CATHI IE WU

“Recovery is possible because the brain is very malleable. However, it’s important to stress that one cannot

overcome this only on their own. There are methods developed in our mental health multidisciplinary areas to help the person overcome, heal, or recover from these complex traumas.“

Cathie Wu is a director and counselling psychologist of ABRI Integrated Mental Health. Having worked with a diverse mix of clientele in USA and Malaysia including US army veterans, international expatriates, and patients with psychiatric conditions, Cathie specialises in treating clients with mood disorders, anxiety disorders, life adjustment difficulties, grief, bereavement and loss, chemical and non-chemical addictions, gender identity disorders, schizophrenia, delusional disorders, as well as personality disorders. She also conducts various psychological screenings for mood disorders, as well as for dementia and progressive neurocognitive decline.

What is complex trauma and how does it develop?

Complex trauma can be defined as exposure to multiple traumatic sources̶ often of a repeated, prolonged nature ̶ and the wide-ranging, long-term effects of this exposure.

Unfortunately, we do see cases where there’s complex trauma in individuals who arise from a dysfunctional family. In many cases, we’re talking about a child who spent almost two decades in a dysfunctional environment. Complex trauma may arise from different origins. All these formative years that’s shaped by abuse, types of abuse that are repeated and prolonged over the course of decades. These events are severe and pervasive, such as abuse or profound neglect. Can you tell us about the impact of trauma on a person’s wellbeing and behaviour?

Historically, we understand trauma within the context of post-traumatic stress disorder (PTSD), and it develops after a single stressful, frightening, or distressing event. With PTSD, traumas were understood to have features such as somatic, physical arousal, and anxiety. The fight or flight mechanism, flashbacks, and avoidance of trauma-related stimuli, these were features understood to be associated with PTSD.

On the other hand, complex post-traumatic stress disorder (CPTSD) is understood to affect a person in a multifactorial way. Because of its multiple origins as well as prolonged duration, we learned that the effects from complex trauma are way more complicated. Studies have shown that trauma can change the structure of the brain. The three areas of the brain that are most impacted are the amygdala, hippocampus, and prefrontal cortex. And these changes play a part in regulating emotions and responding to fear.

In essence, complex trauma affects a person mentally, even physiologically in the brain structure. Therefore, emotion regulation is disrupted, which leads to change in behavior. So really, the person is wired to experience anxiety later in life. In many instances, whenever I meet clients who are experiencing anxiety disorders or depression, we link it back to trauma.

What happens if trauma goes untreated?

If complex trauma is left untreated, the person starts to internalise negativity ‒ self-blame, shame, doubt, guilt. These are all very defining features of internalising behaviour. Furthermore, one may even experience externalised behaviours ‒ aggression, anger, further abuse of others. It’s very common for people who grew up with abuse to get into toxic relationships. In many instances, the cycle repeats itself.

Is it possible for people to heal from complex trauma?

Recovery is possible because the brain is very malleable. However, it’s important to stress that one cannot overcome this only on their own. There are methods developed in our mental health multidisciplinary areas to help the person overcome, heal, or recover from these complex traumas. One very effective strategy is a recall-based therapy modality called EMDR (Eye Movement Desensitisation and Reprocessing). Clinically, we use it for a lot of conditions under the umbrella of anxiety disorders which includes PTSD, CPTSD, phobias, obsessive compulsive disorder (OCD), and more.