Why Trauma Affects Some People Differently Than Others

Vision (1919) by Otto Lange (1879-1944) for trauma blog post

A Conversation with Neuroscientist Daniela Schiller

Part Three of a three-part interview. Read Parts One and Two.

Large swaths of populations, including Americans, are experiencing the devasting effects of trauma. To honor this epidemic, to offer new insights into its mechanisms, and to inspire hope for the reduction of human suffering, I extended my interview with Daniela Schiller, Professor of Neuroscience and Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai Hospital and Director of the Schiller Laboratory of Affective Neuroscience.

Dale Kushner: Can someone suffer the effects of a traumatic memory, but be unaware of the event that caused it? If someone had trauma, but doesn’t remember it, what’s going on?

Daniela Schiller: A lot of what is happening in the brain is unconscious. We have learnings that we are unaware of. We can have events that impact our behavior such that when there is a trigger, we’ll respond in a certain way, but we won’t remember the association that formed it. A simple example is phobia. People are afraid of flying, but it wasn’t always because of a traumatizing event. The same is true with phobias about snakes or blood. The heart of these could be some event that they’re unaware of. There are events that shape our behavior, that make our behavior habitual or strongly associated with something without our awareness.

DK: But if your research is about eliminating or muting the negative feelings and someone doesn’t know the original trauma, how could they be helped?

DS: There are several lines of research, like the research on reconsolidation, the idea that you have to reactivate a memory in order to modify it. Also, the research that we’ve been discussing, that traumatic memory is an experience of the brain as if it’s happening in the present[1] These point to the fact that a memory, in order to be modified, has to be active and engaged with. At the same time, there are other ways to approach behaviors when their source is unknown — by analyzing the behavior. Even if we think we know the source, we don’t always necessarily know, because sometimes we can have a memory that is very disturbing for us, or a focal event, which very well can be not accurate or was revised or reconstructed over time.

Dr. Daniela Schiller for trauma blog postThe interesting thing is that now there’s growing research on the effect of psychedelics in treatment for PTSD and other conditions like depression. What people are reporting is that while they are on this psychedelic trip, many memories come up, memories that they didn’t know they had, memories they never linked. So there’s an event and suddenly there are additional peripheral events like, oh, and then you make new connections, and that suddenly makes the memory either more understandable or frames it differently. That type of flexibility seems to be occurring in research on psychedelics. When you don’t have that, that could be part of the rigid response or not necessarily accurate response that you have to a particular event that you think you remember.

DK: What determines the severity of the effect of trauma? We know that some people who have experienced severe trauma don’t seem to be affected while others who have had less severe trauma, or maybe just bad experiences, seem to be very altered by them.

DS:  Yes, that’s interesting because the definition of the trauma is not in the event itself. You don’t compare events, you compare the responses to the events. That’s why there’s no competition between someone who was at 9/11, for example, close to the building versus far from it but with a different interaction. There’s no measure like that. It’s all in the response. The definition is: to what extent does a trauma affect your daily life and functioning? If it impairs functioning — this is the measure of the severity. If you can’t get out of bed, if you don’t interact, you can’t work, you don’t need — these are the degrees of severity, how it affects you at that personal level.

DK: Are some people more vulnerable? Who is more likely to be affected? Can we predict who will be affected?

DS: Yes, some people are more naturally resilient than others. Many factors come into play. One is the past, like childhood trauma. The other could be genetics. Some processes make your brain more sensitive. The way the brain reacts could lead to some processes versus others, like epigenetics, which is the experience of your parents. We see this in studies of the second generation of Holocaust survivors, and also in animals. If the parents were stressed, then the pups, the offspring are also more reactive or more sensitive to negative experiences. This is because of the way the genes are being monitored, what is being inherited. In this sense, experience is being inherited. It’s also about the context. In what conditions do you have social support? Many parameters will influence resilience.

DK: Which is more important: the intensity or the duration of the trauma?

DS:  These all come into play. The intensity, the duration, and also the age of the memory. In the present moment, each of these can have a serious effect on trauma. There are traumas that are one-time events, and there are traumas that are very much chronic or prolonged. These are complicated types of trauma. They are different from a one-time trauma. So now you get into the different forms that trauma can take, and each one comes with its own characteristics and complexities.

DK: Can someone who has inherited the epigenetics of a traumatized parent change their epigenetics, if intervention is early enough?

