February 18, 2021

Understand & Overcoming 3 Types of Trauma: Acute, Chronic, and Complex

by | Feb 18, 2021 | Trauma & PTSD

Three types of trauma include; acute trauma, chronic trauma, and complex trauma. There are additional types and subtypes that can affect everyone differently.

Research shows that approximately 60% of adults indicate a history of abuse or difficult family issues during childhood. As people transition into adulthood and later years, trauma can include anything from sexual assault to natural disasters to complicated grief.

Although trauma is often used as a catch-all term to describe any life-threatening event, it’s essential to understand the nuances. This information can help you better understand your circumstances and receive the appropriate care. 

Acute Trauma

Acute trauma refers to a single, traumatic incident that happens in your life. The event is specific and defined with a beginning, middle, and end. 

These traumas may include events like:

  • Sexual assault or rape
  • Physical altercation
  • Car accident 
  • Serious injury
  • Natural disaster
  • Witnessing a violent event

Acute trauma can affect people in many ways. Some people don’t have much of a traumatic response at all. Others may have immediate symptoms that require professional support and intervention. And some people develop symptoms several weeks or months after the event. All reactions are normal, but unprocessed symptoms may lead to PTSD.

Chronic Trauma

Chronic trauma typically results from prolonged and ongoing abuse. This type of trauma may persist for several weeks, months, or years. It’s often within the context of a specific relationship. 

Intimate Partner Violence (IPV)

IPV refers to physical, sexual, or financial abuse that occurs within the context of a romantic relationship. The perpetrator seeks power and control over the victim. They often use various manipulation and abuse tactics to maintain the relationship’s status quo. 

Survivors of IPV often indicate having a desire to leave the relationship multiple times before they actually do so. That’s because perpetrators often isolate their victims from loved ones. They also tend to strip away their confidence while increasing their dependence on the relationship. It becomes a vicious cycle- even if someone wants to leave, they may not have the resources to make it happen. And if they get caught, the perpetrator often engages in even more dangerous abuse.

Bullying

Some research shows that persistent bullying represents a form of chronic trauma. Bullying can entail mental or physical abuse. Although some people assume it’s only a childhood issue, many adults suffer from the consequences of bullying in the workplace.

Bullying undoubtedly affects someone’s self-esteem and self-worth. The more people “gang up” on you, the more their actions can impact your sense of safety in the world. Additionally, bullying can make it challenging to form meaningful relationships, as it can feel hard to trust other people.

As the use of social media continues to grow, so does cyberbullying. Parents and caregivers, watch this series on cyberbullying to learn more about this societal epidemic.

Complex Trauma

Complex trauma refers to experiencing chronic trauma with long-term emotional and physical symptoms. 

This kind of trauma may be the most severe- it can ultimately affect someone’s development and sense of safety in the world. When a child endures complex trauma, they may experience severe psychological distress.

Complex Trauma in Childhood

Complex trauma in childhood often includes a combination of the following variables:

  • Prolonged neglect and real or perceived abandonment
  • Lack of secure attachment to caretakers
  • Extreme financial instability and distress
  • Verbal abuse and threats
  • Physical abuse
  • Mental health problems within the family
  • Sexual harassment or sexual abuse 
  • Homelessness or transitioning in-and-out of foster care systems

At times, the evidence of complex trauma is apparent. For example, the child may struggle in school or bully other children. They might have difficulty with authority or present as disheveled. But in other cases, this trauma can be far more discreet. Many children present well in the outside world and can seemingly conceal any real proof of trauma.

Complex Trauma in Adulthood

Complex trauma in adulthood can happen in various situations, including:

  • Prolonged experiences with homelessness or severe financial distress
  • Domestic violence
  • Ongoing struggles with substance use
  • Repeated medical emergencies 
  • Family-related stress related to extreme conflicts of interests and estrangement
  • Being involved in a cult

Complex trauma happens when it feels like the traumatic events keep blending into one another. When one issue ends, two more appear. It can seem like a never-ending cycle of despair, anger, and hopelessness.

What Symptoms Do People Experience After Trauma?

No two people respond to trauma in the same ways.

It’s important to be open-minded, sensitive, and compassionate when supporting a loved one. If you’re the one struggling, remember that your feelings are real. It’s okay to have good days and bad days- this is a normal part of the recovery process.

Numbness/Shock

After an acute trauma, it’s normal to feel a sense of apathy or numbness. These feelings often indicate being in a state of shock. You may not be able to process the events that happened to you fully. In some ways, shock serves as a protective measure. It helps you from feeling absolutely flooded by the trauma.

Denial

In some cases, people may deny the severity of the event that happened to them.

Denial can sound like, It really wasn’t that big of a deal. Other people have it so much worse.

It can also sound like, I don’t even think about it that much. What’s done is done. It’s in the past.

Denial isn’t the same as lying. It’s usually a way to try to convince yourself that the reality wasn’t so terrible (even if it was).   

Confusion

Confusion may persist after feelings of numbness or shock. The confusion can be related to feeling unclear about the events that happened to you or why they happened. You might also feel somewhat disorientated. For instance, days may blend into each other. You might find yourself walking into a room and forget why you’re there. In extreme cases, confusion can lead to memory problems and complete forgetfulness.

