Article Summary: Understanding complex trauma in adults is critical, as complex PTSD shows up in approximately 1%–8% of the global population. Helping these adults recover from trauma can help them lead happier, healthier lives while improving their relationships with the people around them. Therapy can assist in overcoming trauma and reconnecting with the world in a positive way. 

Nearly everyone will experience something traumatic in the course of their lifetime. While this can often be managed through reflection and therapy, some people aren’t so lucky. 

Some people experience multiple, layered traumatic events, which can lead to complex trauma—a terrible affliction that can disrupt one’s entire life. 

We connected with Associate Counselor Michelle White, LCSW, MSW, who has years of experience working with adults with complex trauma and kids with complex trauma, thanks to her former role with Children, Youth, and Families. 

Table of Contents
What Is Complex Trauma?
How Common Is Complex Trauma In Adults?
Therapy for Complex Trauma In Adults
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What Is Complex Trauma?

Complex trauma is psychological and emotional damage from prolonged and repeated traumas, such as domestic violence, child abuse, neglect, or other interpersonal conflicts. 

It’s different from single-event traumas like a car crash, major injury, or an assault.  

Complex trauma frequently leads to long-term consequences, like anxiety, panic disorders, self-esteem issues, emotional dysregulation, depression, and other problems. Left unaddressed, complex trauma can diminish your quality of life and even reduce your life expectancy. 

Related Reading: PTSD Acute Vs. Chronic: Differences and Similarities

How Common Is Complex Trauma In Adults?

If you’re suffering from complex trauma, you’re not alone. Some estimates say 1%–8% of the global population suffers from complex post-traumatic stress disorder (C-PTSD).

And it’s even more common among certain populations, lifestyles, and career paths. For example, complex trauma may be more common among:

• Veterans and active members of the military – One study found 13% of veterans suffer from C-PTSD. 
• Adults who were adopted – 62% of children in the foster care system have been abused or neglected at some point. 
• First Responders – 85% have suffered from some sort of mental health issues.
• Incarcerated People – Nearly 100% of people who are incarcerated have experienced potentially traumatic events. 

Therapy for Complex Trauma In Adults

Therapy isn’t only good for repairing complex trauma. It’s also good for building post-traumatic resilience. 

How long you attend therapy for complex trauma really depends on a few different variables, as Michelle explains: 

“Although it varies from person to person, some studies say it can take three to five years to fully overcome complex trauma,” Michelle says. 

“If they can have empathy for their past selves, they can start ‘clearing’ memories pretty quickly, sometimes even one per therapy session. It really depends on how productive they are in therapy and how much damage we have to overcome together.”

Some of Michelle’s favorite tactics for addressing complex trauma include:

1. Finding Resources

Although many people with complex trauma are high-functioning members of society, others may struggle with addiction, employment, physical health, and other issues that potentially require welfare services like Supplemental Nutrition Assistance Program (SNAP) and Medicaid. 

In these cases, it’s essential to help clients find stability in their lives while working through trauma in therapy. 

“I often refer back to Maslow’s hierarchy of needs,” Michelle says. “Sometimes clients talk about wanting to pursue a relationship or take a vacation, and I have to help them refocus with, ‘Hey, before anything else, we need to establish stable housing and reliable access to food.’”

This is where Michelle’s experience in CYF comes in handy, as she’s still well connected to resources available in Allegheny County. 

Some of her favorite places to send clients include:

• Allegheny Link – Allegheny Link connects local residents with emergency shelters, rental assistance, affordable housing resources, eviction prevention programs, and other support services.
• Greater Pittsburgh Community Food Bank – This is the region’s largest hunger-relief organization, providing access to local food pantries, meal programs, senior food boxes, and SNAP outreach services throughout Allegheny County.
• Just Harvest – Just Harvest helps individuals apply for SNAP benefits, Medical Assistance, LIHEAP heating assistance, TANF, and other public benefits.
• PA CareerLink Pittsburgh – This free resource offers employment services, including job searches, résumé assistance, career counseling, interview preparation, job training, and workforce development programs.
• United Way of Southwestern Pennsylvania – This is a free, 24/7 resource that connects residents with thousands of local services, including food assistance, housing, utility assistance, transportation, healthcare, childcare, and crisis support.
• ACTION-Housing – Connect with housing counseling, eviction prevention, rental assistance navigation, affordable housing resources, and homeownership support throughout Allegheny County.

2. Person-Centered Therapy

At the heart of Michelle’s work is person-centered therapy, an approach that recognizes every client’s experiences, emotions, and healing journey are unique. 

Rather than telling clients how they should feel, person-centered therapy creates a safe, nonjudgmental environment where they can begin making sense of what happened to them.

Validation is one of the most powerful tools in this process. Many people with complex trauma have spent years being told their feelings were wrong, exaggerated, or unimportant. Simply hearing, “What happened to you wasn’t okay,” or “Your feelings make sense,” can be an important first step toward healing.

DBT & CBT

Michelle commonly blends DBT (dialectical behavior therapy) and CBT (cognitive behavioral therapy) during her sessions. While they’re related approaches, here are the unique benefits of each therapy:

• Dialectical Behavior Therapy – DBT emphasizes mindfulness, distress tolerance, and emotional regulation. At its core, DBT is all about accepting difficult emotions while learning how to choose healthier behaviors. 
• Cognitive Behavioral Therapy – CBT is all about identifying our negative thoughts, feelings, and behaviors, and working to choose healthier, practical solutions. Some clients in CBT will work with a therapist to set goals, track progress, and even complete practice exercises. 

“To me,” Michelle says, “the most important things are to challenge thoughts, set boundaries, and work on communication with others. From there, we can begin building a better life.”

Ego State Work

Another technique Michelle and other trauma therapists frequently incorporate is Ego State Work. Ego State Work stems from the idea that we all have different “parts” or emotional states within us, and each one is shaped by different life experiences.

For someone with complex trauma, these parts may conflict with one another. For example, one part may desperately want close relationships, while another pushes people away to avoid being hurt. Another part may still carry the fear, sadness, or anger of a frightened child who never had the opportunity to feel safe.

Rather than trying to eliminate these different parts, Ego State Work helps clients understand why each one exists. Most developed for a reason—even unhealthy behaviors often began as attempts to survive impossible situations.

“One of the most important things is to develop empathy for ourselves,” Michelle says. “We have to have empathy for the child within us, for the person in our past.” Instead of criticizing the frightened child, the perfectionist, or the people-pleaser, clients learn to understand what each part was trying to accomplish and what it needed at the time.

EMDR

EMDR is one of the most effective therapies for complex trauma. 

If you’re unfamiliar, EMDR stands for Eye Movement Desensitization and Reprocessing, and it works by using bilateral stimulation to activate the entire brain to process and reorganize intense memories, trauma, and emotions. 

It can be incredibly impactful. While it varies from person to person, studies have shown EMDR can fully address complex trauma in as few as 6–12 sessions. 

Michelle often uses it with clients to give them an opportunity to revisit their most painful memories in a controlled environment. 

“We want to take them back and give them an opportunity to respond in a different way,” Michelle says, “or to talk to their younger self. We ask questions like, ‘What would your inner child say about this?’ and ‘What would the wise version of you say about this?’”

Careful examination and reflection during EMDR can rewire the way you experience your most painful memories, while also giving yourself another chance to emotionally and psychologically heal. 

Find Therapy

If you’re ready to tackle complex trauma, contact us. Our compassionate therapists are here to help you overcome the darkest moments of your past to reveal a happier, healthier future.