Managing Symptoms of Complex Trauma in the Workplace

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Complex trauma is described as a child’s exposure to multiple events that were experienced as traumatic to that child and typically have long-term negative effects on their adult life. Complex trauma often occurs during key developmental stages in a child’s life and can result from chronic abuse, maltreatment, and neglect from a primary caregiver.

Adults who grew up in an unpredictable or unstable environment which lacked a sense of protection and security can struggle with feeling safe, even around those closest to them. There are often myriad problems that an adult living with the effects of complex childhood trauma experiences, including troubled relationships, dissociation, poor self-concept, physical health complications, and difficulty seeking and maintaining employment.

The effects of complex trauma are significant and can affect a person's overall functioning, including how they see themselves. Complex PTSD (CPTSD) is a diagnosis in the newest revision of the World Health Organization’s International Classification of Diseases, but is not included in the DSM-5-TR.

Symptoms and behaviors differ from person to person but often include:

• Trouble with concentration
• Difficulty sleeping
• Chronic hypervigilance
• Muscle tension
• Gastrointestinal problems
• Loss of trust in self and others
• Avoidance of situations or people who remind them of their trauma
• Beliefs that people and the world are dangerous or unsafe
• Irritability
• Reckless behavior (impulsivity, self-medication)
• Emotional dysregulation (chronic feelings of numbness and/or heightened emotional reactions)
• Heightened startle reflex

These kinds of symptoms can profoundly affect the quality of a person’s life, including their ability to function at work. Experiences of emotional, physical, and psychological distress are highly correlated with filing for disability, including as many as 66 percent of adults who claim their disability has kept them from being employed full-time or being able to manage other work-life obligations.

Additionally, those who are able to work may experience specific stressors in the workplace from living with the effects of complex childhood trauma, which can include:

Stigmatization. Many who experience mental health challenges have also reported being turned down for a job if they self-disclosed their condition or did not look for work because of experienced stigmatization. Some may have experienced pay discrepancies or were only offered jobs that paid less based on their self-disclosure. Others may have experienced a "glass-ceiling" effect where resistance from management prevented them from being promoted into higher-ranking positions.

However, not reporting their condition can also be a double-edged sword. For example, a seemingly “innocent” joke or conversation among employees about how “crazy” or “stressed out” they feel regarding an upcoming deadline can be experienced as a form of stigma to someone living with the effects of complex trauma. Similarly, misinformation in the media, a lack of employers providing ongoing education on mental health, a misrepresentation that portrays a person as aggressive, paranoid, or incompetent, or minimizing or downplaying a person’s lived experiences all contribute to ongoing stigmatization.

Lack of Trauma-Informed Practices. The ways in which an organization supports its employees’ mental, emotional, and physical health are critical to that employee’s sense of safety, as well as feeling valued and supported in their job. When an institution is not mindful of how trauma can affect a person, or if an employee feels unheard or unseen by their employer, this can lead to a sense of feeling betrayed, or what is referred to as institutional betrayal.

Institutional betrayal exacerbates negative feelings and experiences of trauma, which can make the workplace feel unsafe or breed feelings of contempt. Trauma-informed practices allow for a safe space in the workplace where acknowledgment of what a person needs is met with trust and supportive action.

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Lack of Clear Direction on Responsibilities. Many living with the effects of complex trauma may struggle with loud, chaotic, or busy environments where there is little direction from management. When employees have limited support with what is required for their job, this can lead to disengagement, confusion, and overall dissatisfaction.

However, for a person living with trauma, a chaotic or disorganized workplace can increase avoidance behaviors, where a lack of direction or support from management may lead to not performing certain tasks that are required for their job. An employee may unfairly be reprimanded and not know how (or whether) to disclose their challenges, which can further trigger their symptoms, including deep feelings of shame.

Overcoming Barriers. Symptom management requires ongoing commitment and education with employers and employees with mental health challenges. It is important that a workplace cultivate a culture of compassion that educates on the importance of self-care and the impacts of mental health on both personal and professional obligations.

Companies should promote healthy work-life balance and educate employees to recognize stress's red flags. Additionally, employers should provide ongoing resources that promote employee well-being, such as providing coaching or therapy for their staff and the ability to take personal time when needed.

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