Relational Trauma

Navigating the aftermath of traumatic and abusive situations can be difficult. Nowadays, there seems to be many definitions relating to traumatic experiences. One thing I notice, is that some confuse or use the words ‘relational trauma’ and ‘complex PTSD’ interchangeably.

While there are many overlaps between these words, their definitions are quite distinct.

The word trauma identifies any traumatic experience, or repeated traumatic experiences in a person’s life. These traumatic events may include something that has caused significant interpersonal pain and suffering which have affected a person’s ability to cope in a healthy and beneficial way.

With regard to the word relational, it includes any relationship that is impactful to a person; the closer and more influential a person is in someone’s life, the greater the impact the trauma can have. These relationships may include family, friends, colleagues, or a romantic partner.

Because my work surrounds adverse childhood experiences, relational trauma typically includes toxic, maladaptive, repeated, and traumatic events between a child and their caregiver where there is a significant power imbalance. Thus, the child learns to fear their caregiver while still having to rely on them for their most basic needs. Relational trauma may or may not include their primary caregiver (i.e. “mom” or “dad”), but may include any close adult, including extended family.

Relational trauma is not limited to childhood experiences with a power-imbalance between caregiver and child, but can include any relationship dynamic where there is a power imbalance, coercive control, dependency or codependency, and mistreatment, including narcissistic relationships.

Complex Post-Traumatic Stress Disorder (cPTSD) is the aftermath of a series of traumatic events that have caused significant distress and a reduced ability to function. Dr. Judith Lewis-Herman coined the term “complex PTSD” as a way to identify the complexities of chronic, repeated, and often early relational trauma on a person’s life, as being separate and distinct from current definitions of Post-Traumatic Stress Disorder (PTSD).

Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR, 2022) does not currently recognize cPTSD as a unique stand-alone diagnosis. However, the International Classification of Diseases (11^th Edition), ICD-11 (2019) does recognize cPTSD as separate and distinct from PTSD, including its symptoms, and their overall effects on a person’s life.

Healing from a pattern of relational trauma or cPTSD is possible, and should include a comprehensive approach where stabilization, grieving, and reintegration are included. Additionally, because of the complexity of relational trauma, intervention should additionally include a behavioral approach that can be used to monitor, modify, and master specific goals that include: somatic work, fostering new skills that target social, emotional, physical, psychosocial, and cognitive domains and evidence-based interventions that help provide a solid framework for lasting recovery.