Complex Trauma

If you are involved in direct service, which involves providing direct interventions to survivors of human trafficking or population who may encounter interpersonal violence, you may have heard the term "trauma-informed." This term refers to treatment methodologies that are inclusive to traumatic experiences as a focus in a survivor's case plan or treatment modality.

I have had the wonderful opportunity to work for a number of organizations who do include trauma into the focus of their treatment for assisting persons to overcome adversity. Including, an in-depth exploration to the neuroscience of trauma and its physical impact on the brain. Trauma information is presented during every training opportunity for all staff, including case planning and multidisciplinary action teams. Trauma-informed care is inclusive to survivors in the process and allows the survivor to become an integral part of the healing process.

While trauma-informed care is considered to be a best-practice model for serving individuals who have experienced trauma and adversity, there is another more advanced type of trauma that is rarely talked about and, rarely trained on—complex trauma. Human Trafficking (long-term trafficking) survivors often fall under the umbrella of complex trauma because of their repeated exposure to violence and adverse experiences, as well as a lack of available services for persons with this level of trauma.

When I was 16 years old, I was stuck in a relationship with Satan. My boyfriend at the time enjoyed the pain he inflicted on me. Physical, sexual, psychological, you name it, I lived it with him. The trauma I experienced took place during the limbic stage of brain development and rewired my brain to think that violence was normal in a relationship. This primed me for exploitation when I moved away from my parents' house.

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The National Child Traumatic Stress Center defines complex trauma as a type of trauma that occurs repeatedly, cumulatively and even increases over time. In a family context, a conspicuous example of complex trauma is ongoing (physical or sexual) violence against family members. There are many different scenarios that can play out when looking at what complex trauma looks like. A common example in my work with survivors most often includes someone with an extensive history of sexual abuse, starting sometime during their childhood. I've also met a substantial number of survivors who share that they watched a domestic violence situation play out over and over again during their childhood. Many survivors tell stories of watching someone murdered in front of them. All of these are severe levels of exposure to trauma, but what is signature to complex trauma is when the exposure is repeated over an extensive time period (more than a few weeks).

The main difference between the two include the symptoms. The image below gives a helpful guide on what complex trauma looks like.

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In this image, you can see that there is a solid base of re-experiencing, avoidance, and sense of threat in both PTSD (trauma) and Complex PTSD (complex trauma). What sets complex trauma apart is that on top of those signature behaviors of repeated exposure to trauma, you also see the person's affect becoming chronically dysregulated with difficulty seeing oneself in any positive light, and is constantly engaging in negative interpersonal relationships. This means that you usually see the survivor sabotaging relationships or allowing the lack of trust to prevent that individual from connecting or attaching with anyone. 

You can't talk about complex trauma without talking about brain science, specifically how early trauma exposure can rewire the brain, increasing vulnerability to adverse experiences later on. I am not yet a neuroscientist, but I will share information I have been given at the trainings I've been to recently. When a child experiences trauma during any of the various milestones of development, that trauma can leave a mark (or scar) on the brain until that child is able to overcome what they experienced. Someone who has experienced a lot of abuse can actually lose parts of their brain. This can impair the way the child (or later the adult) interacts with others, and even the ability to keep meaningful relationships. What is more alarming is that the complex trauma can actually alter the brain's responses to trauma, impairing judgment, and making someone susceptible to even more devastating trauma. There's a video of a Ted Talk by Dr. Nadine Burke Harris of the Center for Youth Wellness in California that blows my mind every time I see it! She talks a lot about the ACEs Assessment (which is accessible at https://www.cdc.gov/violenceprevention/acestudy/) and how the assessment is an especially useful tool to identify trauma histories in patients so that the treatment can be trauma-informed.  (https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime)


When I graduated high school at 18 years old, I was able to walk away from that relationship. I am making it sound really easy, but it definitely wasn't. After I was able to successfully end that relationship, I engaged in promiscuous behavior including sneaking out with boys and girls, drinking, and blatantly defying my parents. When I actually got to college, I was primed and ready for someone to take complete advantage of my vulnerabilities. Do you think that there were services for me out in Podunk, KS? NO! There was nothing. There's still nothing. How do you think that never getting services helped me? Spoiler alert…it didn't. 

Think about all of the amazing kiddos who are at risk for human trafficking. There are so many kids out there who have lived through worse than I did, at a much earlier age. There are so many kids who have lived in the shadows and grew into traumatized adults who later result to maladaptive survival behaviors because that trauma has disintegrated their temporal lobes (responsible for computer auditory information) or damaged their prefrontal cortex (responsible for managing impulsivity and judgment). These kids….who were severely traumatized….who were forgotten by the system…..grow into TRAFFICKERS. Complex Trauma creates Traffickers.

Listen, y'all – there's no justification for traffickers' behaviors. There's no making what they did okay. But we can learn from them. We can work to own up to and eventually fix the mistakes we have made as a society. WE can prevent human traffickers. Think about the impacts of the foster care system on children. Or what about poverty, dang it??? Think about how our society manufactures trauma that creates this everlasting river of cruelty. The river flows from population to population, shifting the blame, demonizing human beings, and never solving the issue of violence that perpetuates complex trauma. The cruelty moves and shifts so that it becomes unrecognizable in another form (until smart people like me figure it out). 

It's time to destroy this river (and only this river). You can make a difference by engaging in a conversation with someone you have had difficult relationships with in a way that is kind. You can start to challenge those "good guy/bad guy" ideas that are so blatantly part of our culture. You can raise your kids under a rainbow of glitter, unicorns, and kindness. Perpetuate a world where we accept one another, no matter anyone's views. Perpetuate a world where love is the goal.

Kristen Tebow is an advocate for survivors of human trafficking with almost a decade of serving marginalized youth and adults, developing programs, and educating the public on the indicators and red flags of human sex trafficking. Kristen is an artist, a dreamer, and a visionary. She is a respected member of the Human Trafficking Survivor Leader community and continues to empower, provide support to, and collaborate with Survivor Leaders from around the globe. Kristen is renewed through relationships with friends and family, especially her Husband and their two Jack Russell Terriers. K.T. enjoys painting, singing and dancing, and yoga. K.T. has been nationally recognized for her artwork, providing two paintings for the world-renown Pathbreaker Award at the Shared Hope JuST Conference.