DS:  Yes, I would expect so. It is not my research, but in principle what epigenetics means is that you have the DNA, but peripheral factors affect which gene is being expressed. They’re like the monitors, the modulators of the genes that you already have, and some of them will be expressed more or less depending on your experience. What is shaping the next generation is the environment in the fetus when the fetus is evolving. This is where epigenetic factors come into play, what is formed in the growing fetus of the next generation. Whatever is in that environment at the time of the pregnancy will have an effect. If you did have a negative experience, but then it was mitigated, this will have an influence because epigenetics is about the environmental and experiential context of your development.

DK:  One last question. Where are you headed now with your research? What are you excited about?

DS:  I’m excited about diving into complexity, diving into experiments that touch on personal experience. They’re difficult to study in the lab, which has to be very controlled. With new methods of analysis and also with artificial intelligence, machine learning gives us approaches to study more complex processes. I hope science will become more personal in the sense that it could characterize and be able to focus on the individual. Science is usually about statistics in large groups, and you need large samples to see effects, but I am hoping we can explore it more at the individual level.

For artists and scientists, their goal is to understand experiences in life. Their goals are exactly the same, and even as specific. If your character in the novel you’re writing is struggling with a certain memory, it’s a very specific sliver of reality you are trying to capture. I think science is trying to do the same.

[1] O. Perl, O. Duek, K. Kulkarni, C. Gordon, J. H. Krystal, I. Levy, I. Harpax-Rotem, D. Schiller, “Neural patterns differentiate traumatic from sad autobiographical memories in PTSD,” Nature Neuroscience, 26, 2226-2236 (2023); Published November 30, 2023.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at 

If you found this post interesting, you may also want to read “How the Brain Stores Traumatic Memories,” Part One of three conversations with Daniela Schiller, “Memory and Trauma: We Are More than What We Remember,” Part Two of three conversations with Daniela Schiller, and “Recognizing and Healing Inherited Trauma,” an interview with Rabbi Dr. Tirzah Firestone.

Keep up with everything Dale is doing by subscribing to her newsletter, Exploring the Unknown in Mind and Heart.



How the Brain Stores Traumatic Memories

Sagittal MRI slice of a brain with highlighting indicating location of the posterior cingulate cortex. The study cited found traumatic memories engaged this area, usually associated with narrative comprehension and autobiographical processing, like introspection and daydreaming.

A Conversation with Neuroscientist Daniela Schiller

Part One of a three-part interview. Read Parts Two and Three.

Does the brain encode traumatic memories differently than it does other memories? This question prompted a recent series of experiments by a group of researchers at Yale University and the Icahn School of Medicine at Mount Sinai. The publication of their breakthrough findings in Nature Neuroscience[1] in November generated news media headlines.[2] To learn more about these findings, I interviewed one of the authors of the study, Daniela Schiller, Professor of Neuroscience and Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai and Director of the Schiller Laboratory of Affective Neuroscience. In 2014, The New Yorker did an extensive profile[3] of Dr. Schiller’s achievements in memory research.

Dale Kushner: Is it accurate to say your goal is to untangle a traumatic memory from the strong emotion it evokes so that a person might be able to remember something traumatic but not feel its negative effect?

Daniela Schiller: Yes. That’s the ultimate goal. The way to go about it is to ask questions about how to understand the mechanism: how the brain forms emotional memories, how it maintains these memories. Are these memories malleable? Do they change over time? Under what conditions do you retrieve them, in what way? To prevent the malfunctioning of it or the negative impact of it in certain cases you try to understand the entire mechanism of it. How does it work in the brain before it goes awry? And then what might change that it has such a negative impact?

DK: Could you briefly describe what you’re looking at now and how that unfolds for you in the lab?

DS: Sure. Here you have two main approaches. One will be the very, very controlled way that you create some experience in the laboratory and then you test it. For fear or for emotional memory, we can use this basic process that is called classical or Pavlovian conditioning, where you take one stimulus and associate it with something negative. That stimulus that used to be neutral is now negative. This you can do in the lab. You just present something on the computer, and they can get a mild electric shock, or they can lose money, something negative. They then develop this emotional response to the stimulus because they know that something negative is going to happen. When you look at that in the FMRI (Functional Magnetic Resonance Imaging) scanner, you can see specific responses in the brain to that stimulus before and after learning, or in comparison to other such stimuli, or such cues.

