Relational trauma is an aftereffect of abuse, neglect, and suffering. Those whose are betrayed by people they loved, trusted, or relied on may encounter enormous mental and behavioral health challenges, as they attempt to forge interpersonal connections and cope with life’s many challenges. Relational trauma distorts self-image in unfortunate ways, but with intensive therapy and a commitment to healing sufferers can overcome its effects and learn to build more satisfying, sustainable relationships.
Important life relationships have a profound impact on psychological and emotional development, and when those relationships are dysfunctional, abusive, or unreliable it can leave wounds that are difficult to heal. Those wounds may linger indefinitely, worsening over time if mental health treatment is not provided.
This is the case with relational trauma, a form of mental health disturbance that grows from the seeds sown by past abuse or neglect. Relational trauma damages a person’s self-esteem, self-image, and ability to create lasting, meaningful, and sustainable connections with others. People with relational trauma find successful relationships elusive because of the mistrust, fear of intimacy, and overall insecurity that follows them everywhere they go.
There are some similarities between relational trauma and PTSD, which also causes recurrent symptoms of fear and anxiety that can be disrupt daily living. But with relational trauma the source of the emotional and psychological injuries is always found in past relationships, and that interpersonal element makes relational trauma unique.
Types of Relational Trauma
There are two categories of relational trauma: childhood relational trauma and adult relational trauma.
People who suffer from childhood relational trauma can trace the source of their insecurity, lack of trust, and inability to form successful relationships to their treatment at the hands of parents or other caregivers. Physical, sexual, and emotional abuse can all lead to relational trauma, as can parental neglect or abandonment.
Inconsistent parenting or caregiving that includes episodes of neglect or abuse mixed with better treatment is often the source of relational trauma. Kids who are raised this way experience frequent confusion, uncertainty, anxiety, depression, and feelings of unworthiness (they blame themselves when things go wrong), and as they mature into adulthood they continue to carry the scars of their previous mistreatment.
Occasionally, abuse at the hands of others can contribute to childhood relational trauma (being a victim of persistent bullying, for example). But caregiver abuse and neglect is usually at the heart of the disorder.
Adult relational trauma sufferers may carry some baggage from childhood, but it is their experiences later in life that push them over the edge. While there is a certain primacy to childhood abuse or neglect, since it occurs at such a vulnerable stage of life, abuse, neglect or abandonment by partners, family members, friends, employers, co-workers, peers, teachers or predatory strangers can be equally devastating and emotionally traumatizing in some circumstances. It can leave sufferers with powerful, unresolved feelings of rage, guilt, shame, a sense of betrayal, and feelings of inferiority, all of which can permanently affect their existing relationships and make it difficult to start new ones.
While childhood abuse and neglect are especially likely to cause relational trauma, ultimately it is the impact of the experiences that matter the most, not the source or the time of life when the trauma occurs.
Facts and Statistics
About 80 percent of patients who seek treatment in community mental health clinics have experienced at least one incident of serious trauma in their lives. Many suffer from symptoms consistent with relational trauma, along with other mental health disorders.
Here are some more statistics that reveal just how common exposure to life-altering trauma really is:
- 60 percent of adults suffered abuse and/or experienced other types of family difficulties in childhood.
- 40 percent of children will be physically assaulted at least once in any given year.
- 14 percent of children report frequent mistreatment by caregivers.
- Two percent of children experience sexual abuse or assault each year, and that number rises to 11 percent among girls aged 14-17.
- 13 percent of children are physically bullied and 33 percent emotionally bullied each year.
- 10 percent of children will suffer maltreatment, be injured in an assault, or witness one family member assaulting another in their homes each year.
- 20 percent of women report being sexually assaulted at some point in their lives, and nearly half (46.7 percent) are acquainted with their attacker.
- One-third of women and one-fourth of men will be victims of intimate partner violence at some point in their lives—and one in 15 children will witness such violence in any given year.
Trauma is everywhere, and the emotional and psychological toll it takes on those who experience it is immense. Much of the trauma occurs within the context of relationships that are supposed to be loving and nurturing, and it is that abuse and mistreatment that sets the stage for the development of relational trauma.
Symptoms and Diagnosis of Relational Trauma
Relational trauma can complicate every aspect of an individual’s social life, based on their inability to feel safe and secure when making interpersonal connections or forming attachments.
It can also distort self-image and inhibit emotional control, while creating further disruptions that affect mental and behavioral health. It causes alterations in brain structure and function as well, which can cause behavioral problems, learning difficulties, impulsivity, and excess vulnerability to stress.
