Understanding Complex Trauma: How It Impacts the Nervous System and How Therapy Can Help

Complex trauma is a term that’s gaining more recognition in both clinical settings and everyday conversations about mental health. For many queer and neurodivergent individuals, the effects of complex trauma are deeply woven into their daily lives—but often misunderstood or misdiagnosed.

In this post, we’ll explore what complex trauma is, how it impacts the nervous system, how the experience may differ for neurodivergent people, and how working with a trauma-informed therapist can support healing.

What Is Complex Trauma?

Complex trauma refers to exposure to multiple, repeated, or prolonged traumatic events—often beginning in early life or persisting over time. Unlike a single-incident trauma, complex trauma usually occurs in the context of relationships and environments that should have been safe: families, schools, institutions, systems of power, parent relationships.

This may include:

• Ongoing emotional, physical, or sexual abuse

• Chronic neglect or abandonment

• Growing up in invalidating or unsafe environments

• Long-term exposure to systemic oppression (such as racism, ableism, or homophobia)

• Religious trauma, medical trauma, or caregiver unpredictability

Is Complex PTSD in the DSM?

Currently, Complex PTSD (C-PTSD) is not included as a distinct diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). However, it is widely recognized in the global mental health community, particularly by the World Health Organization, which includes C-PTSD in the ICD-11.

C-PTSD includes the core symptoms of PTSD (like intrusive memories, avoidance, and hyperarousal), plus additional difficulties with:

• Emotional regulation

• Self-perception (e.g., shame, guilt, or a chronic sense of failure)

• Relationship patterns (e.g., distrust, difficulty feeling close to others)

How Complex Trauma Impacts the Nervous System

When we experience trauma, especially in childhood, our nervous system adapts to help us survive. These adaptations often include:

• Hypervigilance: always scanning for danger

• Emotional dysregulation: big reactions, shutdowns, or numbness

• Dissociation: disconnecting from the body or present moment

• Chronic anxiety or fatigue: being in survival mode for too long

These are not flaws—they are nervous system responses to unsafe environments.

What Is the Window of Tolerance?

The window of tolerance, a term coined by Dr. Dan Siegel, describes the optimal zone of nervous system arousal where we can feel our feelings, think clearly, and respond to stress without becoming overwhelmed or shutting down.

When we're within our window of tolerance, we feel emotionally regulated and grounded.

• Above the window (hyperarousal): fight or flight mode—anxious, panicked, irritable, overwhelmed

• Below the window (hypoarousal): freeze or collapse—numb, disconnected, fatigued, shut down

How Complex Trauma Narrows the Window of Tolerance

Repeated trauma—especially during childhood—can shrink the window of tolerance, making it harder to stay regulated during everyday stressors. This can result in:

• Frequent shutdowns or emotional flooding

• Trouble focusing or making decisions

• Difficulty maintaining relationships

• Feeling unsafe or “on edge” even when nothing is wrong
  

Neurodivergence and the Window of Tolerance

For neurodivergent individuals (including those with autism, ADHD, sensory processing differences, and other forms of cognitive diversity), the window of tolerance may already look different—not because something is wrong, but because their nervous systems are wired differently.

Complex trauma can compound this, making self-regulation even more difficult. Some examples include:

• Sensory overload triggering shutdown or meltdowns

• Difficulty distinguishing between sensory discomfort and emotional distress

• Social trauma or masking leading to chronic stress responses

• Misdiagnoses or pathologizing of trauma responses (e.g., calling emotional flooding “manipulative” or “too much”)
  

How Complex Trauma May Present in Queer and Neurodivergent Clients

In queer and neurodivergent individuals, complex trauma may be shaped by:

• Identity-based trauma (e.g., rejection, discrimination, conversion therapy, invalidation)

• Masking or camouflaging to appear “neurotypical” or meet others’ expectations

• Attachment wounds from caregivers who didn’t or couldn’t affirm their identity

• Medical trauma, especially for trans and nonbinary people navigating affirming care

• Religious trauma rooted in exclusion, shame, or moral injury
  

These experiences often leave folks feeling emotionally unsafe, disconnected from their bodies, or unsure how to trust themselves or others.

Nervous System Responses in Neurodivergent Folks With Complex Trauma

While everyone has nervous system responses to trauma, neurodivergent people may experience or express those responses differently. For example:

• Autistic shutdowns or meltdowns might be misunderstood as defiance or dysregulation

• ADHD impulsivity may increase under stress, leading to shame or unsafe coping

• Dissociation may be more frequent or harder to identify in people who were taught to suppress their needs

• Masking trauma responses can lead to burnout, chronic illness, or emotional exhaustion
  

How Therapy Can Help With Complex Trauma

Healing from complex trauma is possible—and working with a therapist trained in trauma-informed, neurodiversity-affirming, and LGBTQIA+ affirming care can make all the difference.

Here’s how therapy can support your healing:

1. Creating a Safe, Affirming Space

The therapeutic relationship itself becomes a container for safety, connection, and trust—especially important for people who’ve never felt emotionally safe before.

2. Nervous System Regulation Tools

Therapists can teach grounding skills, mindfulness practices, and body-based tools to help expand your window of tolerance and respond more flexibly to stress.

3. Unpacking the Narrative

Therapy helps make sense of what happened, giving language and context to experiences that may have felt confusing or invisible.

4. Exploring Identity and Self-Compassion

Working with a therapist who understands neurodivergence and queerness allows for deep work around self-acceptance, authenticity, and reclaiming your story.

5. Modalities That Help

Many therapists use trauma-informed approaches such as:

• Acceptance and Commitment Therapy (ACT)

• EMDR (Eye Movement Desensitization and Reprocessing)

• Somatic Experiencing (SE)

• Internal Family Systems (IFS)

• Sensorimotor Psychotherapy

• Neurodivergent-affirming DBT
  

These modalities go beyond talk therapy and help integrate healing across both mind and body.

You Are Not “Too Much”—You Are Responding to Too Much

If you’re a queer or neurodivergent person navigating complex trauma, your responses make sense. You are not broken—you are adapting. Therapy can help you unlearn survival patterns, reconnect with yourself, and feel safe in your body and relationships again.

Looking for a Therapist?

At Divergent Path Wellness, we specialize in working with LGBTQIA+ and neurodivergent individuals navigating trauma, burnout, and identity exploration. If you’re curious about therapy or wondering where to start, we’re here to support you.

📍 Serving clients across Virginia via telehealth and in-person in Charlottesville 🌈 Trauma-informed, neurodivergent-affirming, queer-led care 📅 Link to schedule a consultation

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By Hannah Dickey LMSW

Supervisee in social work at Divergent Path Wellness

 Want want to work with a trauma-informed, queer and neurodiversity affirming therapist? Schedule a free 15-minute consultation with a therapist at Divergent Path Wellness—available to teens 14+ and adults across Virginia.