Complex Trauma, cPTSD, and Gifted Neurodivergence

By Dr. Patty Gently on August 13, 2024

Bright Insight Support Network founder and president Dr. Patty Gently (Formerly Williams) is a trauma therapist and coach who specializes in EMDR, ND-Affirmative DBT, and IFS modalities. Through Bright Insight she works to counsel, coach, and advocate for gifted, twice-exceptional, and neurodivergent persons, along with other marginalized populations.

Complex Trauma, cPTSD, and Gifted Neurodivergence

It is time to write specifically about complex trauma and cPTSD (complex posttraumatic stress disorder) in relation to giftedness and neurodivergence.

First, let’s talk about complexity.

In Intersection of Intensity: Exploring Giftedness and Trauma, I used the word “complex” or some variant such as “complexity,” 119 times.  Is this because of the exploration of complex trauma? Well, certainly this is part of it. However, complexity does not only describe some types of trauma. It also helps us conceptualize giftedness.

In her books and blogs, author and psychotherapist Paula Prober identifies gifted individuals with rainforest minds as those who are complex, creative, sensitive, empathetic, intuitive, and often misunderstood. My own unique definition of giftedness involves an understanding that gifted persons are “complex beings with a distinctly above-average ability and compulsion to develop new understanding, knowledge, behaviors, skills, values, attitudes, and preferences.” I even describe one category of gifted persons as “deep, complex, and compassionate” though this may not describe ALL gifted persons. The complexity appears to be a common thread, however.

If gifted and neurodivergent folks are neurologically complex (oh, by the way, gifted persons are researched as having a higher volume of gray matter and more complex white matter in their brains, while autistic persons are identified in research as having a greater quantity and density of synapses that neurotypical peers), then it is understandable that they might also be impacted by other forms of complexity in the world. That is, maybe the complex is that much more complex to a neurodivergent person (gifted folks being undoubtedly neurodivergent). So let’s go there.

What are complex trauma, cPTSD, and DTD?

According to complextrauma.org, a comprehensive repository of information and resources on complex traumatic stress gathered by professionals and those with lived experience:

Complex trauma is defined as the exposure to multiple, often interrelated forms of traumatic experiences AND the difficulties that arise as a result of adapting to or surviving these experiences. The adverse experiences encapsulated by Complex Trauma typically begin in early childhood, are longstanding or recurrent, and are inflicted by others. Most often they are perpetrated within a person’s formative attachment relationships. Sometimes they are compounded by patterns of risk and dysfunction afflicting generations of families. Frequently, they intersect with structural and institutional forms of violence and oppression that beset certain peoples and communities, particularly those holding minority status within a given society.

I love this comprehensive definition. Identifying complex trauma more concisely and then expanding on it, I like to explain how complex trauma is often identified as a mix of both big T and little t trauma or different types and combinations of little t trauma, resulting in a complex developmental profile and trauma history. When treating complex trauma with EMDR, I will generally identify developmental trauma with clients that then impacts how more recent big T or little t traumas are affecting them. For example, if a client is enduring workplace harassment and is struggling to set boundaries or assert themselves, it may be because of the impact of earlier, developmental traumas in their childhood home where they learned to avoid conflict as a means of survival. Here, the complexity of developmental trauma impacts current behavior and little t experiences. Any mixture of trauma that adds to the complexity of one’s psychological profile can result in complex trauma and therefore complex post-traumatic stress disorder (cPTSD). 

Developmental trauma disorder (DTD) and complex post-traumatic stress disorder (cPTSD) diagnoses are not in the fifth edition of the DSM even though the World Health Organization added cPTSD to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) in 2019. Professionals such as psychologist Joseph Spinazzola, Ph.D., trauma psychiatrist Bessel van der Kolk, MD, and clinical psychologist Julian Ford, Ph.D., ABPP championed the inclusion of DTD in the DSM, however, it was identified in 2011 as lacking evidential support. In the decade following this finding, these professionals and others have amassed substantial scientific evidence about the occurrence of DTD, further supporting the knowledge of how trauma accounts for developmental disruptions. It is likely that we will see significant changes in the next DSM inclusive of expanded or new trauma diagnoses.  

So why do we see so much about cPTSD and complex trauma in general in gifted spaces?

Well, as my dear friend Youssef Sleiman likes to say, “Giftedness weirdifies psychology” or “Giftedness weirdifies everything.” I’ve started adopting this idea more and more as it seems to be true. Riding on the wake of my book, I would propose that giftedness intensifies a lot- and certainly something intense like trauma. And gosh, I could say that giftedness intensifies the complexity of the already complex. So where complex trauma is already a risk for anyone with a complex and traumatic childhood (or otherwise), it is certainly imaginable that a gifted individual who seeks and identifies complexity might further internalize and experience complex trauma.

Maybe obviously, I am oversimplifying this understanding.

However, I write about this in my book and plan to blog about it more. This is an important conversation as we gain awareness and understanding about gifted neurodivergence and trauma of all types.