What Is Complex Trauma? How It Can Show Up in High-Functioning Women
You Can Be High-Functioning and Still Be Struggling
You have a career. You take care of your responsibilities. People depend on you. From the outside, you probably look like you have things pretty well together.
And yet, internally, you might feel like you’re always “on.”
You overthink conversations. You have a hard time relaxing without feeling guilty. You’re incredibly independent. Sometimes to the point that asking for help feels uncomfortable. You might notice yourself people-pleasing, trying to anticipate everyone else’s needs, or feeling responsible for keeping everything running smoothly.
When people hear the word “trauma,” they often think of one catastrophic event.
But trauma doesn’t always look that way.
For some women, the patterns they’re experiencing today may be connected to repeated experiences that taught them how they needed to behave in order to feel safe, accepted, loved, or in control.
This is one way we can begin to understand complex trauma.
What Is Complex Trauma?
Complex trauma generally refers to the impact of repeated or ongoing distressing experiences, particularly when those experiences happen within important relationships or during periods when someone has limited ability to escape or protect themselves.
Rather than being connected to one isolated event, complex trauma may develop through patterns of experiences over time.
What matters isn't simply whether something “looks traumatic enough” from the outside.
What matters is how your mind and body learned to adapt to what was happening.
Those adaptations can be incredibly useful at one point in your life.
The problem is that sometimes they continue long after you need them.
Complex Trauma Can Look Like Anxiety
One of the most common ways trauma can show up is through anxiety.
You might experience:
Constant overthinking
Difficulty relaxing
Feeling responsible for other people's emotions
Perfectionism
People-pleasing
Fear of disappointing others
Difficulty trusting people
Feeling uncomfortable asking for help
Being highly sensitive to criticism
Always preparing for what could go wrong
Feeling guilty when you rest
Trouble identifying or expressing your own needs
None of these automatically means someone has experienced complex trauma.
But when several of these patterns occur together, it can be helpful to become curious about where they came from.
The “Strong One” Pattern
Many of the women I work with have spent years being the capable one.
They learned how to keep going.
They learned how to solve problems.
They learned how to read a room, take care of other people, accomplish difficult things, and push through uncomfortable emotions.
These qualities may have helped them become incredibly successful adults.
But being capable doesn't necessarily mean you feel calm.
Sometimes the person everyone else relies on is also the person who has the hardest time allowing herself to rely on anyone else.
Why Insight Isn't Always Enough
One of the frustrating things about these patterns is that you may already understand them.
You might know you're a people-pleaser.
You might know your perfectionism isn't helping you.
You might recognize that you don't need to respond to every email immediately or solve everyone else's problems.
And yet your body still reacts as though you do.
That's because understanding a pattern intellectually and changing the emotional response connected to that pattern aren't always the same thing.
Trauma therapy can help explore both.
How EMDR Therapy May Help
EMDR, or Eye Movement Desensitization and Reprocessing, is a psychotherapy approach originally developed for treating trauma.
Rather than only discussing an experience, EMDR focuses on helping the brain process distressing memories and the beliefs, emotions, and physical sensations associated with them.
For someone experiencing complex trauma, therapy may involve identifying patterns such as:
“I have to keep everyone happy.”
“I can't let my guard down.”
“I have to do everything myself.”
“If I make a mistake, something bad will happen.”
“My needs aren't as important.”
Treatment is individualized, and EMDR isn't appropriate for every person or every situation. Preparation, stabilization, and building coping resources can be important parts of trauma treatment.
You Don't Have to Wait Until Things Fall Apart
One of the biggest misconceptions about therapy is that you need to be in crisis before you're “allowed” to get support.
You don't.
You can have a good career, supportive relationships, a family you love, and a life you're grateful for—and still recognize that certain patterns are exhausting you.
Both things can be true.
If you're interested in exploring how past experiences may be affecting your anxiety, relationships, or ability to slow down, trauma-informed therapy can be a place to start.
Learn more about EMDR Therapy Here
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About the Author
Meghan Hanes, LCSW, is a trauma and substance use therapist providing virtual therapy throughout Oregon. She is trained in EMDR and helps high-functioning adults understand and heal the patterns beneath stress, trauma, and coping behaviors.
