Many traumatic events (e.g., car accidents, natural disasters, etc.) are of time-limited duration. However, in some cases people experience chronic trauma that continues or is repeated over months or years, sometimes commencing in childhood. While the current PTSD diagnosis is a very good fit in describing the symptoms suffered by someone who has experienced a discrete or short-lived traumatic event, it does not fully capture the severe psychological harm that occurs with prolonged, repeated trauma.
Examples of such trauma are:
- Physical or sexual abuse or severe neglect from childhood
- Long-term domestic violence
- Long term captivity, as a result of kidnap, hostage taking or war
- Enforced long term prostitution
Each of these scenarios involves the victim being held in a state of captivity, either physically or emotionally (or both). The victim is under the control of the perpetrator and is unable to easily get away from the danger.
Research suggests that 92% of people who have suffered trauma of this nature meet the diagnostic criteria for PTSD (DSM IV Field Trials), but that they also demonstrate additional symptoms such as changes in their self-concept and the way they adapt to stressful events; difficulty in regulating emotion; interpersonal difficulties and in some cases alteration in consciousness (dissociation).
A disorder which encompasses all these different symptoms in addition to PTSD is variously known as Complex Trauma, Complex PTSD or Developmental Trauma Disorder, (given that the trauma frequently has its root in childhood). Symptoms can overlap with other commonly recognised psychiatric disorders, particularly personality disorders, with the result that misdiagnosis is possible.
Survivors of Complex Trauma may often use alcohol or other substances as a way to numb or avoid their feelings. Various forms of self-harm are also common.
Treatment for Complex Trauma involves treating a wide range of symptoms and difficulties, and is long-term as opposed to time limited as in single-incident PTSD treatment. For this reason such therapy is more difficult to access and may involve funding difficulties.
ASSIST Therapists are trained and experienced in treating Complex Trauma and this therapy is available at the ASSIST clinic in Rugby provided that funding can be put in place. Therapy for Complex Trauma is not available via Outreach Therapists.