Understanding and Healing from Relational Trauma
What Is Relational Trauma?
For better or worse, relationships affect our physical and mental health throughout our lives. In an ideal world, relationships would always improve well-being. All parents would be loving, responsible, and consistent. All marriages would involve mutual respect and caring. All workplaces would value and support their employees.
Unfortunately, relationships can and do go wrong in devastating ways.
“Relational trauma” refers to the psychological harm caused by a relationship that doesn’t reliably offer the safety, stability, love, respect, validation, attention, support, and/or caregiving that someone needs. Relational trauma can also result from physical abuse, sexual abuse, or neglect of someone’s bodily needs. People do not choose to experience, or not experience, relational trauma. It is an involuntary nervous-system response to harm.
Most people in harmful relationships try to manage the pain they experience by suppressing or denying it. However, even when this works in the short term, it is not healthy in the long term. In fact, persistent denial and suppression of emotional pain can lead to mental-health problems like depression, anxiety, and substance misuse.
People can suffer relational trauma at any age, from infancy onward. Trauma that happens early in someone’s life tends to have the most profound impact.
Relational trauma happens in families, friendships, marriages, workplaces, schools—any setting in which people are in relationship with each other. While relational trauma sometimes results from a single event, such as a major betrayal, most often it results from repeated negative patterns in a relationship.
How Common is Relational Trauma?
The exact prevalence of relational trauma is unknown, in large part because most people who have experienced relational trauma don’t recognize it. They may instead believe that the after-effects of trauma are just their personality. They may consider their struggles in life to be inexplicable or baffling, rather than trauma-related. Some people truly don’t remember what happened to them; others insist it was “normal” or “not that bad”; still others idealize the person who mistreated them and blame themselves instead.
However, it is safe to say that relational trauma is a common experience, and one that impacts physical and mental health. Relational trauma exists on a spectrum of severity, from a single instance of betrayal in a dating relationship, on the milder end; to pervasive child abuse, on the more severe end.
Examples of Relational Trauma
Here are some examples of relational behaviors that cause trauma. This is not an exhaustive list.
Abuse (physical, sexual, verbal, or financial)
Neglect (of physical, emotional, or developmental needs)
Abandonment (disappearing from someone’s life without warning or closure; leaving someone to fend for themselves when they cannot; abandonment can also occur in episodes, such as leaving a young child alone for the day)
Enmeshment (not allowing for privacy, individual development, or differences of opinion; being overly involved in someone’s personal affairs and choices; not seeing where one person ends and the other begins)
Inconsistency (running “hot and cold” with attention, love, caregiving, or safety; being unreliable and unpredictable)
Betrayal (being unfaithful or deceitful; breaking promises; revealing secrets; or doing things without someone’s knowledge or consent)
Criticism (especially when harsh, excessive, unwarranted, or unconstructive)
Triangulation (bringing a third person into a conflict, such as through gossip; triangulation is especially harmful when used to spread damaging lies)
DARVO (Deny, Attack, Reverse Victim and Offender, a strategy used to deflect blame and create false narratives. An example of DARVO would be punishing a child for disclosing their abuse to a teacher, while insisting the child is lying. This deflects from the parent’s behavior and positions them as the real victim)
Manipulation (bribing, tricking, or indirectly coercing someone into doing something that may harm them)
Gaslighting (gaslighting is not just lying or withholding information; instead, it is a systematic effort to make someone mistrust their own reality and become dependent on the other person’s version of events)
Scapegoating (blaming one person for everything that goes wrong; targeting one person for criticism, abuse, or exclusion from the family or group. Scapegoating is typically an enduring pattern with little basis in reality. It occurs regardless of the scapegoated person’s goodness or innocence)
Objectification (using someone as a means to an end, without acknowledging their full humanity; for example, only valuing someone for their looks)
Domination and Control (insisting on the other person’s compliance, deference, and obedience; ruling by fear; creating dependency in the other person in order to control them)
Role Reversal/Parentification (expecting a child to care for a parent’s needs, whether physical or emotional, at their own expense; expecting a child to care for younger siblings when this is not age-appropriate)
Childhood Vs. Adult Relational Trauma
The most commonly recognized forms of childhood relational trauma are neglect of basic needs, physical abuse, and sexual abuse. These are devastating experiences for children. Emotional and verbal abuse can be equally devastating. However, identifying and healing from childhood emotional abuse can be especially tough due to the widespread belief that so long as a child is physically unharmed, they cannot experience “real” abuse.
