As human beings, we have an incredible capacity to heal – physically, mentally, emotionally and spiritually. As a therapist and spiritual director, I’ve been privileged to provide well over 10,000 hours of care to many hundreds of people healing complex PTSD or trauma. I’ve also seen people experience an unnecessary sense of failure when they come to trauma counselling with an agenda other than healing. It can be helpful to establish what we’re dealing with when we speak of complex trauma and to have realistic expectations of trauma processing.

What we mean by PTSD, trauma and complex trauma

PTSD stands for stands for Post-Traumatic Stress Disorder, a collection of symptoms as described by the Diagnostic and Statistical Manual of Mental Disorders. The DSM is in its 5th Edition as of the time of this article. It is a product of the American Psychiatric Association and represents the understanding of a committee that is tasked to represent the professional mainstream at the time it is being updated. 

This means that the DSM, like humanity, is flawed. It was only in 1973, for example, that homosexuality was removed from the DSM’s list of mental health disorders. And so-called female hysteria was removed even later, not until the 1980s.

Trauma is threat or perceived threat to the physical, mental, emotional or spiritual survival of a person.  You should know that many of us who specialize in helping people recover from the normal aftereffects of trauma do not use the word “disorder” to describe these symptoms. We consider the symptoms of post-traumatic stress to be the normal and expected response of the human brain to abnormal conditions. That is, to trauma. Rather than disorder, we speak in terms of unprocessed trauma.

The threat to wellbeing may be a single-incident (acute) trauma such as being hostage in a bank robbery or the sudden loss of a loved one in the context of an otherwise safe-enough life. Complex trauma refers to the situation of a person who encounters acute traumas on top of having traumatic developmental conditions as an everyday occurrence. 

Conditions for spontaneous healing

You may be surprised to learn that many acute traumas – without the background of developmental trauma – resolve themselves when given the conditions for healing. Spontaneous healing is the default!

Years ago, I became aware of these conditions via the classic The Grief Recovery Handbook. The more experience I gained in treating the symptoms of trauma, the more I saw that these conditions are not only necessary for grief: they are necessary for all emotional healing. Healing occurs when:

1) There is time to feel; i.e., recovery time after an event;

2) There is space to feel; i.e., no further threat;

3) There is permission to feel – in our family, culture; and

4) There is a sense that we have a witness to our feelings. They don’t have to be in the room with us, but there needs to be a sense that someone knows what we’re processing and that we’re processing, and that we can reach out if we need to.

A great example of spontaneous healing came from a colleague several years ago. Her toddler had taken a spill down a long flight of stairs before my colleague could reach him. The child was not seriously harmed, which my friend considered a miracle. Several hours later, though, she found that her own brain was replaying the incident over and over (as part of its attempt to recover from the jolt of fear) sometimes with scaryelaborations, such as the potential for a broken neck or traumatic brain injury. 

My colleague asked if I could hold space for her to do some Brainspotting the next day if this continued. I assured her I would make the time. The next morning, though, my colleague found that a good night’s sleep for the whole family had cleared the intrusive visual thoughts. She thanked me for being ready to help, but she didn’t need it.

Complex Post-Traumatic Stress

Complex trauma, on the other hand, describes the pain and other symptoms of a person who faces one or more acute traumas, but whose brain developed in an environment that consistently lacked some or all of the above conditions for spontaneous healing.

When an acute trauma occurs against a backdrop of overall wellbeing, it is clear to the person that the trauma is the problem. This brain has developed in a world where needs are met, people are trustworthy, and trauma – while painful and upsetting – is an anomaly and says nothing negative about the person who experiences it.

For the person who ends up with lingering symptoms and/or a diagnosis of PTSD, trauma means that something is seriously wrong with the person – at least, it feels that way to that person. In an environment where the brain has learned it is not safe to seek witnesses for pain or grief, or where being in survival mode is the long-term norm, each new trauma appears to validate one’s unworthiness at worst, or bad luck at best. 

Providing the conditions for healing is the work of trauma counselling, but those conditions can feel so unfamiliar that they actually appear untrustworthy to the traumatized person. “Feelings? Who has the time? They’re just trying to trick me into showing weakness.” Fortunately, frightened and untrusting parts of the brain can be updated through brain-based modalities.

