Ruth A. Lanius

As we have discussed, individuals who have experienced severe and repeated trauma typically struggle with a range of serious physical and emotional symptoms. Some of these symptoms include feeling chronically on edge, chronically numb and flat, or alternating between the two; feeling like previously experienced traumas are happening again in the present (re-experiencing emotions and/or sensations); spacing out or detaching from reality; difficulties with thinking or attention; unusual sensory experiences; and physical experiences like pain, difficulty breathing, digestive problems, or sexual problems. Those who are not knowledgeable about complex trauma may conclude that such a severe and varied constellation of symptoms must be inexplicable, unrelated, exaggerated, or even completely made up. Many patients with trauma-related disorders (TRDs) have spent years hearing and believing such messages from health care providers and possibly friends and family. This often leaves them in a state of confusion and distress in which they may belittle and disrespect themselves and their experiences. They may feel they are “making it all up,” are “too sensitive” or maybe are even “crazy.” Therapists working with chronically traumatized individuals must have a coherent theoretical framework for understanding these symptoms in order to educate their patients and to guide their response to what can seem like a baffling level of wide-ranging problems.