filing systems to allow us to move through them fluidly. However – do we ever teach a child to manage neglect? teach a teenager to understand abuse? teach a woman to understand the effects on her emotions of narcissism? These un-filable items create inner torment and pain and without appropriate support swim around the mind slowly torturing their victim long after the event has occurred.
In the case of children we were wrongly led to believe that they would simply ‘forget’ these situations. In recent years as the severity of attachment disorder and complex trauma become better understood we begin to recognise that the moment the child is perceived as ‘safe’ the problems often occur.
For the woman who was a victim of abuse or narcissism in a safe relationship she may question, doubt or feel insecure, on red alert awaiting the moment that ‘everything changes’ like it did before.
Complex trauma has multiple symptoms both behavioural, emotional and social, these are created from the initial trauma and extend in situations where the child has learnt that they are unsafe, at risk or unsure of how to manage. These can include any combination of the following:
- Stress related behaviours – rapid breathing, high alert, shut down
- Overreacting or unresponsive reactions
- Withholding emotions
- Anxiety, anger, sadness in situations which trigger previous trauma
- Difficulty to trust
- Difficulty regulating behaviours and emotions
- Unpredictable, violent or excessive reactions to situations
- Difficultly forming long term secure attachments
- Physical complaints including headaches, stomach aches, illness
- Hypersensitivity to sound, smells or touch
- High risk behaviours
- Low self-worth – believing that they are bad, unwanted or unlovable
- People pleasing or behaviours requiring validation.
It is important to understand that the previous experiences of the child or adult involved in complex trauma cases does not develop the typical regulation system expected in their peers. Therefore their reaction to seemingly ‘normal’ situations can be out of place or significant. Often, the lack of ability to regulate their own behaviours and ‘calm’ down means that they struggle to comprehend what is going on around them. In cases where an individual is rejected or abused the can struggle to form attachments and trust others creating a dissociative state as they feel powerless and that nothing is positive. In some cases these can lead to high risk behaviours in later life as boundaries, and right from wrong become hazy.
As we begin to explore the complexities of multiple trauma we can identify the difficulties that the individual can have in navigating everyday life experiences. A heightened sense of stress (or fight and flight) means that a child or adult may find themselves unable to find joy or happiness in situations that we would expect them to enjoy. Maintaining friendships and relationships becomes a mind-field of difficulty as they have not developed the initial strong attachments to build on this from, low self-worth developed from the initial trauma makes them more vulnerable. As opposed to popular belief they will not ‘get over it’ or ‘forget it’ over time, particularly when this occurred when they were very young or went on for significant lengths of time. In addition it should be acknowledged that being ‘out of the situation and safe’ will not prevent the consequential symptoms, behaviours and feeling from presenting. The symptoms and behaviours may also reappear at later stages, particularly when there are unexpected or significant changes which occur.
Supporting a child or adult with complex trauma requires patience and professional expertise. The internal scars, invisible to the eye may sit dormant for periods of time and appear at unpredictable or unexpected times. In children this is often in spaces where the brain feels safe and there are clear expectations in which they do not need to navigate risk. In adults again this is often with those they feel safest to ‘let it out’. However where previous history has taught them rejection when they express these in some cases reactions will become suppressed to avoid further rejection.
Offering children and adults support can feel difficult as it can take prolonged time to develop a relationship with them, however it is imperative to offer consistency in responses and identify that the behaviours that they present are not desirable – not the person themselves.
Offering suitable therapy can be difficult as different therapies may be required for different stages of the journey. However finding a professional with experience of working with trauma and committing to a period of sessions (this will not be a short fix solution) offers required respite and support to explore thoughts, feelings and behaviours. The individual may return to support sessions when they have new situations to navigate and require help to develop responses to these.
For resources, support and information please follow the links at the bottom of the page.
If you are concerned about a child please contact your health visitor or GP at a first instance.
For wider reading about complex trauma please visit:
The National Child Traumatic stress Network – www.nctsn.org
Kids Matter – www.kidsmatter.edu.au
Blue Knot Foundation – www.blueknot.org.au
Recognising complex trauma – www.psychologytoday
Centre for anxiety disorders – click here
Beacon House Trauma and Attachment Support, West Sussex – click here
For support as a parent to manage difficult or challenging behaviour in children
Visit – https://sarahpfisher.com/