Another approach is to investigate memories that the participants themselves bring. This is what we did in the research that was just published. The participants had been diagnosed with PTSD and they had their own real life traumatic memories and also sad memories. We reminded them of these memories while they were in the FMRI scanner, and we then looked at the brain. So, we found a way to analyze that very naturalistic experience and real-life memory. And of course, this is personal. In classical conditioning, everybody undergoes the same stimulus. All the participants look at a blue square paired with a shock. Then we’ll see in the entire group on average how the brain is reacting. With the PTSD group we see each and every individual brain reacting to the personal memory, but we still find commonalities. And these commonalities tell us what is different between traumatic memories and sad memories.

DK: That’s very interesting. So, the participants in the first group who have not had PTSD, you’ve induced some kind of shock so that you have a parameter of what an untraumatized person might experience when they are initially getting traumatized in the laboratory. Then you compare that to someone who comes to you with a history of trauma and look for the same things. Then you compare the responses and figure out how the brain is working in both cases. Is that accurate?

DS: Yes. What you’re describing is a challenge to the field because we really cannot induce trauma in the lab. What you have in the laboratory is a model, something that mimics aspects of trauma. With animals, you would do an animal model, an animal will undergo something negative, and then they will be afraid. In humans, you can do the same, but what you do in this case is you’re asking questions about basic learning and memory processes in the brain. And by understanding these processes, which are in the neurotypical, in the healthy realm, by understanding these, you assume that when these systems are impaired or you can envision or try to manipulate the impairments, then you can hypothesize what is happening in the traumatic state. In this case, it’s more like an extrapolation or an assumption that it would apply to trauma.

That’s why our last experiment was exactly to address that issue or those assumptions. Is it true that very simple emotional processes by way of exaggeration become traumatic, or is it a whole alternative process?  It can either be an extension or really a dissociation. It’s a challenge to study trauma in the lab.

DK: Yes. I bet. So, what are your findings on that question so far?

DS: My understanding now is that it’s really both. It depends on what you’re asking. You can see these basic processes in relation to emotional stimuli that are not a traumatic event. You could still see impairment in the aftermath of trauma because for example, people with PTSD would be more sensitive to negative information or some negative surprise or the way they compute and interact with emotional stimuli. You do see changes at the basic level. So that approach is very informative. In addition, when we look at the specific individual personal traumatic memory, we did see a difference between the traumatic memory and a sad memory. It wasn’t just more of an exaggeration of it, which in the brain you would see as more activation, more impact. It really looked like an alternative path of representation. This stayed virgin between the two memories. So, I think both are occurring at the same time. I hope that makes sense.

DK: Yes, it does. And it gives me a sense of what clinicians are dealing with and going to have to deal with. This research is going to be applicable and so crucial for coming generations.

Part two of this interview will follow in January.

[1] O. Perl, O. Duek, K. Kulkarni, C. Gordon, J. H. Krystal, I. Levy, I. Harpax-Rotem, D. Schiller, “Neural patterns differentiate traumatic from sad autobiographical memories in PTSD,Nature Neuroscience, 26, 2226-2236 (2023); Published November 30, 2023.

[2] Barry, Ellen, “Brain Study Suggests Traumatic Memories Are Processed as Present Experience,” The New York Times, November 30, 2023.

[3] Specter, Michael, “Partial Recall,” The New Yorker, May 12, 2014.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at 

If you found this post interesting, you may also want to read “Recognizing and Healing Inherited Trauma,” “The Things We Carry: How Our Ancestors’ Traumas May Influence Who We Are,” and “Diagnosing and Treating PTSD and Complex PTSD: It’s Not About ‘What’s Wrong With You?’”

 Keep up with everything Dale is doing by subscribing to her newsletter, Exploring the Unknown in Mind and Heart.



Diagnosing and Treating PTSD and Complex PTSD: Changing the Ways We Adapt

Ripples and bubbles on water for treating Complex PTSD blog post

An Interview with Trauma Therapist Brad Kammer – Part Two of Two

In Part One of my interview with trauma expert Brad Kammer, LMFT, currently on the faculty of the NARM Training Institute, we discussed how Brad and his colleagues distinguish between PTSD and complex PTSD. In Part Two, we explore how NARM’s NeuroAffective Relational Model addresses the impact of adverse childhood experiences and complex trauma. Brad and Dr. Laurence Heller outline the therapeutic framework of NARM in their new book, The Practical Guide for Healing Developmental Trauma: Using the NeuroAffective Relational Model to Address Adverse Childhood Experiences and Resolve Complex Trauma.