Some of the common symptoms of relational trauma include:
- Neediness, overdependence on the attentions of others (especially partners or romantic interests)
- Volatile, uncontrollable emotions
- Poor self-esteem and a lack of self-confidence
- Helplessness or frustration in the face of stressful situations
- Fear and mistrust of intimacy, even though romantic relationships are desperately desired
- Social anxiety, an inability to make friends or socialize in public
- Mistrust of or hostility toward authority figures
- Antisocial personality traits and attitudes
- Manipulative, selfish behavior
- Negativity, cynicism, and pessimism about the future and the world in general
- Learning or discipline problems in school
- Developmental delays
- Depression and lethargy, low motivation
- Constant aches, pains, and illness, but without apparent medical causes
- Reliving past trauma, vividly and frequently
- Avoidant behavior, with respect to people, places, events, or situations that might remind the person of their traumatic experiences
- Inconsistent, neglectful, or abusive parenting styles (the cycle of relational trauma is repeated)
Relational trauma can be endlessly disruptive, and its effects can reverberate for years if no action is taken to stop them.
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Diagnosing Relational Trauma
Relational trauma is not an officially recognized mental health disorder, even though many mental health professionals believe it should be (and will be eventually).
It can sometimes function as a background factor in other mental health conditions, and its presence will likely be detected and acknowledged by clinicians even if there is no actual diagnosis. But its symptoms are often recognizable enough and its impact decisive enough to justify its designation as a unique disorder that must be identified by name.
Patient testimony will form the basis of a relational trauma diagnosis, and when multiple symptoms are present such a diagnosis can be provided by any mental health professional.
Causes and Risk Factors for Relational Trauma
Victimization is the ultimate cause of relational trauma, and anyone who experiences trauma at any point in their lives (but especially in childhood) could conceivably suffer from its distinctive and pervasive symptoms.
Exposure to physical, emotional, and/or sexual abuse in childhood is the most significant risk factor for relational trauma, which can begin to manifest in adolescence and continue to worsen over time. However, there are other types of exposures that also carry significant risk for relational trauma, and they include:
- Being victimized by domestic violence, or witnessing acts of domestic violence committed by parents
- Being bullied in school or on social media sites
- Childhood abandonment by one or more parent (because of divorce, death, or desertion)
- Infidelity, or abandonment by a spouse/partner
- Being a victim of a violent assault, sexual or otherwise
- Being rejected, bullied, or otherwise mistreated because of physical or mental disabilities
Violations of trust are the underlying source of relational trauma symptoms, and any events, encounters, or circumstances that contain that element could put a person at risk for developing this condition.
Exposure to trauma, particularly in childhood, is a powerful predictor for a broad range of behavioral and emotional conditions. Because of shared risk factors, relational trauma often co-occurs with other mental health disorders, and its symptoms can merge with the symptoms of those disorders and intensify their impact.
While the two are not identical, PTSD has a close relationship with relational trauma, and the former is frequently comorbid with the latter. Social anxiety, panic disorder, and generalized anxiety disorder are often diagnosed in people with relational trauma, and depression is a common condition for those who feel overwhelmed by traumatic memories and the feelings of low self-esteem that accompany them. Eating disorders and self-harming behavior are also common among relational trauma sufferers, who lack the skill to cope with their symptoms in a healthy manner.
Many people with relational trauma eventually develop chemical dependency, which thrives as a malignant companion to mental health issues of all types. Drugs and alcohol can provide a temporary escape from relational trauma symptoms, but in the end they will only make the situation worse.
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Relational Trauma Treatment and Prognosis
The truth about relational trauma, its sources and its effects, must be brought out into the open before a relational trauma sufferer can begin the process of healing, and the best place to start recovery is in a residential, inpatient treatment program. In this safe, secure, compassionate environment, individual, group, and family therapy sessions will be offered on a daily basis to people who have serious issues they must confront before they can transcend their suffering.
Because relational trauma is not an officially recognized mental health condition, most people who seek treatment for its symptoms do so carrying a diagnosis for another mental or behavioral health condition, possibly even a substance abuse problem. In these situations, it is especially vital to begin treatment in a residential facility; the work that must be done is extensive, and round-the-clock support from mental health treatment specialists may be necessary to ensure patients get the personalized attention they need.
Relational trauma leaves scars, but they are the kind of scars that can be healed over time. Long-term therapy that helps patients face the past and their unpleasant memories head-on can make all the difference, giving relational trauma sufferers a real chance to construct healthier relationships while they rebuild their self-esteem and self-confidence.