Such beliefs are rooted in a misunderstanding of child development. In reality, the psyche and body are interrelated. Each profoundly affects the other. Longitudinal studies of children raised in orphanages where staff met their material needs, but not their emotional and attachment needs, show a high incidence of serious, lifelong developmental problems.
It is important to distinguish childhood relational trauma from adverse childhood experiences (known as ACEs). ACEs do include child abuse and neglect; however, they also include other hardships such as having unstable housing or food, witnessing random acts of violence, and the illness or death of a family member.
Children who belong to marginalized communities (racial, ethnic, socioeconomic, LGBTQ+, etc) also experience ACEs in the form of being humiliated, excluded, or mistreated because of their identity. These experiences may qualify as relational trauma if they happen within a relationship, such as with a teacher or friend.
Meanwhile, adult relational trauma often occurs in intimate relationships, such as dating and marriage. It can also occur in friendships, work relationships, or within one’s family of origin. Some adult relational trauma occurs in relationships with imbalances of power-- such as between a manager and an employee, or between spouses when one is financially dependent on the other.
Childhood Affects Adulthood
Childhood relational trauma typically affects adult relationships, notably through the re-enactment of early relational patterns like people-pleasing, conflict avoidance, and passive aggression. In many cases, people are unconsciously driven toward adult relationships that mirror what they experienced as children, even if that was painful.
However, even someone who had a happy childhood can experience relational trauma as an adult. In such cases, adult relational trauma can shatter someone’s long-held sense of optimism, safety, and faith in humanity.
Effects of Relational Trauma
Relational trauma is not a psychiatric diagnosis, by itself. However, it can predispose some people to develop psychiatric conditions like dysthymia (chronic low mood), major depression, anxiety, panic disorder, PTSD, personality disorders, and substance use disorders.
While Complex PTSD is not yet an official diagnosis, many clinicians embrace the term to describe the unique impact of relational trauma, especially that which occurs in childhood. Symptoms of complex PTSD include frequent mood swings; feeling “flooded” or overwhelmed by emotions; an unstable sense of self; numbness or detachment from reality; difficulty trusting oneself and others; and fight/flight/freeze/fawn nervous-system responses that are over-generalized, meaning that they happen even in the absence of danger.
Relational trauma also increases some people’s risk of medical conditions such as autoimmune disorders, hypertension, fibromyalgia, and heart disease, among many others. The experience of relational trauma affects the body, such as by increasing the production of cortisol (the primary stress hormone). Over time, this chronic stress load can weaken the immune system or cause harm to various organs, especially in those with a genetic predisposition to certain diseases.
Even beyond any specific illness, though, relational trauma can cause generalized problems in living such as low self-esteem; self-sabotaging behavior; and a cycle of unhealthy or abusive relationships. Some people with a history of relational trauma avoid relationships entirely, keep things superficial, or flee at the first sign of conflict.
Relational trauma can leave someone confused about their own identity, values, and preferences. It can even alter someone’s sense of reality, such as about who is to blame for abuse.
What Is Trauma Bonding?
It’s crucial to note that even harmful relationships offer some benefits (like positive attention or caring), some of the time—but in an arbitrary or inconsistent way. Traumatizing relationships create cycles of hope followed by disappointment and pain. For example, a physically abusive partner has moments of remorse and self-awareness, but then returns to their abusive behavior. Or a parent provides grossly inconsistent care from one day to the next, ranging from affectionate to cruel.
Paradoxically, these cycles can intensify someone’s feelings of attachment to the harmful person. They cling to the hope that they can change, heal, or appease the harmful person. This phenomenon is known as trauma bonding. It is not a sign of personal weakness. Rather, trauma bonding is an unconscious survival response to abuse. Survival responses are adaptive in the face of short-term danger; however, when used for long periods of time, they can harm someone’s health and well-being.