(Note: This is the second of a two-part  interview)

You are currently on the faculty of the NARM Training Institute. What does NARM stand for? What is your working definition of trauma?

NARM stands for the NeuroAffective Relational Model, which is a model designed by my long-time mentor Dr. Laurence Heller, to address the impact of adverse childhood experiences and complex trauma.  In NARM, we recognize that in most cases we cannot change the traumas we experience.  But, we can change the ways we have adapted in order to survive these traumas.

NARM’s five core needs and their associated core capacities for treating complex PTSD blog postWe use a developmental framework that describes five Adaptive Survival Styles which are ways we learned to adapt to attachment and environmental failures early in life. These styles form the blueprint for our adult personalities.  We focus on five specific developmental stages early in childhood when the Self is just being shaped, and the ways that attachment and other environmental failures impact healthy development in each of these stages (which we are learning so much about through the Adverse Childhood Experiences research).  The way that our brain and bodies adapt to these early traumas – specifically through shame – leads to various levels of often profound Self-disorganization and creates various symptoms, disorders, and syndromes.

In Part One of our interview, you identified the important differences between Post-traumatic Stress Disorder (PTSD) and Complex-PTSD. How might the treatment for each differ?

I am biased as to how I’m going to answer this question since I have been a somatic psychotherapist and trainer now for over two decades. I believe that any form of trauma healing must involve the body. Many of my colleagues have been pushing back against the more prominent “evidence-based approaches” that are usually derivatives of Cognitive Behavioral Therapy, and which demonstrate questionable long-term efficacy. Dr. Bessel van der Kolk’s book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, continues to be a best-seller ten years after it was first published. Many people intuitively, and experientially, know that talking and thinking about our issues only take us so far. To make true and lasting change, they have to shift deeper internal patterns.  This is where somatic approaches come in.

I have practiced Somatic Experiencing for over twenty years now and I find it to be the most effective model out there for PTSD.  As I continued to seek models that worked more specifically with attachment, emotional, and relational trauma, I found NARM, which I believe is the most effective model out there for treating C-PTSD.

Please tell us what you mean by a person having “agency.” Why is it a game-changer?

The simplest way to define how we use the concept of Self-Agency is to highlight the various ways that individuals organize and relate to life experiences.  Agency is a by-product of secure child development where a child progressively experiences themselves more as actors in their life than simply passive conduits for life experience.  Other models may refer to related concepts such as Self-Activation, Self-Actualization, or Self-Realization.

When a child has experienced developmental trauma, they experience everything as just happening to them. They feel helpless to change not only their external conditions but also how they feel internally. Children may grow up feeling out-of-control (i.e., lack of impulse control), reactive (i.e., affect dysregulation), fragmented (i.e., dissociative self-states), and fragile (i.e., decreased sense of resiliency).  Their lives are significantly impaired by their inner sense that they cannot self-activate, let alone change the way they feel or how they relate to the world.

NARM is grounded in an inquiry process that explores Self-Organization – how clients are organizing their internal worlds, and then relating to both their inner and outer experiences, in ways that either support connection and health or lead to disconnection and disease.

Types of Adverse Childhood Experiences for treating complex PTSD blog postFor example, your client shares a story about their experience at work last week where they were walking in the hallway and said “hello” to a colleague they were passing, and the colleague didn’t say hello back. Immediately, your client started feeling worthless, unliked, and lonely, and then started telling themselves that “I’m stupid and no one will ever like me.” They use this experience to justify why they withdraw from social interactions and experience social anxiety and depression.  However, they later found out that their colleague had just received a text from a family member of a sudden loss in their family, had been in a state of shock, and not even heard your client say hello. Your client describes shaming themselves for having such a strong reaction, saying that “I’m stupid for telling myself that I’m stupid based on this situation.”  This cycle of shaming oneself for shaming oneself can go on and on.

As we help clients begin to gain greater awareness of the unconscious and often automatic ways they are organizing their inner reality and relating to themselves and the world through self-shame, self-rejection, and self-hatred, they begin to experience more possibilities for organizing and relating to themselves differently. This is not just a cognitive process. It entails working psychobiologically to shift long-standing personality patterns that keep shame-based identifications intact.

