Week 2: Complex Trauma - Phase One Processing

Signs of Racialized Trauma

• Infants (0-3)

  • distress in unfamiliar environments or unfamiliar people

  • difficulty soothing

  • sleep and feeding difficulties

• Preschool (3-6)

  • negative statements about skin, colour, hair or identity

  • avoidance of unsafe presenting people

  • hyperviligance to tone, correction or adult authority

  • aggression or withdrawal following experiences of bias or exclusion

• School-age (6-12)

  • chronic anxiety, sadness, or anger related to experiences of racism

  • internalized racism or negative self-concept

  • disengagement from school

  • fear of being targeted, punish or misunderstood

• Adolescents (13-18)

  • chronic anger, hopelessness, or emotional numbness

  • sensitivity to injustice or discrimnation

  • identity conflict or pressure to suppress cultural identity

  • distrust in authority figures

  • depression, anxiety, or trauma-related symptoms following racial violence

Brain architecture

• genes provide basic blueprint

• environment & experiences shape the process that determine whether a child’s brain will provide a strong or weak foundation of all future learning, behaviour and health

• neurons — in brain, connect to form circuits which reinforce through repeated use (the more use = stronger & faster)

  • no to minimal use → go through a process called pruning

serve and return

• building child-adult relationships that are responsive and attentive

• build a strong foundation in a child’s brain for all future learning and development

• inconsistent = anxious attachment

• largely absent = avoidant attachment

• harmful = disorganized attachment

• disrupts brain development and can activate body’s toxic stress response (trauma)

1. notice — pay attention to what the child wants

2. return — support, acknowledge and encourage what you see they are telling you

3. name it — “yes those are ——”

4. wait — give time to child to respond

5. switch

6. (practice endings and beginnings)

4 types of attachment styles

1. secure

2. avoidant

3. anxious

4. disorganized

fear circuitry

traumatic event ignites this mechanism

Impacted areas of the brain by trauma

• prefrontal cortex: regulates emotions and impulses

• hippocampus: controls memory

• amygdala: emotional and instinctual centre

these areas manage trauma and stress

impacted brain areas post-trauma

• prefrontal cortex: becomes supressed and less capable of controlling fear

• hippocampus: focus on survival details, cannot tell difference between past and present

• amygdala: goes into overdrive

• Threat perception system — on high alert

• filtering system — focus on perceived threats

• self-sensing system — numbed

Attachment-Focused Trauma

• Chronic and cumulative – arising from repeated or ongoing adverse experiences rather than a single event.

• Relationally embedded – occurring within caregiving and attachment relationships, often involving neglect, misattunement, or harm by primary attachment figures.

• Developmentally disruptive – affecting emotional regulation,
  identity formation, behavior, cognition, and the integration of self
  across developmental stages.

• Attachment-disorganizing – undermining the child’s capacity to experience safety, trust, and co-regulation in relationships.

• Frequently dissociative – leading many children to rely on dissociation or fragmentation of experience as a survival strategy in the face of overwhelming stress.

In this model, complex trauma is understood as trauma that fundamentally disrupts both the attachment system and the developing nervous system, requiring treatment that addresses relational safety and regulation before direct trauma processing

Dissociation

• infant (0-3)

  • somatic & relational

  • stillness, limp posture

  • checked out

  • sleep-wake disruptions

  • failure to seek comfort when distressed

• preschool (3-5)

  • zone out

  • blank facial expression

  • sudden emotional numbing

  • repetitive or trance-like play

  • confusion between fantasy and reality

  • regression in toileting, language or play skills

• school age (6-9)

  • memory gaps

  • confusion about time

  • withdrawal from peers or activities

  • emotional detachment

  • headaches or stomach aches

• Pre-adolescence (10-12)

  • emotional numbing

  • foggy and disconnection

  • difficulty identifying emotions

  • increased somatic symptoms

• Adolescence (13-18)

  • feeling unreal or detached from self

  • world feels unreal or distant

  • time loss

  • memory gaps

  • identity confusion

  • emotional numbness

  • self-harm

  • substance use

  • disconnection from body, emotions or relationships

Phase One

• Safety and stabilization – establishing physical and emotional safety, predictability, routines, and containment to reduce chronic dysregulation.

• Therapeutic alliance – building a consistent, attuned, and trusting relationship between the child and therapist that serves as a secure base.

• Co-regulation – supporting emotional and physiological regulation through relational presence before expecting independent self-regulation.

• Assessment and engagement – ongoing evaluation of trauma history, attachment, patterns, dissociation, triggers, and regulatory capacity to guide pacing and intervention.

• Skill development – teaching grounding, sensory modulation, emotional
  awareness, and coping strategies to increase affect tolerance.

• Caregiver and system involvement – supporting caregivers to
  understand trauma responses, strengthen attachment, and provide
  regulation and safety beyond the therapy setting.

• Flexible pacing – remaining in Phase One as long as needed, with
  progress measured by stabilization and relational safety rather than
  time or session count.

DSM-5

diagnostic and statistical manual that diagnoses a variety of disorders (clinical depression, anxiety, ADHD, ASD, OCD, ODD, DID, PTSD, personality disorders, schizo-typical disorders)

Major Depressive Disorder

• irritable mood

• persistently depressed

• weight loss/gain

• fatigue or low energy

• suicidal ideation, self harm

Anxiety Disorders

• excessive, inappropriate fear or worry

• difficulty with uncertainty

• avoidance behaviours (social withdrawal, school refusal)

• somatic symptoms (headaches, stomach aches)

• reassurance seeking, clinging

ADHD

• Persistent inattention and/or hyperactivity-impulsivity

• Symptoms present before age 12

• Occurs in two or more settings

• Interferes with learning or relationships

ASD (Autism Spectrum Disorder)

• Persistent social communication differences

• Difficulty with reciprocity and peer relationships

• Restricted or repetitive behaviors

• Sensory sensitivities or seeking

• Early developmental onset

OCD (Obsessive-Compulsive Disorder)

• Intrusive, distressing thoughts or images

• Repetitive behaviors or mental rituals

• Rituals aimed at reducing anxiety

• Significant distress or impairment

ODD (oppositional defiant disorder)

• Frequent anger or irritability

• Argumentative or defiant behavior

• Vindictiveness

• Duration of at least 6 months