Christine A. Courtois

“Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust, confusion, low self-esteem, loneliness, shame, and self-loathing. They seem to be prisoners of their emotions, alternating between being flooded by intense emotional and physiological distress related to the trauma or its consequences and being detached and unable to express or feel any emotion at all - alternations that are the signature posttraumatic pattern. These occur alongside or in conjunction with other common reactions and symptoms (e.g., depression, anxiety, and low self-esteem) and their secondary manifestations. Those with complex trauma histories often have diffuse identity issues and feel like outsiders, different from other people, whom they somehow can't seem to get along with, fit in with, or get close to, even when they try. Moreover, they often feel a sense of personal contamination and that no one understands or can help them. Quite frequently and unfortunately, both they and other people (including the professionals they turn to for help) do misunderstand them, devalue their strengths, or view their survival adaptations through a lens of pathology (e.g., seeing them as "demanding", "overdependent and needy", "aggressive", or as having borderline personality).

Yet, despite all, many individuals with these histories display a remarkable capacity for resilience, a sense of morality and empathy for others, spirituality, and perseverance that are highly admirable under the circumstances and that create a strong capacity for survival. Three broad categories of survivorship, with much overlap between them, can be discerned:

1. Those who have successfully overcome their past and whose lives are healthy and satisfying. Often, individuals in this group have had reparative experiences within relationships that helped them to cope successfully.
2. Those whose lives are interrupted by recurring posttraumatic reactions (often in response to life events and experiences) that periodically hijack them and their functioning for various periods of time.
3. Those whose lives are impaired on an ongoing basis and who live in a condition of posttraumatic decline, even to the point of death, due to compromised medical and mental health status or as victims of suicide of community violence, including homicide.”
― Christine A. Courtois, Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach

“Their experiences led them to create assumptions about others and related beliefs about themselves such as "this is my lot in life" and "this is what I deserve". Some also learned that personal safety and happiness are of lower priority than survival and that it may be safer to give in than to actively fight off additional abuse and victimization. When abuse is perpetrated by intimates, it is additionally confounding in terms of attachment, betrayal, and trust. Victims may be unable to leave or to fight back due to strong, albeit insecure and disorganized, attachment and misplaced loyalty to abusers. They may have also experienced trauma bonding over the course of their victimization, that is, a bond of specialness with or dependence on the abuser.”
― Christine A. Courtois, Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach