Developmental and Complex PTSD Shape Adult Identity

How common is developmental trauma?

Developmental trauma is more common than many of us realise. According to the National Child Traumatic Stress Network, 78% of children reported more than one traumatic experience before the age of 5. Twenty percent of children up to the age of 6 were receiving treatment for traumatic experiences, including sexual abuse, neglect, exposure to domestic violence, and traumatic loss or bereavement.

Adults who suffered from developmental trauma go on to develop Complex Post Traumatic Stress Disorder, or “PTSD”, which is characterised by difficulties in: emotional regulation, consciousness and memory, self-perception, distorted perceptions of perpetrators of abuse, difficulties in relationships with other people, and negative effects on the meaningfulness of life.

Complex trauma can be caused by childhood abuse in all its forms as well as neglect and growing up with family violence or dysfunction.

Any form of violence experienced within the community – civil unrest, war trauma, genocide, cultural dislocation, sexual exploitation or re-traumatisation of victims later in life can also cause complex trauma. It’s important to differentiate single incident trauma often classified in terms of PTSD from complex trauma and deliver service responses accordingly as responses to complex trauma based on a diagnosis of PTSD alone are often seriously inadequate. This can be witnessing a horrific car accident or a gun shooting or similar singular stressful situation. Be its Complex PTSD or PTSD developmental trauma results.  Although we do not have statistics on the rates of Complex PTSD, risk factors for Complex PTSD are disturbingly commonplace. According to the CDC, in 2012 there were 3.4 million referrals to state and local child protective services for cases of abuse or neglect. It is estimated that in 2012 alone, 686,000 children, or 9.2 per 1000, were victims of maltreatment. However, experts believe these numbers under-estimate the true frequency, and up to 1 out of 4 children may actually experience some form of maltreatment. It is estimated that the total lifetime economic cost of child maltreatment in the US is $124 billion. While thankfully not all children who experience maltreatment go on to develop  Complex PTSD, many will – and recovery is challenging even for those who do seek treatment.

How does developmental trauma impact identity formation?

Identity formation is an important part of normal development, and takes place across the lifespan from birth, through childhood and adolescence, adulthood, and old age. Identity – including one’s sense of self as being good enough, integration of emotion and intellect, basic awareness of emotional state, feeling secure and coherent as an individual, and even the basic experience of who one actually is – is disrupted by developmental trauma because basic survival takes precedence over, and uses resources ordinarily allocated for, normal development of the self. Early trauma shifts the trajectory of brain development, because an environment characterised by fear and neglect, for example, causes different adaptations of brain circuitry than one of safety, security and love. The earlier the distress, on average, the more profound the effect.

The task of identity development in adulthood, challenging enough (though rewarding) for those with a secure, safe and enriching upbringing, is especially fraught for those grappling with the aftermath of developmental trauma. Because of developmental delays and adult consequences of trauma, which often included substance abuse, eating disorders, depression, and difficulty in personal relationships and professional development, identity development gets stuck.

Identity for adults with unresolved developmental trauma is often organised around being a survivor and maintaining basic safety in relation to others, leading to re-traumatising and disheartening repetitions, preventing growth-oriented experiences. Individuals in this situation become highly identified with a “traumatic self”, at the expense of a more inclusive, flexible sense of self. People with significant-enough developmental trauma dissociate from their environment, and from themselves early on – a last ditch survival mechanism – and may remain disconnected from themselves throughout childhood, adolescence and early adulthood – only recognising what has happened when there is no other choice but to do so.

With these considerations in mind, I am highlighting key ways that identity tends to be shaped by earlier traumatic experiences. Understanding these basic themes, which are often a result of dissociative effects on the traumatised personality, can help people recognise areas of difficulty so they can take steps toward doing the work of recovery, repair and personal growth.

1. Loss of childhood: “I never really had a childhood” or “I can’t remember much from growing up.”

People who experience a very distressing childhood often can’t remember big swathes of their childhood. They may remember particularly vivid moments, sometimes called “flashbulb memories”, which don’t have any context to them. They often don’t have a clear story of themselves as a child, up into adolescence, early adulthood, and sometimes later in life. This autobiographical sense is called a “coherent narrative” in attachment theory, and can be absent, under-developed, false or oversimplified. Many people have told me they feel like their childhood has been stolen, and without such a foundation, adult identity is compromised.

