Relational trauma therapy in the San Francisco Bay Area (Complex-PTSD)

Healing from childhood trauma is possible

Anny Papatheodorou, LMFT

Therapy offerings for adults in Walnut Creek, Oakland, and available online throughout California

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As a relational trauma therapist, I'm passionate about helping adults who did not experience good childhoods, live fulfilling and meaningful adulthoods.

While we can’t rewrite the past, together we can make sense of it, grieve it, and heal it so that it no longer governs your present.

What is complex relational trauma? (C-PTSD)

The nature of relational trauma

Many people experience wounding in their childhoods, even though they may not refer to it as “trauma” because it seems a bit over the top. It may feel as if there isn’t much to complain about; you’ve had food, clothes, and shelter; you may say to yourself, “it’s ungrateful of me to complain; others have had it worse.”

Yet, trauma can take on many forms. In particular, complex relational trauma happens in relation to those closest to us, i.e., the nature of relational trauma is interpersonal. It results from feeling unloved, unwanted, shamed, and/or rejected in childhood. And it cuts deep because the perpetrator is usually someone we idolize and depend upon to care for us, like a parent.

Research has also indicated that emotional trauma and neglect can have the same impact on your mental health as physical and sexual abuse.

There is no undeserving pain.

All pain deserves to be witnessed, unburdened, and healed.

What are the signs of childhood trauma in adults?

People who find my practice may have been told or have self-diagnosed that they suffer from complex, developmental, relational, or childhood trauma. They might also know or suspect that much of their suffering stems from their childhood experiences, where pervasive and insidious shame has taken root. As a result, they want to break the wheel of undesirable behaviors.

Yet, others seek therapy without an understanding of how their past is influencing their present, yet may be struggling with:

Anxiety and depression.
Loneliness, separation, and not fitting in.
Fear of staying or leaving a relationship and general reluctance to trust others and yourself.
Self-soothing with food, alcohol, gambling, excessive shopping, self-injury, and other undesirable behaviors.
Constant scanning for emotional safety in the environment, hypervigilance, and being on edge.
Disconnection from your true self, desires, needs, and wants.
Withdrawal from others and overdependence on others for validation.
Low sense of self-worth, feelings of being unlovable, frequent self-blame, seeing oneself as “damaged,” shameful, and a general feeling of “I’m not enough.”
Things seem fine on the surface, yet something is very off inside.
Ongoing physical pain (stomach aches, headaches, etc.) without an apparent physiological reason.

What matters is that you've been raised by a caregiver who was any (or a combination) of the following: absent, neglectful, narcissistic, incredibly critical, abusive, and struggled with alcohol and substances. More than likely, that caregiver also suffered from the same type of abuse, given that this type of trauma is often intergenerational.

Childhood trauma isn’t something you get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect, and parents struggling with mental health or substance abuse issues has real, tangible effects on brain development.

Features of relational trauma can include:

We are wounded relationally by people we depend upon for shelter, food, a sense of belonging, and emotional warmth and presence. Thus, wounding can happen in our relationships with parents, caregivers, guardians, and other authority figures within our formative systems, such as schools, orphanages, foster care, and places of worship.

All these experiences have in common the imbalance of power between the child/youth and the people in control with authority.
Another important feature is the lack of control and high level of dependency the child/youth experiences in those relationships. For trauma to occur, there is often an overriding sense of hopelessness and immobilization - nowhere to go, no one to turn to.
Moreover, relational trauma is not about one acute event that happens to us. Instead, it has more to do with repeated events that have a cumulative impact over time. It may be a reason you may find yourself in abusive relationships, with the underlying belief that you “don’t deserve any better” and that “this is what normal looks like.”

Complex relational trauma is any continuous period of mistreatment that creates anguish and long-term psychological repercussions.

Physical, sexual, or emotional abuse, neglect, bullying, betrayal of trust, abandonment, separation, and rejection are all examples of complex trauma.

Healing from childhood trauma (C-PTSD)

Parts work / Inner Child Work / Internal Family Systems therapy (IFS)

IFS (Internal Family Systems) therapy is a unique, compassionate, and evidence-based approach for resolving relational trauma. With its clear and comprehensive trauma-responsive methodology, IFS enables us to heal and release the trauma held by our wounded parts, commonly referred to as Exiles.

IFS therapy allows us to access our inherent capacity for healing – called Self-energy; it also helps us welcome and unburden the extreme emotions frequently associated with trauma.

With IFS therapy, we can reclaim self-connection, experience self-love, and relearn the ability to connect with and love others. Moreover, this can happen in a non-pathologizing way since IFS therapy doesn’t require us to remember, feel or behave in ways that may be re-traumatizing.

All parts are welcome.

Our parts are our humanity.

Mindful Self-Compassion

Self-compassion is a key component of IFS (see above). Still, I want to single it out since it’s such an important cornerstone that warrants its own mention.

Unresolved relational trauma from childhood often shows up in our lives and ourselves as self-critical thoughts (also known as our inner critic), a non-forgiving attitude towards our mistakes, or self-soothing with undesirable behaviors. As a result, our self-esteem and sense of self-worth plummet, leaving us depressed, anxious, and in general discomfort.

This is where self-compassion can come in as our staunchest inner ally. While our self-esteem gets depleted, our self-compassion has our back. In trauma recovery, our self-compassion aids us in transforming our pain. You can learn how to deliberately respond to your wounded parts with warmth and tenderness.

Even if you didn’t have a present and emotionally attuned caregiver, you could learn how to reparent yourself through practicing self-compassion. Your adult self no longer needs to hold onto and repeat the judgmental and harsh voices of the past. Instead, it is possible to experience loving kindness and radical acceptance of aspects of yourself that are caught up repeating unwanted behaviors out of their need to survive.

