Complex Trauma & Dissociation

“Trauma Survivors teach what it means to be a human being.”

— Dr. Stephen Porges

At Holding Space Therapy, we offer a therapeutic approach that is gentle, compassionate, and paced to support healing from complex PTSD and dissociation. Our therapists specialize in addressing dissociative symptoms, helping clients reconnect with themselves, their bodies, and their surroundings. In a collaborative environment, clients work towards self-regulation and develop healthy skills to manage life's stressors and build lasting relationships. Our therapists are dedicated cheerleaders, committed to supporting clients on their journey to well-being.

What is Complex Trauma?

Complex trauma, also referred to as Complex PTSD or C-PTSD, arises from extended exposure to distressing experiences that may not be linked to a single identifiable event but still create profound emotional and psychological impacts. Unlike acute traumas, such as domestic violence or sexual assault, often labeled as "Big T Trauma," complex trauma—sometimes referred to as "Little T Trauma"—involves ongoing personal distress that is equally significant and warrants comprehensive attention and healing.

Although complex trauma is not an official diagnosis in the DSM (Diagnostic and Statistical Manual of Mental Disorders), it is a valid and challenging condition. It often stems from prolonged abuse or neglect, particularly in childhood. Symptoms may overlap with other disorders such as OCD, ADHD, or Borderline Personality Disorder, but these may actually be trauma responses.

Complex trauma can manifest in various ways, often without an obvious traumatic incident, including:

  • Unexplained Trauma Symptoms: Individuals may experience physical and emotional symptoms of trauma, such as racing thoughts and anxiety, without a clear traumatic event to identify.

  • Relationship Difficulties: They often have trouble forming and maintaining healthy relationships, avoiding close connections or ending up with people who disregard their boundaries.

  • Childhood Gaps: Even if their childhood appeared happy, they might feel that something was missing and hold unexplained resentment towards their parents, which can affect their relationships with their own children.

  • LGBTQIA+ Challenges: Despite finding joy within the LGBTQIA+ community, ongoing covert discrimination from the wider world can result in increased stress, depression, and anxiety.

  • Neurodiversity: Individuals with ADHD, learning differences, autism, and other neurodiversities experience persistent challenges such as social exclusion, academic struggles, and being misunderstood. These repeated adversities often exacerbate feelings of inadequacy and stress, leading to heightened emotional distress, impaired self-regulation, and a diminished sense of well-being.

  • Racial Trauma: As BIPOC individuals, they encounter persistent racial bias and systemic racism, which can lead to racial trauma or stress from both personal and vicarious experiences of discrimination.

  • Identity Confusion: They may struggle with identity confusion when the image they see in the mirror does not match their self-perception, causing uncertainty about their true identity.

Effects of Complex Trauma

Complex trauma can profoundly affect mental, relational, and physical health. 

Mentally, individuals may experience chronic anxiety, depression, emotional dysregulation, cognitive issues, low self-esteem, and even dissociation.  A common effect of C-PTSD is a persistent sense of worthlessness, unlovability, and rejection, often manifesting as toxic shame, which can persist into adulthood and appear as emotional flashbacks.  

Relationally, they might struggle with forming and maintaining healthy relationships, managing boundaries, building trust, and dealing with heightened reactivity and conflict. 

Physically, trauma can lead to chronic stress responses, increased risk of health problems, sleep disturbances, and poor self-care, medically unexplained physical symptoms (such as migraines, chronic pain, and restless limb syndrome). 

Overall, C-PTSD can significantly impair quality of life, reduce life satisfaction, and increase the risk of substance abuse, ultimately affecting personal and professional achievements.

What is Dissociation?

Dissociation is a mental process where individuals feel disconnected from their thoughts, feelings, memories, or sense of identity, often as a response to trauma or intense stress. This disconnection can manifest as:

  • Depersonalization: A sense of detachment from oneself.

  • Derealization: Viewing the world as unreal.

  • Amnesia: Gaps in memory or difficulty recalling events.

  • Identity Confusion: Uncertainty about one’s identity or personal history.

  • Identity Alteration: Experiencing different identities or personality states, such as in dissociative identity disorder (DID).

While occasional dissociation can be normal, persistent episodes that disrupt daily life may need professional intervention.

Common Causes and Triggers
Dissociation can arise from:

  • Chronic childhood trauma (e.g., abuse, neglect)

  • Unstable home environments

  • Natural disasters

  • Intense stress or exhaustion

  • Experiences of war or torture

Studies indicate that most clients experience significant improvement or recovery with dissociation infromed therapy. Effective methods include psychotherapy, somatic therapies, and EMDR, all proven to treat trauma and dissociation.

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