2. Missing parts of oneself:  “I’ve always felt like something was missing, but I don’t know what it is.”

With chronic developmental distress, children often disconnect important parts of themselves in order to survive, a form of dissociation. They may come to rely on one major persona in order to have stability and make it appear as if everything were OK – such as being an exemplary student – while having little or no real personal life. Later in life, they may feel like parts of themselves are missing. Through personal growth and therapy they may rediscover and even create anew these missing parts. Sometimes they are there, stowed away for better times if you will, but younger-feeling than the their everday persona. It’s common for these missing parts to be associated with particular emotional states and memories, and reuniting leads to a fuller sense of identity.

3. Attraction to destructive relationships: “I’m the kind of person who always dates people who are bad for me.”

It is not uncommon for people who are traumatised by key caregivers to end up with friendships, romantic relationships, and even finding work settings which are not good for them. They find people who fit their traumatic identity, even when they are trying to make different and better choices, leading to re-traumatisation through repetition of the past.

They may end up being around emotionally unavailable people, abusive or narcissistic people, or end up trying to rescue and fix people they date, for example. Consciously, they want to find someone who provides what they intellectually know they need and want, but unconscious influences lead them down unwanted familiar paths. Frequently, there is a powerful “chemistry” with new relationships which makes it seem like the relationship will be different, only to learn with disappointment it is all too familiar. When friends try to warn them, it’s not unusual to pick the new romance over a trusted friend. Repeatedly getting into destructive relationships can be disorienting and confusing, leading one to question one’s self-understanding, locking them into the old identity while preventing new identities from taking root.

4. Avoidance of relationships: “I’m someone who is better off alone.”

Alternatively, people with negative developmental experiences involving intimate relationships may opt to avoid closeness, and isolate themselves. Sometimes this starts early on, and sometimes later as an attempt to break the cycle of harmful relationships. But, healthy relationships with other people are crucial for personal development, presenting opportunities for growth and change. Missing out on them in adulthood as a self-protective measure further impairs development of a fully adult identity, solidifying a self-perception of unworthiness and self-condemnation.

5. Avoidance of oneself: “I don’t like to think about myself; it only makes me feel bad.”

Especially when childhood trauma was a defining component of key relationships – parents, siblings, and other important people – any reminder of those experiences may lead to efforts to manage painful emotions and experiences through escape from oneself. In extreme, this may lead one to self-destruction.

Connection with oneself, as with others, is a powerful reminder of prior trauma, activating memories and emotions which are often too much to handle. Self-care is impaired, and one learns to live apart from oneself as a matter of habit. They may not be able to reflect upon themselves at all, and flee from any encouragement to do so. A sense of self is often characterised by disgust and essential badness, reflecting a rigid traumatic identity.

6. Difficulty integrating emotions into one’s identity: “I’m not the kind of person who has strong feelings about things.”

When feelings had no place in one’s family of origin, emotions become split away from identity. They continue to have influence, leading to confusion and an unstable sense of self because one is unable to predict, let alone manage, strong emotions. We need that emotional data to be fully ourselves, and to make decisions. Emotional dysregulation leads to problems from impulsive decisions and gets in the way of forming healthy relationships with others.

People may experience a sense of emotional numbing, or (paradoxically) feel they don’t have any emotions at all. They may experience a limited range of emotions or feel muted emotions. They may, for example, only be able to feel vague emotions such as frustration or boredom, or they may block out dissatisfaction until anger explodes. They may only feel negative emotions about themselves, such as disgust and self-loathing – and recoil from anything or anyone presenting a positive view of them, feeling uneasy with gratitude from others, “not knowing how to take a compliment” or feeling mistrustful when people express kindness. They may adopt an overly intellectualised identity, acting stilted or awkward around others.

This leads to difficulty in personal relationships, as emotions are required for intimacy and shape career choices while often limiting advancement. Identity is narrow and flat, and re-integrating emotions into one’s sense of self, while rewarding and necessary for growth, can be very challenging, full of fears and difficult learning experiences.

Moving forward

While it can be disheartening to read about the effects of developmental trauma in adulthood, and daunting to contemplate doing the work of recovery and identify formation beyond that of the traumatised self, therapeutic efforts are effective.

Recovery, grieving and growth often take place over a longer time period than one would want, and re-connecting with oneself have many layers. Developing a sense that long-term goals are attainable and worth working toward is an important element to establish, even if it doesn’t feel possible or true. Working toward getting basic self-care in place is an important first step, as is working toward feeling comfortable seeking help when trust in caregivers has been broken. Developing compassion for and patience with oneself can be difficult, but useful.

About the Author

Grant Hilary Brenner, M.D., a psychiatrist & psychoanalyst, helps adults with mood and anxiety conditions and works on many levels to help unleash their full capacities and live and love well.

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