Understanding complex trauma

Complex trauma

While most trauma research focuses on post-traumatic stress disorder (PTSD) and war, there is growing recognition that most people experience trauma through childhood experiences.

Childhood trauma is often differentiated between acute exposure to a single event, with supportive adults to help the child make sense of the experience, and complex trauma.

Complex trauma occurs with cumulative exposure to traumatic experiences that may involve interpersonal violation and can occur within the child’s care giving system or child maltreatment.1

Complex trauma can also occur in social institutions, particularly in relation to Aboriginal and Torres Strait Islander children.

How complex trauma occurs

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 a child’s development and their physical, social and emotional wellbeing.3,4

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

Complex trauma impacts on health

Increasing evidence demonstrates how complex trauma is strongly associated with a range of health problems, including:

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

Complex trauma impacts on perinatal period

Parents who have experienced complex trauma may experience triggers during the perinatal period, which is from pregnancy through to the the first two years of life. Particular risks during this time include the intimate nature of pregnancy and childbirth experiences, and the demands of becoming a parent of a young baby.

These experiences can trigger trauma responses associated with the parent's 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

For most people, pregnancy is the first time they have regular contact with health services since their own childhood.5 This makes the perinatal period a unique opportunity for healing and emotional development for those who have experienced complex trauma.

Growing research indicates that a positive strength-based focus at this time can turn the ‘vicious cycle’ of intergenerational trauma into a ‘virtuous cycle’ where love and ‘nurturing the future’  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.

Find out more about trauma with our helpful resources.


  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.