Relational trauma is a complex and often misunderstood form of trauma that can deeply affect an individual’s emotional well-being and life-long interpersonal relationships. Understanding the intricacies of relational trauma can demystify the origins, symptoms, and, importantly, the approaches to treatment.
What Is Relational Trauma?
Relational trauma, sometimes referred to as complex trauma or attachment trauma, is a psychological condition rooted in adverse interpersonal experiences and relationships. It’s distinct from single-incident traumas like accidents or natural disasters and typically arises from prolonged exposure to harmful interactions, often in early life.
At its core, relational trauma originates from a profound disruption in an individual’s ability to form secure, healthy attachments. This disruption can result from experiences such as neglect, physical or emotional abuse, or inconsistent caregiving during childhood. Such distressing relationships can lead to a deep-seated sense of insecurity, vulnerability, and mistrust in the world.
What Are The Effects of Relational Trauma?
Relational trauma can have profound and enduring effects on an individual’s psychological, emotional, and physical well-being. These effects are wide-ranging and often extend into various facets of an individual’s life. Here, we explore some of the primary consequences of relational trauma:
Relational trauma can disrupt one’s ability to manage their emotions effectively. Individuals may experience heightened anxiety, depression, anger, and overwhelming emotional responses to triggers that may seem objectively neutral of ‘every day’. People with relational trauma often struggle to maintain emotional equilibrium, often feeling like they are not in control of their emotional state.
Low Self-Esteem and Self-Worth
Relational trauma can severely impact an individual’s self-perception. They often internalize negative messages from the traumatic relationship they experienced and develop a distorted self-image. This leads to low self-esteem, self-criticism, complex conditions of worth and pervasive feelings of unworthiness – especially when relational trauma occurs in childhood.
Difficulty in Trusting Others
Trust issues are a common outcome of relational trauma. People who’ve experienced betrayal or emotional harm in relationships may find it challenging to trust others. They may be hypervigilant – which develops as a protective strategy against instability, volatility and unpredictability from caregivers in childhood. Hypervigilance means the amygdala – the so-called treat detector – is overactive. It may perceive sensory information in the environment, such as a change in tone of voice or facial expressions, to be threatening and dangerous, triggering a cascade of reactions linked to the stress response. When the brain is over-actively looking for signs of potential betrayal, it can hinder the development of healthy, secure connections.
Attachment can be disrupted by relational trauma. Those affected might exhibit anxious, avoidant, or disorganized attachment patterns, impacting their ability to form close, fulfilling relationships. They may fear abandonment, withdraw in times of stress, or become dependent on others.
Re-enactment of Trauma
Without intervention, individuals may unconsciously reenact their past trauma in current relationships. For example, a person who experienced neglect might repeatedly choose partners who neglect or abandon them, perpetuating the cycle of harm. This is a complex phenomenon caused by various factors, and it is important not to judge or blame a survivor of relational trauma who appears to reenact past trauma. The reenactment may be a misguided attempt to regain control and understand the past or caused by a lack of self-worth, which leads to relationships with partners who reinforce negative self-beliefs.
Isolation and Loneliness
To protect themselves from further emotional pain, individuals who have experienced relational trauma may isolate themselves from social interactions as they struggle to trust others or feel relaxed in their company as a result of chronic hypervigilance. Loneliness can exacerbate the emotional wounds caused by relational trauma, creating a cycle that hinders the healing process and maintains feelings of disconnection and vulnerability.
Physical Health Consequences
Relational trauma in childhood, as with other forms of early trauma, can profoundly influence long-term physical health. Childhood trauma is associated with a greater risk of somatic issues, such as musculoskeletal pain, persistent headaches, gastrointestinal symptoms, and fatigue. It also elevates the likelihood of cardiovascular diseases.
Coping with the emotional pain associated with relational trauma can lead individuals to turn to substances such as drugs or alcohol as a way to numb their feelings and escape their painful reality. While self-medicating with drugs or alcohol may provide temporary relief, it can quickly get out of control, often compounding existing challenges and in some cases, progressing into substance use disorder.
Maladaptive Coping Strategies
The absence of healthy coping mechanisms or support systems may lead to the development of maladaptive behaviors. Some individuals engage in self-harming behaviors, emotional eating, or other destructive habits as a way of managing their emotional pain. These strategies can worsen their overall well-being and even contribute to further trauma.
Mental Health Diagnoses Associated With Relational Trauma
Relational trauma is intricately linked to a range of psychological diagnoses. These include but are not limited to post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (C-PTSD),3 attachment disorders, borderline personality disorder, and various mood disorders such as generalized anxiety disorder, social anxiety disorder, and depression. These conditions can be severe and debilitating, and such diagnoses reflect the profound impact that adverse relational experiences can have on a person’s mental and emotional well-being, highlighting the importance of recognizing and addressing the long-term consequences of relational trauma in therapeutic settings.
Healing From Relational Trauma
Healing from relational trauma is a challenging but achievable process, with effective therapeutic approaches available. Trauma-informed therapy creates a safe space for individuals to explore and process their traumatic experiences. It employs techniques like Eye Movement Desensitization and Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for memory processing and reframing.
Attachment-based therapy addresses underlying attachment disruptions through modalities like Emotion Focused Therapy (EFT), and Dialectical Behavior Therapy (DBT). Mindfulness and somatic therapies aid in reconnecting with the body and regulating emotions.
Support groups offer community and understanding, and self-care, self-compassion, and healthy boundary-setting are fundamental. A holistic approach helps survivors rebuild their lives, fostering self-love and acceptance. Recovery is possible, and seeking professional help is a crucial step towards creating healthier, more fulfilling relationships.
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 Raby, K.L. et al. (2018) ‘Childhood abuse and neglect and insecure attachment states of mind in adulthood: Prospective, longitudinal evidence from a high-risk sample-CORRIGENDUM’, Development and psychopathology, 30(1), pp. 367–370. Available at: https://doi.org/10.1017/S095457941700089X.
 Ho, G.W.K. et al. (2021) ‘Complex PTSD symptoms mediate the association between childhood trauma and physical health problems’, Journal of psychosomatic research, 142, pp. 110358–110358. Available at: https://doi.org/10.1016/j.jpsychores.2021.110358.