Paranoia

You may feel paranoid after a traumatic event. This paranoia often emerges from the fear that somebody or something will harm you again. As a result, you may be hypervigilant to the people around you. You might avoid certain triggers that remind you of the trauma. 

Flashbacks

Flashbacks refer to involuntarily reexperiencing trauma after the event has happened. In some cases, flashbacks can feel incredibly debilitating. Even though you know the trauma is in the past, it feels like you’re right back in the chaos. These flashbacks often exacerbate feelings of anxiety, depression, and panic.

Intellectualization 

Intellectualization happens when you try to make sense of what happened using logic and facts. This coping style isn’t always bad- it’s a way of trying to understand and move on. But people who intellectualize their feelings often deny their emotions. They may suppress them altogether. Over time, these feelings may emerge in different ways, which can stunt the healing process.

Depression

Many people feel depressed after experiencing a trauma. Depression symptoms can range from sadness to irritation to feeling worthless. Some people will obsess over the details of what happened, causing them to feel even more upset. Their depression might impact them from feeling motivated to move forward. Suicidal thoughts may also emerge during this time. 

Self-Harm 

Self-harm refers to any intentional act of hurting yourself. These acts may include cutting, burning, hitting, or inserting dangerous objects into oneself. Most of the time, someone’s self-injurious actions aren’t meant to be life-threatening, but they pose serious risks. Over time, the repeated behavior can become compulsive, and the person may find it challenging to stop.

Anger 

Anger is a common emotion experienced after a trauma. Survivors often feel angry about the circumstances they endured. They may also experience a deep resentment towards the perpetrator in the event of violence or assault. This anger may result in the person projecting anger onto others by lashing out physically or emotionally.

Shame 

Shame can be one of the most insidious symptoms that result from trauma. Guilt happens when someone believes they did something bad. Shame occurs when someone believes they are bad. Shame can occur after a trauma, especially if they believe they somehow deserved what happened to them.

Increased Substance Use

Research shows that trauma and substance use are closely connected. An overwhelming number of individuals seeking substance use disorder treatment report having histories of trauma. Many times, people use drugs or alcohol to self-medicate their feelings of sadness, anger, or helplessness. Over time, this pattern can lead to an addiction.

Relationship Problems

After a trauma, people may withdraw, isolate, or lash out at their loved ones. These actions are rarely intentional, but they can create tension within the dynamic. Even if both people endured the trauma together, everyone copes differently. If the coping styles appear to clash, problems may ensue. 

Dissociation

Dissociation is a psychological symptom that refers to feeling detached or disconnected from your body. In a dissociative state, people often report watching themselves as if they exist outside of themselves. It can resemble a dream or a hypnotic trance. In extreme cases, someone may lose the memories of the trauma or lose connection with parts of themselves.

How Do You Heal From Trauma? 

Healing from trauma isn’t a single event. It can require a combination of ongoing support, self-care, and resources. Additionally, many people benefit from professional guidance during this time. 

You may benefit from therapy if you are experiencing:

  • Persistent sadness that doesn’t seem to be improving (or is continuing to worsen)
  • Ongoing anxiety symptoms and panic attacks
  • Distressing relationship problems
  • Increased substance use
  • Suicidal thoughts or behaviors
  • Feeling a sense of hopelessness or dread throughout the day
  • Extreme anger towards oneself or others

These symptoms may indicate PTSD. Even if you don’t meet the full criteria for PTSD, you might still be struggling with residual problems related to your trauma. 

Cognitive-Behavioral Therapy (CBT)

CBT can help you recover from your trauma by reexamining the negative thoughts you hold about yourself, others, or the world. In CBT, you will learn how your cognitive distortions affect your feelings and behaviors. You will also learn healthier ways to cope with intense feelings.

Over time, through this work, you should start feeling more confident and optimistic about yourself and the future.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is an evidence-based trauma therapy model designed to help you feel less reactive to your traumatic memories. In this therapy, you will repeatedly share what happened to you while your therapist engages in a series of bilateral stimulations.

Eventually, this process can desensitize you to the negative thoughts you have related to past events.

Psychodynamic Therapy

Psychodynamic therapy explores how past events and relationships impact your current functioning. You will learn how certain defense mechanisms may keep you feeling chained into past ways of thinking and feeling. In learning to release those defense mechanisms, you can take better ownership over your life. 

Group Therapy 

Support groups can be extremely helpful for coping with trauma. Many organizations hold groups for survivors of domestic violence, sexual trauma, or childhood abuse. Additionally, grief itself can be traumatic, and many bereavement groups help people cope with the trauma surrounding the loss of a loved one. 

Family Therapy 

When a family member endures a trauma, it can be helpful for everyone to seek help to learn how to cope and process the event. This is especially true when the trauma occurred to a child. Family work is systemic- it teaches each member how to take personal accountability for their thoughts and actions.

Psychiatric Medication

Psychiatric medication can provide relief for anxiety or depression symptoms that emerge after a trauma. Many people benefit from either antidepressants (SSRIs) or anti-anxiety medications. Some people only take these medications for a few months to achieve stabilization. Others take them for longer periods of time, as they find it helps with their overall mood management.

Final Thoughts

All trauma can have debilitating effects on individuals and their loved ones. If you are struggling with coping from a trauma, remember that you’re not alone. You also don’t have to struggle alone! Professional support and treatment can help you recover and heal from the past. 

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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