Understanding complex trauma

The Healing the past by nurturing the future project aims to develop perinatal awareness, recognition, assessment and support strategies for Aboriginal parents experiencing complex childhood trauma.


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What is complex trauma?

Most trauma research is around Post-traumatic stress disorder (PTSD) and war – but there is growing recognition that most people are not traumatised by war but by their own childhood experiences.

Childhood trauma is often differentiated between:

  • ‘Type 1’ (acute exposure to a single event, with supportive adults to help child make sense of the experience)
  • ‘Type 2’ or ‘complex trauma’ (cumulative exposure to traumatic experiences that may involve interpersonal violation and occurs within the child’s care giving system – or child maltreatment).1

Complex trauma can occur not only in families in relation to children, but in the context of other social institutions (particularly in relation to Aboriginal children).

Complex trauma can occur when a child repeatedly experiences trauma within their caregiving system.1 This may be directly from their parent or carer, or in the context of other social institutions.2 It can also occur or be exacerbated by cumulative traumatic experiences as an adult.

In secure care-giving relationships, a child’s need for food, security and comfort is responded to sensitively and intuitively. If a caregiver withdraws, or gives a hostile or confusing response, it may activate conflicting attachment and defence systems in the child. 3.

As a result, experiencing complex trauma can have profound and ongoing impacts on:

  • development
  • physical wellbeing
  • social wellbeing
  • emotional wellbeing.3,4

Broader societal factors can interact and amplify or counteract these effects,2 with the factors experienced by Aboriginal communities having a generally compounding negative effect.

Growing evidence shows that complex trauma is strongly associated  with a range of health problems, including:

  • smoking
  • eating disorders
  • unplanned pregnancies
  • adverse birth outcomes
  • psychological illness.3,4

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Impacts of complex trauma during the perinatal period (pregnancy to first two years after birth)

Parents who have experienced complex trauma may experience ‘triggering’ during the perinatal (pregnancy and first two years after birth) period.

There are particular risks for ‘triggering’ during the perinatal period. These include the intimate nature of pregnancy and childbirth procedures and experiences, and the demands of becoming a parent of a young baby can trigger trauma responses associated with their own childhood experiences. These triggers and the long-lasting relational effects can impede the capacity of parents to nurture and care for their children, leading to ‘intergenerational cycles’ of trauma.1

Healing opportunities

The perinatal period offers an opportunity for healing and emotional development for parents who have experienced complex trauma. For most people, pregnancy is the first time they have regular contact with health services since their own childhood.5 And growing research suggests that a positive strength-based focuses during this period can turn the ‘vicious cycle’ of intergenerational trauma into a ‘virtuous cycle’ where love and ‘nurturing the future’ also promotes healing for the parent.6,7

The Healing the past by nurturing the future project aims to develop strategies to identify and support Aboriginal parents experiencing complex trauma.

  • References
    1. Alexander P. Intergenerational cycles of trauma and violence:  An attachment and family systems perspective. New York, NY: W.W. Norton & Company; 2016.
    2. Kezelman, C., & Stavropoulos, P. (2012). Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery. Sydney: Adults Surviving Child Abuse.
    3. McCrory E, De Brito S, Viding E. Research review: The neurobiology and genetics of maltreatment and adversity. J Child Psychol Psychiatry 2010;51(10):1079-95.
    4. Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. Eur J Psychotraumatol. 2014;5.
    5. Amos J, Segal L, Cantor C. Entrapped Mother, Entrapped Child: Agonic Mode, Hierarchy and Appeasement in Intergenerational Abuse and Neglect. J Child Family Studies. 2015;24(5):1442-50.
    6. Fava NM, Simon VA, Smith E, Khan M, Kovacevic M, Rosenblum KL, et al. Perceptions of general and parenting-specific posttraumatic change among postpartum mothers with histories of childhood maltreatment. Child Abuse Negl. 2016;56:20-9.
    7. Segal L, Dalziel K. Investing to Protect Our Children: Using Economics to Derive an Evidence-based Strategy. Child Abuse Review. 2011;20(4):274-89.