Developmental / Complex Trauma

Trauma is a term encompassing emotional or psychological reactions to distressing events like physical or emotional abuse, sexual assault, natural disasters, or other violent, life-threatening experiences. Its effects extend to mental health and overall well-being, leading to manifestations such as anxiety, depression, post-traumatic stress disorder (PTSD), and various mental health disorders.

Trauma and PTSD

Complex trauma refers to the experience of children exposed to multiple invasive, interpersonal traumatic events, leading to extensive and enduring effects. These events, including severe abuse or profound neglect, typically occur in early life, significantly disrupting the child’s development and self-concept formation. As these occurrences often involve a caregiver, they impede the child’s capacity to establish a secure attachment, crucial for various aspects of their physical and mental well-being.

Manifestations of developmental trauma vary widely, with common indicators including challenges in forming emotional connections, struggles in regulating emotions and behavior, heightened sensitivity to actual or perceived threats, inclination toward dissociation or detachment, engagement in self-harming behaviors, substance abuse, or other risky activities. Additional signs may involve difficulties in intimate relationships and an enduring sense of insecurity, worthlessness, or inadequacy.

Complex and developmental trauma can display diverse manifestations, with common signs and symptoms including:

  1. Challenges in emotion regulation
  2. Low self-esteem and feelings of shame
  3. Persistent physical and emotional distress
  4. Disconnection from reality or a sense of detachment
  5. Intense feelings of fear, helplessness, or hopelessness
  6. Heightened vigilance and increased perception of danger
  7. Impaired ability to establish and maintain relationships
  8. Difficulties in intimacy and trust
  9. Memory issues and concentration difficulties
  10. Persistent feelings of being trapped and lacking control
  11. Avoidance of places, individuals, or situations triggering traumatic memories
  12. Compulsive repetition of unhealthy coping habits or behaviors

Is complex trauma a disorder?

The emergence of the concept of complex trauma traces back several decades. Clinicians, particularly those working with individuals who endured persistent traumatic events like survivors of child abuse, observed a broader range of symptoms compared to traditional PTSD. This unique symptomatology was identified as “complex PTSD” (CPTSD), later evolving into a suggested diagnostic category known as “developmental trauma disorder” (DTD).

Managing complex trauma presents unique challenges in treatment. Unlike the more acute traumatic events associated with PTSD, chronic traumatic experiences may persist even during the child’s treatment. Notably, the majority of research supporting evidence-based treatments for trauma symptoms in children primarily centers around PTSD.

1.EMDR (Eye Movement Desensitization Reprocessing):
EMDR a psychotherapeutic approach, has demonstrated effectiveness in addressing diverse psychological disorders like trauma, PTSD, anxiety, and depression. The process entails revisiting traumatic experiences while concurrently experiencing specific bilateral stimulation, such as eye movements. This is believed to aid the brain in processing these experiences in a more adaptive manner.

2.CPT (Cognitive Processing Therapy):

CPT commonly entails collaboration with a therapist to recognize and confront negative thoughts associated with trauma. Additionally, individuals learn coping strategies to effectively manage symptoms. There is supporting evidence indicating the effectiveness of CPT in PTSD treatment, making it a viable option, especially for those who may have faced challenges with alternative forms of trauma-focused therapy.

3.Play and Art Therapy:

Play and Art Therapy are emerging as impactful approaches in trauma treatment, offering innovative ways to address emotional and psychological challenges. These therapeutic modalities provide a non-verbal and expressive outlet for individuals navigating trauma, allowing them to explore and communicate their experiences in a supportive environment. Through creative activities, such as drawing, painting, or play, clients can process and make sense of their emotions, fostering healing and resilience. Play and Art Therapy not only contribute to the therapeutic process but also offer a unique avenue for individuals who may find traditional talk therapy challenging. As part of trauma treatment, these modalities are gaining recognition for their ability to facilitate self-expression, enhance coping mechanisms, and promote overall well-being.

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Echocardiography – $250

Implantable Cardiac Monitor (ICM) – $150

Treadmill stress testing – $300

Transoesophageal echocardiogram (TOE) – $115

Pacemaker checks– $333

Electrophysiology – $258

Holter monitoring – $464


Echocardiography – $250

Implantable Cardiac Monitor (ICM) – $150

Treadmill stress testing – $300

Transoesophageal echocardiogram (TOE) – $115

Pacemaker checks– $333

Electrophysiology – $258

Holter monitoring – $464


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    Nastaran Ali Azizi
    Registered Psychotherapist by the college of Psychotherapists of Ontario

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