For more on self-compassion, feel free to read posts I’ve written over time. Here’s a sample:

Healing relationally

Apart from models and theoretical approaches, I inherently get it as a childhood trauma survivor. I can understand and empathize with you and the trauma you have lived through on a deeper and more embodied level. Therapy with me isn’t like talking to a brick wall; we will explore together, get curious together, and, why not, laugh and feel together. We are hurt relationally, and paradoxically we also heal in relationally. At our very essence, we are social beings who regulate through connection with others. Most importantly, you will develop the skills to be your own best therapist. Our goal is to make me redundant and for you to live a meaningful life full of choice and possibility.

“Trauma is hell on earth. Trauma resolved is a gift from the gods.”

― Peter Levine, Ph. D., Somatic Experiencing Institute

FAQs about Complex Trauma Therapy (C-PTSD)

For the most part, people who suffer from complex relational trauma either already know or discover through the course of therapy that a lot of their wounding can be traced to how they were treated by their parents, caregivers, and other significant authority figures during their formative years. Physical, emotional and sexual abuse can all lead to relational trauma, along with neglect and abandonment.
Inconsistent parenting (not knowing which side of the bed a caregiver will wake up on), as well as mixed parenting that’s layered within unpredictability and a lack of structure, can also impact a child’s emotional world. Children who lived through such conditions can experience confusion, insecurity, anxiety, depression, and self-blame when things go wrong. Self-blame is particularly common, since it is easier for the child to blame herself rather than realize that the person they depend upon is not dependable. This strikes at the child’s core evolutionary need to survive.
Yet, for some people it may be their experiences later on in life that bring them to therapy. Abuse, mistreatment, oppression, and neglect by partners, significant others, family members, bosses, managers, and co-workers can be in certain circumstances as harmful and traumatizing. Such experiences can leave you with potent and unprocessed feelings of anger, rage, shame, guilt, betrayal, and inferiority.
These unresolved feelings can impact the quality of your existing relationships, as well as prevent you from making new ones that are meaningful to you.
In a nutshell, while childhood experiences greatly influence the probability of experiencing relational trauma, adult experiences can also bring forth the same type of feelings. Most often than not, it is a combination of the two, with the latter perhaps serving as the catalyst that brings you to therapy.
At the end of the day, it is the impact such experiences had on your emotional wellness that matters, regardless of the source or life stage when the trauma happened.
Painful memories can’t be erased. And even if we successfully sweep them under the rug because we have become masters of distraction and repression, the symptoms generated by the pain will find their way to the surface. That can result in a number of undesirable behaviors with unwanted outcomes.
In relational trauma therapy, you can reprocess your pain so that you don’t find yourself repeating these behaviors, as if someone else is driving the bus of your life.
And while complete eradication of pain isn’t possible since life is unpredictable, you can learn to change your relationship to hardship so that you have more choice and moment-to-moment awareness of how to respond. It is possible to develop a deeper and more compassionate relationship with yourself, where the pain and shame that you have experienced in the past will no longer be in the driver's seat.
For example, if you have experienced pain because of abandonment or lack of emotional warmth and presence, perhaps your automatic response is to get flustered and activated when you feel that your partner is ignoring your calls or your texts. After healing your inner system, you may still notice some irritation, but it won’t be to the same extend and degree as in the past, and it won’t overrun your nervous system.
Your emotional safety is the most important consideration in therapy. We will go at your own pace, and as a relational trauma therapist, I’m trained to check-in with you as the process unfolds to make sure that the intensity is not too much for you to hold.
My approach is tailored to your needs. We will spend as much time as needed building trust and safety between us, as well as in your own capacity to witness, hold, and heal your pain.
In essence, relational trauma therapy can help you learn to trust again – most importantly, trust yourself and your own ability to heal, so that you walk through life with a feeling of “okayness” on the inside.
One important thing to note is that complex relational trauma is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (aka the DSM, which is the clinical handbook of the mental health professions).
Why is this the case? Let’s just say that while the DSM has its benefits, it doesn’t encompass the vastness of our humanity, and surprisingly the degree to which trauma should be covered in the DSM is severely lacking. Indeed, one thing that I have realized in my work in the mental health field is that the whole DSM can be re-written with a trauma-informed lens - that’s how prevalent complex relational trauma is.
Complex relational trauma is different than PTSD as it is not brought upon by a particular traumatic incident or distinct events. Commonly, complex relational trauma is an outcome of repeated childhood emotional, physical or sexual abuse, or neglect. A parent who is suffering from their own trauma, who may have narcissistic and/or borderline traits, can create relational trauma for their child through recurring violations of boundaries, emotional betrayal, chaos and unpredictability, criticism, and rejection.
Essentially trauma is one’s response to any of the perceived dangerous and threatening experiences that can rock someone to their core. When we can’t integrate our experiences in our lived experiences, it will likely result in trauma. More specifically with relational trauma, the source of the wounding is found in past relationships, and that **interpersonal nature of the trauma** is what makes it unique, as well as elusive.

Welcome! I’m Anny.

I'm a licensed psychotherapist certified in Internal Family Systems (IFS) therapy and Brainspotting therapy. Not to mention a fantasy novel nerd, human and dog mother, and feta cheese aficionado.

I know in my bones what it is like to come from a challenging and painful background. As a relational trauma therapist, I have the honor of helping people heal their childhood wounds so that they create lives full of possibility and choice.

In our work together, I bring my full Self, meaning I'm right there with you every step of the way. I'm not a "blank slate" and will offer reflections and personal examples that may shed some light on your experiences, moments of "stuckness," and isolation.

I can hold intensity. There's no such thing as "being too much or too needy." I will laugh with you. I will curse with you. And welcome all parts of you wholeheartedly.