Death By a Thousand Papercuts

Research shows that people who experience childhood trauma are three times more likely to suffer from anxiety or depression as adults, often without making the connection between their past and present struggles. Many people dismiss their childhood experiences, thinking they “weren’t that bad” because they didn’t endure overt physical abuse or neglect.

But here’s the thing: complex trauma can be subtle. It’s the small, repeated cues from the adults in your life that signal messages about who you are and what you're worth. Often referred to as “death by a thousand paper cuts,” this type of trauma wears you down over time, until you internalize and believe these harmful messages.

Complex trauma differs from what we call single-incident trauma—such as a car crash or a fire—events that happen once and are over. Complex trauma can be trickier to heal because it is so pervasive, often repeated throughout childhood, laying the foundation for our beliefs about self-worth and identity.

As a trauma therapist and certified EMDR therapist in Oakland, CA who specializes in childhood trauma recovery, I often hear confusion from new clients when we start uncovering the root causes of their anxiety. Many say, "That’s just the way I’ve always been."

Let’s dispel that myth together.

What is complex trauma?

Complex trauma refers to prolonged exposure to harmful or stressful situations, often beginning in childhood. Unlike a single traumatic event, complex trauma arises from repeated experiences of adversity that deeply affect a person’s emotional and psychological well-being.

Common examples of complex trauma include childhood neglect, physical or emotional abuse, ongoing exposure to violence, and growing up with emotionally immature or unavailable parents. These early and repeated experiences of instability and harm shape how individuals perceive themselves, others, and the world around them.

One of the challenges of healing from complex trauma is that it is often relational. Because the trauma involves close relationships with caregivers or trusted individuals, it can deeply affect one’s ability to form healthy, trusting relationships in adulthood.

What makes complex trauma so complex?

1. Prolonged Exposure:
   Complex trauma involves repeated exposure to trauma over an extended period, making the emotional wounds deeper and harder to heal. This chronic exposure often creates long-lasting effects on a person's mental and emotional well-being, far beyond the initial traumatic event.

2. Attachment Issues:
   One of the hallmarks of complex trauma is its impact on attachment. Trauma that occurs within close relationships, such as with caregivers, can severely damage a person’s ability to trust others and form healthy, secure relationships. This often leads to challenges in both personal and professional relationships later in life.

3. Impact on Self-Identity:
   Complex trauma can profoundly affect how someone sees themselves and others. Negative beliefs about self-worth, shame, and feelings of unworthiness often stem from early traumatic experiences, shaping the way a person navigates their life and relationships.

4. Mental and Emotional Health Challenges:
   People who have experienced complex trauma are more likely to develop mental health issues such as PTSD, anxiety, depression, and dissociation. These challenges can be ongoing, making daily life more difficult without understanding the root cause.

Signs and Symptoms of Complex Trauma

Common Emotional and Behavioral Signs:
Individuals dealing with complex trauma often experience a range of emotional and behavioral symptoms. These can include:

• Flashbacks: Reliving traumatic events in vivid detail, often triggered by seemingly unrelated stimuli. Flashbacks can look like experiences of a big emotion or reaction and don’t necessarily mean a visual recall of the event (although it can be!).

• Hypervigilance: A constant state of being on edge, always scanning for potential threats.

• Emotional Dysregulation: Difficulty managing emotions, leading to extreme mood swings, anger, or overwhelming sadness.

• Self-Esteem Issues: Persistent feelings of unworthiness, shame, or inadequacy. Complex trauma impacts how you feel about yourself.

  How Complex Trauma Differs from PTSD:
  While complex trauma and PTSD share some similarities, they are not the same. PTSD is often triggered by a single traumatic event, such as an accident or natural disaster. In contrast, complex trauma involves prolonged exposure to trauma, typically during childhood, and affects deeper layers of a person’s emotional and psychological development. People with complex trauma often struggle with identity, relationships, and emotional regulation, in addition to PTSD symptoms like flashbacks.

  A person who has complex trauma in their history may also have complex PTSD or PTSD, or they may have complex trauma in their history and have done healing work around their PTSD symptoms to no longer meet the criteria of a PTSD diagnosis.

How to Heal from Complex Trauma

How to Heal from Complex Trauma

Healing from complex trauma can be a challenging but transformative journey. There are several effective treatment options available to support individuals in processing and recovering from the deep wounds left by prolonged trauma.

While there are many different options out there, here are a few of my favorite treatment options to heal from complex trauma:

• EMDR Therapy: Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy that helps individuals process traumatic memories and reduce their emotional impact.

  EMDR therapy is highly effective for treating complex trauma because it targets traumatic memories directly, helping to reprocess them in a way that reduces emotional distress. Through guided eye movements, EMDR helps to unlock traumatic memories, allowing the brain to heal from the past in a more adaptive and integrated way.

• Talk Therapy: Also known as psychotherapy, this involves working with a therapist to explore thoughts, feelings, and past experiences. In order to heal from complex trauma, this best works in tandem with other trauma-informed approaches and is not recommended as the only treatment option.

• Somatic Therapy: This approach focuses on the connection between the body and mind, helping clients release trauma that may be stored in the body through physical sensations and movement.

• Internal Family Systems: A therapy approach that views emotions, thoughts, and feelings as different interconnected parts of yourself. This approach focuses on learning to hold these different parts of you with compassion, helping to release some of the intensity from different traumatic experiences.

How a Trauma Therapist Can Help

When dealing with the effects of complex trauma, working with a therapist who specializes in childhood trauma can make all the difference in your healing process.
Trauma therapists are trained to recognize the unique challenges that come with healing from complex trauma. They can offer therapeutic interventions tailored to the specific needs of trauma survivors, providing a compassionate and nonjudgmental space for you to explore and process your experiences.

EMDR Intensive Therapy for Complex Trauma

As a trauma therapist and certified EMDR therapist in Oakland, CA, I specialize in helping individuals heal from complex trauma. With a trauma-informed approach and expertise in EMDR therapy, I provide the support needed to guide you through the healing process.
If you recognize yourself in any of the experiences mentioned here, know that you don’t have to navigate the path to healing alone. I invite you to reach out and explore how trauma therapy, including EMDR, can help you reclaim your life from the effects of complex trauma.

Learn more about EMDR Intensive Therapy for childhood trauma here.