Working through Complex PTSD Attachment Trauma: Psychotherapy in San Francisco
Trauma comes in different shapes and forms, and can impact someone’s life for a long time, and in ways they may not be aware of. Complex trauma, also know as complex PTSD or post-traumatic stress disorder, demonstrates a good example of how this happens as complex trauma is often caused by many different small, repeated traumas that can cause an experience in life of things being unsafe. The things that can be perceived as unsafe can be relationships, the ability to survive peacefully and abundantly, and walking through the world smoothly, without perceived risks. Negative experiences around safety are common presenting symptoms of PTSD.
Complex trauma can be caused by growing up in a rough environment, both outside and inside the house, and can be exacerbated by repeated trauma events happening to someone again in their adult lives to confirm their belief that this is the way that life is and will always be. The pattern of complex trauma is hard to break because often, young unsafe experiences and the ongoing beliefs around them are repeated in one’s life until there are resolved, which is how PTSD works.
Because I am an attachment therapist and Integrative Psychotherapy focuses on healing complex trauma and attachment issues in the city of San Francisco, in the Bay Area, and in California, I will focus here on sharing complex trauma issues that arise from attachment, which is a core specialty of Integrative Psychotherapy. Another name for this is simply “Attachment Trauma”, people often don’t realize that attachment trauma is a form of complex PTSD.
How does attachment trauma start? Generally, attachment trauma starts in the early years of life, before someone has learned that they can feel safe and co-regulate in healthy relationships. Attachment traumas can refer to abandonments, such as a divorce with spit custody, a parent leaving, or a parent dying. They can also refer to abuse, physical, sexual, and emotional abuse, often repeated by a caregiver in their young lives.
Attachment traumas are commonly caused by having a parent who, for whatever reason, is not able to stay regulated themselves, thus cannot create a safe and secure emotional environment for a child who does not yet know how to do this on their own. The most common presentation of adults who are working through attachment trauma are people who were raised by parents who had personality disorders, emotionally immature adults, parents with their own trauma, and parents who are addicts.
Someone with a personality disorder often experienced complex trauma of their own. A parent with a personality disorder, or with severe trauma, can lash out at unpredictable times both physically and emotionally. A child who experiences this from an adult becomes hypervigilant, constantly optimizing to keep themselves safe. They may develop fantasies of being able to change their parent’s behavior, of being able to end the emotional abuse, being able to save their parent. They may also be conditioned to respond to other people in their lives who behave in similar ways than their parents. In fact, they may be so used to this behavior that they may not even notice that the people they are getting involved with have personality disorders, they just feel extremely familiar to them, and the empathy extended is also familiar. Unfortunately they may repeat the pattern that they had with their parents until the pattern is resolved through learning how to set boundaries, not taking on the trauma of another, reacting appropriately to emotional and physical abuse (by not tolerating it any more) and even learning how to cut this person out of their life, which they may have never done with their family members. Each time the pattern repeats, the belief that “all relationships are like this” may become stronger, making it difficult to break the pattern.
PTSD is an old fear response (or many) that has/have been trapped in the body. When the fear response is trapped and cannot move through the nervous system, it can get stuck, and can be easily triggered by current events and situations that remind someone of the original trauma. When the old fear response gets triggered in the current situation, it is as intense as the fear of the original trauma, even if the current situation is not as bad or scary. In an attachment situation, let’s use abandonment as an example. If someone’s caretaker often abandoned them, or threatened abandonment, even as nuanced as stonewalling them and ignoring them in early childhood as a punishment, these behaviors will trigger a fear of abandonment as an adult. The reaction will feel just as intense as it did as a child, and the adult will react in the same way to prevent the abandonment; they may beg, have a panic attack, cling to the person abandoning them, or self abandon (drop all of their needs, boundaries, and values) to keep the other person from abandoning them. This response was not formed with the person they are with now, it was formed at a young age. This response is Attachment Trauma, a PTSD response.
Another common example of an attachment trauma is an avoidant response, needing to flee in a relationship. Often times individuals who have an intense flee response were in some way trapped in relationships with their caretakers who were anxious, incredibly needy, expecting an adult relationship from them, unable to have appropriate boundaries with a little one. Sometimes the adults were violent and constantly controlling or belittling the young one. In an adult relationship, the flee response, which is also a PTSD response, may be triggered by conflict, by someone wanting to be too close, by someone becoming attached to them too fast. These indicators may remind this person of the abuse that they face as a child when they were trapped.
How do you work through Attachment Trauma?
Therapists are trained to help people work through complex trauma. Bianca at Integrative Psychotherapy has specialized in helping people in San Francisco work through Attachment trauma specifically. The therapy process itself can be used to help someone focus on and identify what they would like to work on, and then come up with a complex treatment plan specialized to each unique individual to help them overcome their automatic PTSD reactions in their adult lives. Here are some steps that can be taken to begin to heal this trauma:
1. Awareness is always the first step. In order to work through things in therapy, we must first get into your story, your history, how these reactions show up for you, and why. Solving or fixing things before we understand this fully doesn’t work before we understand the complex system that we are trying to shift.
2. Taking the awareness into your everyday life is a helpful step. When you are in a fight with your partner, or you are feeling threatened by your boss, understanding young situations, feelings, an responses in the new situation helps you differentiate what is yours from your childhood and what is happening in the current moment. This lens can help an adult understand that maybe what is happening currently is different then what happened before, and maybe a new response can be used instead of an automatic reaction that is based out of the past.
3. Learn how to slow or change the PTSD response by focusing on nervous system regulation. Before reacting, pause for a second. Take a deep breathe. Before responding to the text, take a quick walk, drink a mug of tea or a glass of water. Maybe chose to call the other person instead of texting or emailing back.
4. Get Curious. What you thing is happening may not be happening. You can learn to be curious about your own response. You can learn to ask curious questions to the person you are being triggered by. You can say something like, “Hey, what did you mean by that?” or “I’m confused. Is something happening here that I don’t understand?” You may find that something very different is happening than you realized.
5. Have a reparative experience. Say what you’ve always wanted to say, maybe something like “Hey, that doesn’t work for me, can you try talking to me differently?” or “No thank you!” or “This relationship may not work for me”. Say all of the things that you didn’t get to say when you were young. Protect yourself. Be the adult that you needed as a child, for your current self.
When people try to make a big change in their lives, it’s often because they are trying to work through a nervous system that is wired to believe that they are always in danger. Therapy is a huge undertaking, but an investment into a future where one can feel safer in their own body.