The Relationship Between Relational Trauma and Functioning: How Therapy Can Help

Relational trauma is a violation inflicted by one person on another in the context of an interpersonal relationship. For many, violations that occur in childhood are particularly traumatic, especially if those violations occur within the context of a child-parent relationship such as physical, emotional, or sexual abuse and neglect. However, relational trauma is not necessarily confined to formative experiences, nor to relationships between children and their parents. Rather, relational violations can be perpetrated by a broad range of actors, occur at any stage of life, and take many forms, including sexual violence, bullying, infidelity, and intimate partner. Even unresolved grief from the loss of meaningful social connections can be experienced as a form of relational trauma, despite the fact that there is no perpetrator in the traditional sense.

At the heart of relational trauma are injuries of attachment, which is the foundation of our sense of security. The mother-infant bond typically acts as the “prototype of attachment” and when that attachment is secure, it imbues us with enduring internal security, resilience, confidence, and a kind of emotional map that guides us throughout life. However, when the attachment between a young child and a caretaker is not secure, it prevents the creation of this fundamental sense of safety. As such, traumas that happen in early childhood may be particularly profound, as they can compromise normal human development and the ability to form secure attachments at the earliest and most critical stages of life. However, the human need for attachment continues throughout life and violations of that attachment through trauma can have a profound impact, including damaging the ability to experience secure attachment in the future.

All forms of attachment injury can have significant effects on survivors and these effects can result in neurological, emotional, and behavioral disturbances:

Neurological Effects

Early childhood trauma has been shown to have a deleterious effect on brain development, creating both structural and chemical changes. These include reduced volume of the hippocampus, prefrontal cortex, and cerebellum. These areas are critical to processes such as learning and memory, emotional regulation, executive functioning, behavior, and cognition. In addition, trauma is linked to abnormal cortisol levels and reduced ability to modulate cortisol levels, which can harm cognitive functioning, socialization, and immune reactions. While childhood trauma can be especially damaging due to interference with early brain development, relational trauma suffered in adulthood has also been shown to result in many of the same neurological deficits.

Psychological Effects

The psychological effects of relational trauma can be devastating and are deeply rooted in the disruption of attachment, whether that disruption happens in early childhood or in one’s adult years. These effects can and typically do include profound specific emotions, of course, including deep sadness, anger, loss of confidence, guilt, hopelessness, self-loathing, and fear.

Additionally, the ability to regulate emotions, cope with distress, experience empathy, form healthy and trusting relationships, and experience true intimacy is often compromised, damaging both one’s relationship with oneself and with the larger world. This alienation can pervade even one’s own self as the ability to form a cohesive sense of identity and recognize one’s own emotions is jeopardized.

Sometimes, the effects relational trauma manifest in distinct mental health disorders, including depression, anxiety disorders, Post-Traumatic Stress Disorder (PTSD), personality disorders, and dissociative disorders. In other situations, the stress of relational trauma can augment the severity of pre-existing mental health disorders or diminish one’s ability to cope with psychiatric illness due to generally compromised emotional functioning.

Behavioral Effects

The neurological and psychological impact of relational trauma often manifests in a host of behavioral problems as your loved one struggles to navigate their inhospitable inner world. Some survivors have trouble verbalizing their emotions, needs, and desires, in part because they may struggle to recognize them and in part because they fear rejection or being hurt once again. This severely compromises the ability to participate in meaningful and mutually satisfying social interactions and creating a strong social support network.

Meanwhile, lack of emotional regulation skills may lead to inappropriate emotional displays and acting out, while an unstable sense of identity may lead to seemingly erratic shifts in interests and goals. Many survivors also turn to self-destructive behaviors such as substance abuse or self-injury in an attempt to cope with overwhelming distress. In some cases, even the basics of everyday living can become too much to handle, including self-care and participation in educational and professional pursuits.

While some people recover from relational trauma naturally over time, for others the effects of such trauma remain deeply embedded in the psyche and present ongoing functional challenges. In these cases, therapy is necessary to remove the obstacles to healing. A trusted and skilled therapist can help your loved one explore the impact of trauma and cope with the damage of attachment injury. In doing so, the therapist can become a vital participant in the formation of healthy attachments, allowing the therapeutic relationship to serve as a model for how to engage in a strong and secure bond. As psychotherapist Rev Sheri Heller writes:

When a relationally traumatized client engages in a therapeutic process with a clinician who offers the opportunity for corrective connection, healing occurs. The heroic and arduous journey of recovery for the relationally traumatized individual means repairing fragmentation, stabilizing the consequences of dysregulation, cultivating life skills, and developing a cohesive meaningful narrative that lends itself to a life-affirming sense of identity and an inspired frame of reference.

Indeed, the therapeutic relationship can guide your loved one toward the insight and skills necessary to resolve trauma and improve neurological, psychological, and behavioral functioning as the result of both understanding and practice. Meanwhile, any mental health disorders and substance use disorders can be appropriately treated to restore psychiatric harmony.

Of course, healing takes time. In cases of severe functional difficulties, long-term residential treatment programs offer an ideal setting in which to begin this journey of recovery. In a safe, monitored environment, your loved one will be able to participate in a broad range of therapies selected to address their unique needs. Guided by experts in trauma recovery, they can devote themselves fully to the process of healing knowing that they are in a secure milieu, surrounded by compassionate clinicians and peers.

During their journey to recovery, your loved one will have the opportunity to continuously gain and hone the skills they need to increase self-awareness, emotional regulation, and self-expression through both formal treatment and everyday life. At the same time, the inherently social environment and duration of long-term residential programs means that your loved one can experience true connectedness with others and form trusting bonds that will serve as a template for future relationships.

One of the most important relationships to nurture after trauma is the relationship with the self. As recovery begins, your loved one will begin to discover who they truly are, learn how to trust and value themselves, and live in a way that is healthy, meaningful, and authentic. With confidence and resilience, they can move toward a richer life and a newfound capacity to love and to be loved.