Collective and intergenerational trauma are vast and necessary subjects worthy of discussion. Individuals can’t change their ancestry, and in many cases, individuals cannot change their marginalized status or persecution within a society. Can the NARM program help people traumatized by an unchanging trauma-inducing culture?

I know from my own personal experience, as well as years of clinical experience, that NARM does impact unresolved cultural and intergenerational trauma. We focus on how clients are relating to the “unchanging trauma-inducing culture” that they are born into and are still part of.  For many people, the concept of “post” in post-traumatic stress disorder doesn’t truly exist.  Many people are still living within and adapting to environmental failures, including sustained oppression, violence, and dislocation.  And yet despite these traumatic realities, we see individuals and communities cultivating health and well-being within.  It is inspiring to watch as people stop defining themselves by how others define them and embody their own authentic humanity.

I see our modern times, at least in the U.S., as defined by a widespread failure of empathy.  We care less and less about our impact on others.  This leads to relationships based on objectification and systems reinforcing dehumanization. The social fabric is rapidly dissolving, leaving an epidemic of loneliness and disconnection in its wake.  To counter this reaction, NARM supports the development of authentic empathy.  As we help people develop an increasing capacity to relate to themselves and others through acceptance and compassion, they begin to shift their own internal objectification and experience themselves as more fully human. This increased sense of humanity allows people to begin to shift the way they are relating to their family, community, and cultural systems.  So while it will likely take time, I do believe NARM can impact larger changes within society.

(Read Part One: Diagnosing and Treating PTSD and Complex PTSD: It’s Not About “What’s Wrong With You?”)

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at 



Diagnosing and Treating PTSD and Complex PTSD: It’s Not About “What’s Wrong With You?”

Azalea flower with stones Photo: Solange Cabe / CC0 Public Domain for Complex PTSD blog post

An Interview with Trauma Therapist Brad Kammer – Part One of Two

I can’t remember the first time I heard the word trauma. Vietnam, the wars in Afghanistan and Iraq? When did “trauma” enter popular parlance? Was it after 9/11? I recently learned that there are now 6,000 podcasts with “trauma” in the title. Are we somehow in the midst of a trauma epidemic? Or does this reflect our growing understanding?

Trauma refers to a wound to the psyche or the body or both. We now know that not only experiencing trauma oneself but witnessing trauma or being told about a traumatic event can be traumatizing.

Brad Kammer for Complex PTSD blog postTo help us understand one of the emerging approaches to diagnosing and treating trauma, I’m delighted to introduce my guest, trauma expert Brad Kammer, LMFT, currently on the faculty of the NARM Training Institute.  NARM stands for the NeuroAffective Relational Model, a treatment model developed by Dr. Laurence Heller, Brad’s long-time mentor, to address the impact of adverse childhood experiences and complex trauma.  “In NARM, we recognize that in most cases we cannot change the traumas we experience. But, we can change the ways we have adapted in order to survive these traumas,” he explains.

Brad brings to his work a holistic approach that includes body-oriented therapies as well as a deep knowledge of attachment theory and survival styles. He and Dr. Heller recently co-authored The Practical Guide for Healing Developmental Trauma: Using the NeuroAffective Relational Model to Address Adverse Childhood Experiences and Resolve Complex Trauma. In a world reeling from destabilization, violence, hatred, and suffering, Brad Kammer and his colleagues at NARM present an opportunity for healing and hope.

This will be a two-part interview.

When many of us hear the word trauma, we think of soldiers, people caught in war zones or natural disasters, but you make a clear and valuable distinction between what you call shock trauma and relational or developmental trauma. Can you explain the difference?

It is difficult to differentiate because as humans we experience both shock and relational traumas, often at the same time.  For example, a parent who physically hurts a child will create a shock trauma reaction in response to the physical violence in the context of the relational failure of the parent not protecting or keeping their child safe from harm.

This is an extremely simplistic way to differentiate it – but in my teaching, I often use this as short-hand to distinguish between PTSD and C-PTSD: PTSD (post-traumatic stress disorder) is about the psychobiological process of fear, and C-PTSD (complex post-traumatic stress disorder) is about the psychobiological process of shame.  While there is certainly much overlap, research suggests there are different neural circuits responsible for fear than for shame.

