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What is complex trauma?

Trauma is very common. People can be traumatised in different ways and situations e.g. natural disasters, accidents, being betrayed in relationships, and/or being abused or victimised.


`Single incident’ trauma occurs as a result of `one off’ events. It is commonly associated with Post Traumatic Stress Disorder (PTSD). Single incident trauma can occur with a bushfire, flood, sexual or physical assault in adulthood, or from fighting in a war.


Most people who have trauma-related problems have experienced multiple traumas. When their trauma is not resolved i.e. they have not ‘recovered’, it is known as complex trauma.


Complex trauma’ is usually interpersonal (occurs between people), and involves ‘being or feeling’ trapped. It is often planned, extreme, ongoing and/or repeated. Complex trauma generally leads to more severe, persistent and extreme impacts than single incident trauma. It impacts tend to be cumulative. They include difficulties with shame, trust, self-esteem, identity, relationships, regulating emotions, and physical and mental health. People affected by complex trauma also often use a range of coping strategies to cope with their trauma and these can include alcohol and drug use, self-harm, over or under-eating


When complex trauma occurs as a result of child abuse or other adverse childhood experiences it is particularly damaging. Any form of violence within the community – domestic and family violence, civil unrest, war trauma or genocide, cultural dislocation, sexual exploitation and trafficking and/or re-traumatisation of victims later in life can also cause complex trauma. 


While the concept of complex trauma is long-standing, it has not been well categorised in the DSM (US manual of mental health disorders) or ICD (global classification of mental health disorders). The diagnosis of Complex PTSD to describe enduring complex trauma is likely to be included in the ICD 11 (June 2018).


It’s important to differentiate single incident trauma (PTSD) from complex trauma and deliver services which address the different needs of people affected by complex trauma (Complex PTSD).

For resources on Complex Trauma click here

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“Blue Knot Foundation has a key role to play in the building of community capacity in care provision to those who have experienced childhood abuse and trauma in any environment.”

NIALL MULLIGAN Manager, Lifeline Northern Rivers

“I think Blue Knot Foundation is a fantastic support organisation for people who have experienced childhood trauma/abuse, for their families/close friends and for professionals who would like to learn how to more effectively work with these people.”

Psychologist Melbourne

“It's such a beautiful thing that you are doing. Helping people to get through this.”


“It was only last September when I discovered the Blue Knot Foundation website and I will never forget the feeling of support and empathy that I received when I finally made the first phone call to Blue Knot Helpline, which was also the first time I had ever spoken about my abuse.”


"At last there is some sound education and empathetic support for individuals and partners impacted by such gross boundary violations.”


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Phone: 02 8920 3611
PO Box 597 Milsons Point NSW 1565
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Phone: 1300 657 380
Hours: Mon-Sun, 9am-5pm AEST

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