What is The Compulsion to Repeat?
“Compulsion to repeat” refers to an unconscious drive to choose adult relationships that are reminiscent of painful childhood relationships. Repeating a familiar pattern, but with a new person this time, instills hope for a better outcome than in the past. All of this typically happens outside someone’s conscious awareness.
For example, someone who grew up with a rejecting parent may be drawn to partners who play “hard to get.” The person may work hard to be seen, loved, and acknowledged by a partner, since they never got this from their parent. When these efforts inevitably fail, the person feels the same disappointment, anger, and shame they felt as a child.
Most people in this situation don’t recognize a childhood pattern at play. However, even those who recognize the pattern may not know how to stop it.
Although the compusion to repeat is painful, it is a near-universal response to childhood trauma. A child who never got crucial attachment needs met will become an adult with the same unmet needs. Thus begins the unconscious search for a partner who feels familiar and might meet those needs. When things go wrong in the relationship, the person will fall back on tried-and-true behaviors such as fawning, avoidance, passive aggression, threats, and so on.
Childhood is a time of maximum brain plasticity, so these learned behaviors run deep—especially since at the time, they helped the child survive a bad situation.
This does not mean that the compulsion to repeat can’t be changed! It simply means that changing it is not as simple as making an intellectual decision to do so. In many cases, healing involves a gradual shift toward greater self-awareness and self-acceptance; this, in turns, leads to choosing partners who are emotionally available and capable of “doing the work” together.
How Can Therapy Help Me Heal?
Therapy can help people heal from the compulsion to repeat, and other symptoms of relational trauma, in many ways. If relational trauma occurred as a single incident, healing may be more straightforward than it is for complex relational trauma. However, healing and relief are possible for anyone with a history of relational trauma.
The components of healing from relational trauma include:
Changing personal narratives of self-blame, defectiveness, and hopelessness
Regaining one’s sense of self and reality
Grieving and accepting past events that can’t be changed
Coping with a lack of closure or justice (such as never getting an apology)
Incorporating the trauma into one’s life story; appreciating hard-won wisdom
Safely working through feelings and memories associated with the trauma
Learning to handle strong emotions, instead of avoiding or suppressing them
Reducing fight/flight/fawn/flee responses in situations that don’t warrant them
Recognizing unhelpful relationship behaviors and practicing new behaviors
Setting boundaries or limiting/ending contact with harmful people
Note: forgiveness of past harm is a healing step for some people, but not for others. Even when forgiveness is not an option, there are other ways to release anger and make peace with the past
What Kinds of Therapy Help with Relational Trauma?
Integrative and somatic therapies, such as breathwork, EMDR, and Somatic Experiencing, can help someone safely tolerate and work through, rather than avoid, painful memories and emotions.
Because emotions are felt in the body, suppressing them means ignoring potentially helpful bodily signals. The ability to feel and modulate one’s own emotions is crucial to developing relationship skills like conflict resolution and boundary-setting.
Meanwhile, “third wave” cognitive-behavioral therapies, such as Dialectical Behavior Therapy and Acceptance and Commitment Therapy, can help someone learn to act from their innate wisdom and personal values, even when emotions run high.
Internal Family Systems therapy can help someone identify, embrace, and learn from rejected parts of themselves (such as their childlike vulnerabilities) so they can feel more whole and empowered in relationships going forward.
Psychodynamic therapy can help someone make sense of their past, understand the history and function of their symptoms and learned behaviors, and discover healthier ways of relating to others within the safety of the therapy room.
Imago Relationship Therapy is a type of couples therapy that sets a great - and safe - foundation to heal past relationship trauma within a present romantic relationship.
Regardless of the modality used in therapy, the therapeutic relationship itself can help someone heal from trauma. Therapy sessions can be a place to experience being accepted for one’s whole self, without being labeled, judged, or controlled. Discovering that so-called “negative” emotions (grief, anger, anxiety, shame) are not only welcomed in therapy, but are a universal and natural part of life, can be transformative too.