The example I often use is you’re walking in the woods and a bear jumps out at you.  In that very moment, you’re not worrying about your relationship with the bear, you just want to survive.  So your brain will bypass the emotional, relational and cognitive centers and go straight to activating the hyperarousal centers of the brain in order to optimize your chances for physiological survival.  Mortal threats activate the fight/flight response.  This is experienced through fear.

Now imagine that the threat isn’t a bear jumping out of the words; it’s your parents, and each day of your life you feel that your sense of security in the world, and within yourself, is not welcomed or supported, but may be dismissed, undermined or attacked.  This puts you into a bind – as young children, we cannot run or fight against the people we are 100% dependent on for our survival.  While these threats may not be immediately life-threatening like the bear, we still have to find ways to survive the ongoing, persistent failures of in our development.

Humans are designed to be connected to themselves and others.  When connection to self and others becomes fraught with pain and danger, we use various strategies to disconnect from ourselves and the pain that we experience internally.  One such process involves the way we relate to ourselves through shame and self-rejection.  We internalize the failures of our early environment and personalize them as our inherent failures.  These shame-based identifications form the foundation of our personality development.

For so many people, they don’t even consider this “trauma.” I have had so many people – not just clients, but mental health and other healthcare professionals – push back that we are broadening the term trauma too much.  “This is just life” they say, or “This is just how childhood is.”  But minimizing and dismissing the effects of these failures is itself a sign of unresolved trauma.

My mentor used to say, “In a world of bent-over people, the one standing upright looks strange.”  So I push back on the notion that we use trauma too broadly. I argue that we don’t have a broad enough understanding of the impact of unresolved complex trauma.

What are some other ways in which PTSD is different from Complex PTSD?

The Adverse Childhood Experiences Pyramid shows how adverse childhood experiences are related to risk factors for disease, health, and social well-being. For Complex PTSD blog postAs the trauma field continues to evolve, we have begun to more clearly differentiate between post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD).  PTSD, which is sometimes called “shock trauma,” is generally caused by one-time events like accidents, assaults and natural disasters, and leads to hyper- and hypo-arousal in the nervous system that creates symptoms like intrusive images, flashbacks, hypervigilance, avoidance and dissociation.

C-PTSD is generally caused by relational and social failures, and leads to disorganization and insecurity in one’s sense of Self, as defined by the three symptom categories that include affect dysregulation, negative self-concept, and interpersonal disturbances.  Developmental trauma, a subset of C-PTSD, is generally caused by adverse childhood experiences that impact a child’s development.  NARM was created specifically to address C-PTSD, focusing on attachment and developmental trauma, but also working with larger social failures such as cultural and intergenerational trauma.

A word cloud of vocabulary related to PTSD, in the outline of a human brain.  Q / CC0 Public DomainThe trauma-informed field has been rapidly growing over the past 40 years since the first introduction of PTSD into the DSM in 1980.  While this field has made tremendous strides, our understanding of complex trauma has lagged behind.  Trauma pioneer Dr. Judith Herman suggested that PTSD doesn’t go far enough, and presented “a new diagnosis” in her 1992 book Trauma and Recovery, which she called C-PTSD.  And yet here we are in 2022 and we still don’t have an official complex (C-PTSD) or developmental trauma disorder (DTD) diagnosis in the United States.  This means that so many people are being misdiagnosed, or at the very least, are being treated for secondary issues.  What if many of the symptoms and disorders we see in our clients are driven by unresolved early trauma?  This changes the way we look at diagnostic categories and even challenges how we currently view psychopathology.

As we describe in our work, maybe it’s not about “what’s wrong with you,” but about “how have you adapted to what happened to you?”  For many of us in the trauma field, we see many “symptoms” and “disorders” as understandable reactions and adaptations to abnormal conditions and environments.  This is particularly true for children and how they have learned to adapt to persistent failures in their early lives.  These are not one-time traumas that can easily be resolved.  This is the territory of complex trauma, and it truly is very complex to understand.  It is also challenging to treat.  This is why we need comprehensive therapeutic models that understand how to identify, navigate and address this complex territory.

Part Two of our interview will be posted next month.

This post appeared in a slightly different form on Dale’s blog on Psychology Today. You can find all of Dale’s blog posts for Psychology Today at