How tragic that people so often don’t have the requisite conditions for spontaneous healing: But what an honor that as mental health counsellors, we have the opportunity to provide those four conditions for healing. What an inspiration it is to know that we are designed to heal!

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Ready to Bring Healing to Your Life?

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Abnormal is not uncommon

Abnormal developmental conditions are, unfortunately, not uncommon in this human experience. In our competitive culture, very brave and well-intentioned parents can inadvertently create homes where “Don’t feel” is the message. Many people are in survival mode just trying to provide for their children and don’t have time for their own feelings. Or maybe home is safe, but it’s the only place that feels safe.

I’m reminded of a client from decades ago who finally got a chance to grieve the automotive death of her husband after she was done raising their children. While she did a wonderful job in so many ways, she became aware that her children did not have a model of feeling and healing. Thus, conditions that do not provide the safety, nourishment and resources to support normal brain development can occur even in the most well-intentioned and understandable situations.

How can we know what normal development looks like? I see it in the people who are recovering or have recovered their authentic selves – the selves they can be when not stuck in survival mode -through resolving trauma.

What trauma processing can do

By “processing” I mean that the brain and body have been able to metabolize painful events. When we metabolize food, the body retains nutrients and disposes of what’s not useful. In metabolizing painful events, too, the body retains important information – e.g., about people or situations that are not safe, about our own creative capacity for survival – and the brain lets go of the rest, instead of continuing to hold trauma in the body in the form of chemical processes and habitual muscle tension. 

When processed, trauma no longer registers in the parts of the brain where painful events continue to affect our heart rate, sleep, and perceptions. Trauma no longer acts like a computer virus – popping up when they’re not wanted, interfering when we’re trying to do other things, taking up too much short-term memory so we don’t have room to learn new things.

Trauma that has been processed behaves more like a Word doc: You can open it if and when you want information about it; it doesn’t take up a lot of space; and it’s stored in such a way that the brain and body experience it as over. The memory is clear, but it’s not active in the body anymore. It is finally and truly past, unable to hurt us.

What “normal” looks like

The more a person processes the backlog of trauma involved in healing complex PTSD, or complex trauma, the more we glimpse what it is for the human system to function normally; i.e., beneficially. We see a genuine sense of care for oneself right along with others, with no false sense of “me or them.” We see playfulness, a return of energy and interest in life. We see acceptance of previously unskillful ways that we tried to solve our problem. We see an ability to imagine a future along with a sense of competence to participate in bringing that idea to fruition. 

There is a sense of worthiness to connect to others, to share our gifts, and a growing trust that there are others worth connecting to – both outside of us and inside of us. Meaning, in addition to people “out there,” we have a willingness to know and tend to parts of ourselves that were previously hidden to keep us safe. There is enough internal harmony that no one part is allowed to oppress other parts – even with good intentions. The authentic adult self is fully online to see to that.

What healing trauma won’t do

What we don’t see in genuine trauma processing is an ability to turn oneself into a completely different person from one’s authentic nature. Instead, there is curiosity and care to discover one’s true nature. This means, for example, that resolving trauma won’t turn a numbers-only person into a spelling bee champion, nor an introvert into an extrovert. 

Resolving trauma does not make a queer person straight. Instead of trying to shape oneself into oppressive – or simply limited – cultural ideals of who one should be, a person in recovery from complex trauma refuses to participate in their own oppression or erasure.

Various means of trauma processing

Today, we have access to means of healing trauma that go so much faster – and usually far better – than talk therapy alone. Some of these include:

– Full participation in 12 Step recovery for adult children of dysfunctional families 

– Internal Family Systems Therapy

– Psychodrama

– Narrative Therapy

– EMDR Eye-Movement Desensitization and Reprocessing

– Somatic Experiencing

– Trauma informed Yoga

– Trauma informed Massage

– LENS (Low Energy Neurofeedback System) 

– Brainspotting and other forms of mindful meditation

While I have training in and great experience with several of the above, I most often utilize Brainspotting with my clients because I value the way it uses the brain’s own healing capacity without the interference of human agendas. You’re very welcome to learn more about Brainspotting by visiting my website, PassatiCounseling & Direction, or visiting the Resources page at the Southeast Brainspotting Institute.