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Understanding Complex Trauma (C-PTSD)

Understanding Complex Trauma (C-PTSD)

A couple of weeks back we revisited the concept of Adverse Childhood Experiences (ACEs) and it was interesting that this week a new meta-analyses paper was published by the University of Sydney which gave an insight into the widespread nature of child abuse and neglect in Australia (Grummitt et al., 2024).  This paper provided analysis that indicates that ACEs within Australia are the cause of 40% of common mental health conditions (i.e., anxiety, depression, substance misuse, self-harm, and suicide attempts).  This is not new news, as we’ve already explored, but it does provide further evidence that more action needs to be taken to recognise and support people who have experienced adverse childhood experiences (including policy change), to intervene earlier with children and young people are experiencing maltreatment, and to support parents.

As I mentioned a few weeks ago in the earlier blog I explained that ACEs are often the building blocks of what we know as Complex Trauma or C-PTSD. As a child, if we are emotionally, physical, sexually abused, or physical or emotionally neglected, bullied (in person or online), exploited, trafficked or subjection to forced adoption, it is likely that we will experience Complex Trauma – either as a child, or later in life. This also extends to experiencing / witnessing community or home-based violence, as well as being culturally dislocated (such as with refugees / asylum seekers and our First Nations children and young people), and being discriminated against (i.e., associated with living with a disability, being part of the LGBTIQ+ or multicultural communities).  However, Complex Trauma isn’t always associated with childhood experiences of trauma – it can also occur as a result of our experiences of violence in the home, family, environment, and workplace.  The trauma can be physical, sexual, emotional, verbal, financial or spiritual.  It can also include living through community-based violence such as war, civil unrest, genocide, sexual exploitation/trafficking, and refugee / asylum seeker trauma. Lastly there’s medical trauma, and the experiences associated with repeated deployments as part of the armed forces.

Complex Trauma: (from

  • usually occurs between people
  • can occur when you experience repeated trauma as a child, young person or adult
  • often involves ‘being or feeling’ trapped
  • is often planned, extreme, ongoing and/or repeated
  • often has impacts which can last a long time
  • can cause you to feel ashamed
  • can stop you feeling safe and being able to trust
  • can make you feel bad about yourself
  • can make it hard for you to manage your feelings
  • can mean that you use different coping strategies such as alcohol and drugs, self-harm, over- or under-eating or over-working
  • can affect your physical and mental health and your wellbeing
  • can affect your relationships and your ability to manage your daily life

We often differentiate between ‘single incident’ trauma which is most commonly associated with Post Traumatic Stress Disorder (PTSD) and the compounding and multiple experiences of Complex Trauma. However, when it comes to diagnoses, we have a messy situation where the DSM 5 (US developed mental health diagnosis ‘bible’) does not recognise Complex Trauma, whilst the ICD-11 (published by the World Health Organisation) added this diagnosis to its compendium in 2022.  This matters because it helps ensure that people get the right kinds (evidence based) treatment from appropriately trained therapists.  The important thing to know is that there are approaches and modalities (such as EMDR and somatic psychotherapies) that can result healing / improvements in symptoms and experiences.

If this blog has prompted you to better understand complex trauma and your own childhood experiences, would like a safe space to talk about how they may impact your mental health, please get in touch with us: / / 03 9077 8194.