Therapy for Abuse, Trauma & Complex PTSD

Childhood experiences have a profound effect on the rest of our lives. If those experiences were traumatic or neglectful you may find yourself experiencing problems in multiple areas of your life.

Austin trauma therapyChildhood is an absolutely essential period in the development of our sense of self, our attachment to others, our sense of safety and security in the world, and our ability to regulate our emotions.

Disruptions to typical development can result in what is often referred to as developmental or complex trauma. Developmental and complex trauma, unlike one-time or shock trauma, happens in family environments and is often repeatedly perpetrated by caregivers.  Because of the interpersonal nature of these experiences, many people experience lifelong consequences that affect both the mind and body. All your life you may have had a sense that something is wrong but you don’t quite know what it is.

Early childhood experiences and family dynamics may result in traumas of omission or commission, or both:

Omission results from what wasn’t there. Lack of love, caring, and comfort from parents means your emotional needs were not met. These are parents who may have been well meaning but due to their own histories had limited capacity to be available for their children. Consequently, you may be experiencing symptoms of emotional neglect. You don’t know what your feelings and needs are, and you don’t know how to go about getting those needs met in relationships. As a result, you likely feel empty, lonely, and isolated from others. Your life may lack a sense of meaning and direction. You may find yourself minimizing your experiences by saying, “I was never hit,” and “things weren’t that bad.”

Traumas of commission result when parents were overtly dismissing, humiliating, or abusive. This can include verbal, emotional, physical, and/or sexual abuse. Study after study has shown that children who grow up in abusive environments experience a multitude of mental health and physical problems. You may be experiencing a great deal of anxiety, depression, worthlessness/shame, and flashbacks into traumatic events. Or you may be trying very hard to keep painful feelings below the surface and therefore go through life feeling numb or “frozen.” 

Research on Adverse Childhood Experiences (ACES)

Both in the mental health community, and in the culture at large, we’re learning more about the significant impact of developmental trauma on adult health and functioning. In the 1990’s, Kaiser undertook one of the largest studies on the impact of childhood experiences (both positive and negative) on the mental and physical health of individuals. The study found that the higher the number of adverse childhood experiences, the greater the likelihood of negative health outcomes. Many survivors of difficult and traumatic childhood events experienced greater rates of:

  • Anxiety and depression 
  • Drug and alcohol use
  • Further victimization, including sexual and domestic violence
  • Suicidal thoughts and actions
  • Variety of physical health problems, including chronic pain and illness

If you’d like to know your ACE score you can take the test here.

Symptoms of Complex & Developmental Trauma

Individuals who seek therapy often present with a variety of difficulties that affect their functioning. I work with clients to address numerous symptoms and manisfestations of past trauma:

Anxiety and vigilance

Anxiety can show up in many ways. Due to past learning there is a tendency to view the world as a dangerous place. This leads to hypervigilance in different contexts and relationships. You might be aware of a startle reflex, social anxiety at parties, dread of underperforming at work, seemingly irrational fears of something bad happening, and/or a compulsive need to please others so they won’t abandon you.

Depression, worthlessness, and shame

Depression is an attack on the self that often arises from deep feelings of worthlessness and shame. You might have a harsh inner critic that berates you and makes you feel bad about your mistakes and yourself. Then, the more you might tell yourself that you’re a “bad person” the more depressed you are likely to feel. Depression pulls you into a black hole of low energy, lack of motivation, and despair in which you might even consider suicide.

Feeling “nothing,” being “numb,” or “checked out”

These are usually symptoms of what is known as dissociation. When humans experience trauma we have at our disposal fight and flight mechanisms. When those strategies are ineffective, such as experiencing abuse from a more powerful parent who the child also relies on for caregiving, the mind and body resort to the last available strategy: dissociation. During a dissociative process all but essential brain functions go offline to ensure survival. This process explains why many survivors of abuse say they “don’t remember it happening,” or “it wasn’t that bad,” or “it feels like it happened to someone else.” In effect, those part traumatic experiences have become “warded off” in the mind because they were too painful to bear. As adults, these individuals are often prone to revictimization because they might automatically switch to a state that feels “frozen” or “checked out” which also means they’re not aware of their environment and lack the power to protect themselves. Additionally, these clients often report feeling like they’re “floating, lightheaded, or out of body.”

Unhealthy and dysfunctional relationships

If our early blueprint for relationships was painful, neglectful, or abusive, then that is the model we will internalize. If parents were abusive or neglectful you may expect the same treatment from others and unconsciously make choices that make this a reality. If you were expected to give up your needs to take care of others, then it is likely you will struggle with codependency and people pleasing in your adult life. If no one could be relied on to meet your needs and provide safety you may become very avoidant of intimacy and closeness, choosing instead to be “self sufficient” and “independent.” While this helps you avoid getting hurt, you also feel loneliness and isolation.

Substances, food, sex

While all the above can be used in healthy ways, they can often become compulsive coping strategies to manage emotional experiences. One of the primary effects of childhood trauma is difficulty regulating one’s emotional experiences. If you were routinely subjected to difficult emotions and had no support for how to handle them, it is likely you’ll struggle with containing your feelings in your adult life. To manage stress, worry, or upset feelings you may develop a “characteristic coping style” of having a few drinks, indulging in too much food, or other habitual activity. This can help soothe your feelings in the short term, but in the long term leads to an unhealthy reliance on said activity. There are times you’ll want to stop or cut down on your consumption but you may feel unable to do so. This often creates a cycle of shame and using.

Low self-worth

In my experience, this is one of the most intrinsic and pervasive effects of a traumatic upbringing. When children are punished or neglected they almost always blame themselves in order to preserve the view of their parent or caregiver as “good,” which is necessary for survival. Consequently, they tell themselves they’re “bad.” This happens at a very unconscious level and becomes encoded as a “truth” about the self. No matter how many accomplishments you’ve achieved, how nice and kind you try to be, etc etc, there’s an unshakeable view of yourself as “fundamentally bad.” As a result you feel a lot of self-loathing and self-hatred.

All of these effects of abuse and neglect I’ve described are adaptations to the kind of environment you experienced growing up. You may not understand why you do what you do, or why you feel a certain way, yet there are always good reasons. A big part of the work of therapy is untangling various parts of you and discovering what purpose different feelings and behaviors serve. 

“Neuroscience research shows that the only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves.” Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

How Therapy Helps

Trauma therapist AustinI help with both reduction of the symptoms I described above as well as the deeper work
of understanding your inner experiences. We might go through life repeating the same unhealthy patterns, getting into one unsatisfying relationship after another, and not know what is motivating us or how to change it.

By exploring your internal experiences we will understand more about the adaptations you developed, the feelings you weren’t allowed to feel, and the needs that weren’t met. This deeper work allows you to develop freedom to make different choices in your life and to develop a different relationship with yourself and with others.

My approach is an integration of dynamic experiential, attachment-based and emotion-focused theories of psychotherapy. I believe that all of of symptoms, behaviors, and feelings are interrelated. Nothing exists in a vacuum. Therefore, I use therapeutic methods that help us to go below surface-level problems to access your deeper experiences and create lasting change. My goal is to help you through this process compassionately, effectively, and at a pace that feels comfortable for you. I strive to create a genuine and collaborative therapeutic relationship and always welcome your reactions and feedback about our work together.