Complex trauma and dissociation in children

What is childhood complex trauma?

Childhood Complex trauma refers to the exposure of early chronic and multiple traumatic events, very often inflicted within the adult/parent- child relationship. The child is in an inescapable situation where their pain is inflicted by the same person that is supposed to meet their needs ( Gomez,  2013). Early interpersonal trauma shapes the structure and functioning of the brain. Dissociation is often viewed as an intra psychic process developed as a defence against trauma and or pain (Putnam, 1997).

Complex trauma is not always recognized

Complex trauma, dissociation, and personality fragmentation in children is a controversial topic and is not always recognized by the various professionals that are working to support and help these children and their families. There are many reasons for this.

One main reason is that the Diagnostic and Statistical Manual used by physicians and psychiatrists to diagnose mental health disorders in western society does not include the category of complex child trauma.  All of our systems in society including the education system, child welfare system, judicial system, and mental health system are intricately connected to what this leading authority says about childhood trauma.

My passion to learn how to help this population culminated after 20 years of working in the mental health field in various capacities including the in the child welfare field.  I worked with many children and families and realized long ago that what we were doing simply was not working. Children were simply not receiving the level of mental health support they required to heal from the trauma and adversity they had experienced.

Children and families who have come into contact with child welfare authorities often have extensive familial histories of intergenerational neglect, abuse, and overall trauma.  In my experience, the support and approaches used with this population are often band-aid approaches that do not heal the experiences of the child, leaving them with continued and ongoing symptomology.

Domains of impairment with Complex Childhood Trauma

Children with extensive histories of trauma (which includes relational attachment trauma), frequently exhibit differential diagnoses such ADHD-ADD, PTSD, eating disorders, bipolar disorder, reactive attachment disorder, mood disorders, conduct disorder, and psychotic like symptoms. They may experience amnesia for events, alternate personalities, rapid age regressions, shifts in demeanor, and auditory hallucinations.  Quite often these children deny behaviors and get labeled liars, and manipulators. All of these symptoms are adaptive responses to maladaptive environments where the child developed these above noted strategies for survival.

There are many domains of impairment as a result of complex trauma. Below is a chart adapted from the National Child Traumatic Stress Network (2003)

There is hope!

Recently, I travelled to Phoenix Arizona to train with child trauma and EMDR expert Ana Gomez.  The training was titled EMDR Child, Complex Trauma & Dissociation Specialist.  It was the second level of EMDR child specialization training.

I am honored to be one of about 30 participants from around the world who will now be able to support children and adolescents with complex trauma, dissociation and personality fragmentation using EMDR. I am proud to be one therapist in the first cohort of therapists to receive this training from Ana Gomez.  I am also sad to be one of the firsts as the issue of complex trauma and personality fragmentation in children is slowlybeginning to take hold as an issue. I believe it is a bigger societal issue than anyone recognizes and most certainly needs greater attention.