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What Survivors of Complex Trauma Want You to Know []


By Grace Back, Marie Claire, October 28, 2019

The 28th of October marks the tenth anniversary of Blue Knot Day, established by the Blue Knot Foundation to raise awareness of the more than five million adult survivors of complex trauma. This year's theme was: untangle the knot of complex trauma.

Blue Knot Foundation President Dr Cathy Kezelman AM said Blue Knot Day was about uniting Australians to help untangle the knot and complexities of trauma and abuse to support the recovery, resilience and empowerment of survivors.

“Over 5 million adults in this country have experiences of complex trauma, which is repeated ongoing interpersonal trauma and abuse, often from childhood, as an adult, or both,” Dr Kezelman said. “This Blue Knot Day marks the 10th anniversary of the Blue Knot Foundation delivering awareness, support and practitioner guidelines to help address the impacts of complex trauma on survivors.

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Scarlett  sums up my thoughts and what I know is true about complex trauma.   This isn’t going to ever be simple to treat. I would really like doctors to get serious about thinking about effective treatments like Neurofeedback as one example of an effective treatment but I would also like to see doctors putting out educational materials that offer a complete understanding of the very real physiological process that has happened to the mind and bodies of people who have experienced and live with complex trauma.   The physiology is as real as it is in hypovolemic shock and it is as understandable but patients have to be educated about what occurs to their bodies.   I’m coming to believe that these dissociated parts are actually neural networks that were created by repeated and prolonged use in extreme emotional /behavioral/ physiological states where emotions were activated but suppressed.   These states occur over prolonged periods of time in development - like a very compliant set of behaviors and ways of being in a kid who is 2-11  as an example who has had to act and behave in a particular way to avoid being beaten (compulsively compliant with false positive affect) or a set of neural networks that develop onto a complex set of emotions and behaviors that can be triggered in an adult and lead to a set of behaviors and a physiological state that is identical to the state a child may have slipped into over and over again during repeated and prolonged child sexual abuse. You cannot heal what you do not understand.   It’s also very important to understand that at this point most of American psychology/psychiatry doesn’t and can’t offer the vast majority of patients who need treatment for complex trauma what they need or even an explanation of what happened to them.  How many Medicaid therapists completely or even partially grasp secondary structural dissociation?  A parenting program is not going to treat secondary dissociation in complex trauma.    I only learned about secindary trauma two months ago and I have seen therapist after therapist at good institutions for 30 years.  I’ve met no one who knows about structural dissociation.   I had to educate my current therapist on this topic yesterday.   I have different sets of neural networks “parts”  that I can recognize likely developed in my childhood as a defense against serious danger.  These “parts” have different brainwaves on the EEG during Neurofeedback.  I can now tell my therapist what “part“ is doing Neurofeedback. That is a huge step forward.   Once you understand something, you can observe it and use top-down strategies to regulate it.  

I loved the mention of Epistemic Trust. How many people have heard that word?  Complex trauma comes with a huge dose of Epistemic Mistrust especially after seeking honest help over and over and being traumatized even more. 

Complex trauma aka Developmental Trauma is really, really common.   We don’t explain to patients what has happened so they are left switching into different complex behavioral and physiological states all the time w/o even knowing what is happening which leads to confusion, shame, self-harm, compulsive eating, substance use etc.  

Boys are also affected by complex trauma.   Boys need to understand what has happened to them too and they need proper treatments just as much as girls do. 

I would like to learn more about dissociation, especially secondary dissociation.   I don’t think a massive number of people with complex trauma/developmental trauma have DID or tertiary dissociation but I admit, I could be wrong about this.     I do know I have secondary dissociation and have for over three decades but  I only figured this out now.   But now that I know what is happening, I can observe this, befriend this and modify this. I can be the one in control.  With all this screening for ACEs,  I have 2 thoughts.....

We need treatments for complex trauma including secondary and tertiary dissociation and patients need to be evaluated for secondary & tertiary dissociation because it can easily go uneecognized for decades.  Patients need an honest abd understandable explanation of these processes. 

Screening for ACEs using only the ACEs questionnaire  will miss those kids who are being traumatized at the hands of their parents and who are using compulsive compliant or compulsive caretaking strategies to avoid and minimize danger (the quiet kids who don’t cause any trouble or do anything wrong). The parents of these kids will not tell you anything about ACEs and the kids will not either because they have no idea who you are or what you might do to them whether on purpose or because you just don’t understand the seriousness of the real danger that they live in everyday... this was what I thought (and believe to this day) when teachers asked me if my dad hit me in the face. I never told anyone and in all these decades, I have not changed my mind.  

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