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  • Lemuel Tan

Trauma: Acute Trauma (PTSD), Chronic Trauma and Complex Trauma

Updated: Dec 25, 2023

Trauma is a complicated part of human life that can impact people in different ways. The word "trauma" has its roots in ancient Greek. It is derived from the Greek word "τραῦμα" (trauma), which means "wound" or "injury." There are many times of wound (emotional, relational and psychological) and the word trauma is not exclusive to a physical injury. However, among the myriad of trauma-related conditions, three often misunderstood terms are acute trauma, chronic trauma and post-traumatic stress disorder (PTSD).


Acute Trauma (Type 1) -  Acute trauma refers to a single, intense, or sudden incident that causes significant distress or harm. It is often a one-time event that has a powerful and immediate impact on an individual's well-being. The PTSD symptoms and diagnosis of accurately portrays this. For example: Someone involved in a severe car accident. The sudden impact and resulting injuries create a traumatic experience. This is an example of acute trauma, a one-time event with a clear beginning and end.


Chronic Trauma (Type 2) - Chronic trauma involves prolonged and repetitive exposure to stressful and adverse events. This type of trauma is typically associated with ongoing, enduring situations that create persistent stress and disruption in a person's life. For example: Someone who works in a toxic environment where they face consistent bullying, harassment, or discrimination over an extended period. The ongoing nature of the mistreatment leads to chronic stress and adversity.


Complex Trauma (Type 3) - Complex trauma, also known as developmental trauma or relational trauma, results from prolonged and repetitive exposure to traumatic events, particularly during childhood. It often involves interpersonal trauma within close relationships and can have a profound impact on a person's emotional and psychological development. For example: A child growing up in a home where there is ongoing physical, emotional, or sexual abuse experiences complex trauma. The repeated interpersonal violations during crucial developmental stages can have profound and lasting effects on the child's emotional well-being and future relationships.


Some difference between Complex Trauma and Acute Trauma


Prolonged Exposure vs Single Incident

  • Complex Trauma: Involves repeated exposure to traumatic events over an extended period. Distress often arises from a combination of interpersonal and environmental factors, influencing overall well-being.

  • Acute Trauma: Can result from a single traumatic incident or multiple discrete events. Distress is primarily linked to the meaning of the memory and impact of a traumatic incident, influencing thoughts, emotions, and behaviors.


Time Frame of Symptoms:

  • Complex Trauma: Symptoms are often pervasive and enduring, impacting various aspects of life over an extended period.

  • Acute Trauma: Symptoms may persist for an extended period but are often more directly linked to the specific traumatic incident.

Symptomatology:

  • Complex Trauma: Manifests in a wide range of symptoms, including emotional dysregulation, relationship difficulties, and identity challenges.

  • Acute Trauma: Has a more specific set of symptoms, including flashbacks, nightmares, hypervigilance, and avoidance behaviors.


Treatment Approach:

  • Complex Trauma: Treatment often involves a comprehensive, long-term, and trauma-informed approach, addressing various aspects of the individual's life and functioning.

  • Acute Trauma: Treatments may include evidence-based therapies such as cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), or medication, with a focus on addressing symptoms related to a specific traumatic incident.


Diagnosis:

  • Complex Trauma: Currently, there are no official diagnosis specifically termed "complex trauma" in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-V-TR). Clinicians often use the term descriptively to capture the complexity of prolonged trauma experiences.

  • Acute Trauma: Recognized as a specific mental health disorder with diagnostic criteria outlined in the DSM-5, facilitating standardized identification and treatment.




Understanding the differences between acute trauma, chronic and complex trauma is important to help individuals in accessing the right support. All forms of trauma need a compassionate and trauma-informed approach that recognises the individual challenges in their recovery process. Knowing these differences can help us create a caring and knowledgeable society, making spaces that encourage strength and recovery for those dealing with trauma.


Below are some common challenges that occur in trauma-based therapy:


Emotional Disregulation: Trauma often affects emotional regulation, causing heightened or hypoarousal and making it challenging for individuals to manage and express their emotions appropriately.


Avoidance: Individuals who have experienced trauma develop avoidance behaviors as a coping mechanism. This is not intentional and is a trauma response. Engaging in therapy may be challenging, as exploring the trauma can create resistance and discomfort.


Fragmentation of Memory: Trauma can lead to fragmented or incomplete memory recall, making it challenging for individuals to articulate their experiences coherently during therapy.


Resurgence of Traumatic Memories: The resurfacing of intense emotions and vivid recollections can cause distress for individuals when revisiting traumatic memories.


Bodily Symptoms: Trauma can be stored in the body, leading to physical sensations and symptoms. Integrating body-focused approaches while holding the mind is important in the recovery process.


Shame and Guilt: Trauma survivors may struggle with feelings of shame and guilt, often stemming from self-blame. Other emotions may also arise, such as fear, hate, disgust, embarrassment, etc.


Comorbid Conditions: Trauma often coexists with other mental health conditions such as depression, anxiety, or substance use disorders, necessitating a comprehensive and integrated treatment approach.


Safety & Trust: Trust issues are common among trauma survivors. Again, this is non-intentional and is a by-product of a trauma response. Building a therapeutic alliance requires time and patience to establish trust and safety within the therapeutic relationship.



If you are concerned about trauma challenges and symptoms, please do not hesitate to contact AURE: Psychology, Counselling & Therapy. I would be more than happy to support you on this journey.


Disclaimer: The material on this blog is not to be used by any commercial or personal entity without the expressed written consent of the blog's author. The article above is an opinion of an individual clinician and should not be taken as full clinical advice. The statements on this blog are not intended to diagnose, treat, cure, or prevent any mental health or mental illnesses. Always consult your doctor for medical advice or seek professional therapy.

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