The Path to Healing After Relational Trauma

Relational trauma refers to trauma that happens within a close relationship. This can be the result of abuse, neglect, abandonment, or enmeshment. Although this can occur in adult relationships, this pattern of trauma often occurs when there are traumatic interactions between caregivers and children during critical development phases. These interactions impact the child's brain and create negative attachments that shape the way the child interacts with others throughout their life.

This article will define relational trauma as it occurs in childhood and as adults, discuss types of family interactions around closeness and their potential long-term impacts, present the effects of untreated relational trauma, and provide healing options.

Shot of an older woman sitting with her daughter on the sofa at home and not talking

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What Is Relational Trauma?

As children, we are highly vulnerable to the words and actions of our caregivers. During these crucial developmental years, children's brains begin to form an understanding of their surroundings based on their lived reality. This highly subjective reality forms an inner dialogue about who we are as people and how we relate to others. It also contributes to our feelings of self-worth and confidence.

This dialogue we all have runs constantly in our minds throughout the day. When the input we received as children was negative or harmful, the inner dialogue about who we are is negatively swayed and can be in conflict with who we truly are. This can be confusing and makes it difficult to form healthy relationships.

Types of Family Closeness and Relational Trauma

Abandonment

Abandonment can mean physical abandonment (such as through adoption or by leaving the child with another parent or guardian permanently) or abandonment of parenting roles.

When parents don't fulfill their responsibilities and provide safe, healthy boundaries within the family, it leaves the children to have to fill in and create these roles themselves. This teaches children that they cannot rely on or trust others, especially those who are supposed to be closest to them. As adults, this leads to difficulty relying on others and forming close, trusting relationships.

Enmeshment

Families with an enmeshment style of closeness lack clear boundaries, which causes members of the family to become overly emotionally involved in each others' lives. There is a high level of interdependency among family members, and children become sensitive to and experience increased stress as a result.

Family Cohesion

Family cohesion can be thought of as the emotional bonding that family members have toward one another. When families have cohesion, each member is permitted to have clear and flexible boundaries. There is support, warmth, closeness, and respect for each family member, and it doesn't occur at the expense of any individual person. This kind of family closeness can help protect against relational trauma.

Relational Trauma As Children and Adults

Childhood Relational Trauma

Relational trauma can overlap with complex trauma or the diagnosis of complex PTSD. This type of PTSD forms when there is repeated trauma at the hands of a needed relationship, like how a child needs a parent. Complex PTSD has many of the core symptoms of regular PTSD, but is thought to include the development of a negative self-image, emotional dysregulation, dissociation, and impaired relationships.

Complex PTSD is different from acute trauma, which occurs when a single traumatic event, like a car accident or act of violence, takes place.

In childhood, common causes of complex trauma that can lead to relational trauma include:

  • Sexual, physical, or emotional abuse
  • Trafficking
  • Torture and kidnapping
  • Ongoing medical trauma
  • Chronic neglect or abandonment

Adult Relational Trauma

As adults, the results of internalizing the thoughts, behaviors, and words of others when we are children creates the framework of who we believe we are. When formed out of traumatic interactions with caregivers, the constant conflict between who you truly are and who you think you are weakens your ability to connect with others in meaningful ways. Indecision, anxiety, irritability, anger, and guilt become common realities for adults coping with relational trauma.

Impact of Relational Trauma

Mental Health Impact in Children

Children coping with relational trauma often experience a wide range of anxiety symptoms, depression, and emotional and behavioral problems. Young children might emotionally revert back to an earlier developmental stage and become clingy, emotional, or start showing behaviors like bedwetting long after they have mastered toilet training.

Left untreated, childhood trauma can lead to risk-taking, substance misuse, and self-harm or suicide.

Impact of Unresolved Relational Trauma As an Adult

Dealing with relational trauma as an adult is like living with another person's critiques and opinions in your head all the time, expecting to be let down or abandoned in every interaction. Even though that person isn't actually there, they leave an imprint that creates an ongoing conflict that is not based in reality.

Adults who are coping with relational trauma often suffer from various mental health problems, including depression, anxiety, and personality disorders. They might also struggle with substance misuse or self-harming behaviors. 

Addressing Relational Trauma Through Therapy

There are many therapeutic approaches that can address relational trauma at different points in a person's life. A therapist who specializes in attachment theory, relational trauma, or family systems can help identify and heal some of the issues that emerge from relational trauma.

Therapy Approaches for Children

  • Family therapy: Child and family therapists will want to work with the entire family to address behavioral or mental health concerns presented by a child. Concerned caregivers may notice their child is acting out and wants the tools to fix it. When relational trauma or attachment issues are involved, the concern must be addressed as a unit. The therapist will work with caregivers to understand their parenting style and work to address any dysfunction in how attachments have been developed.
  • Play therapy: This is a highly effective therapeutic approach to working through relational trauma with children. Through the use of play, a therapist builds a trusting relationship with the child and can allow them to express their emotional distress in ways in which they may not yet have the capacity to do in speech.
  • Adolescent dialectical behavior therapy (DBT): DBT is an evidence-based type of cognitive-behavioral therapy that helps children learn about their emotions and behaviors and how to manage them.

Therapy Approaches for Adults

Even though relational trauma is rooted in unhealthy childhood bonds, attending therapy as an adult can help tremendously in repairing the damage caused by caregivers. Through their support, therapists can demonstrate what healthy bonds look like and ultimately contribute to improving a person's self-worth and developing healthy relationships.

Through developing a healthy attachment in therapy, the brain learns what it feels like to have a healthier type of care-taking relationship.

Common therapeutic approaches in adults would be similar to those that help heal trauma. These include:

  • Cognitive behavioral therapy (CBT): CBT has a large evidence base to support its use in PTSD and complex PTSD. It challenges unhealthy thinking and behaviors.
  • Psychodynamic psychotherapy: This type of therapy helps you explore and better understand how your past continues to affect your current emotions and relationships.
  • Mindfulness: Mindfulness-based therapy techniques can be part of a variety of psychotherapeutic approaches. It can teach you how to be present in the here and now. This practice can help reduce feelings of overwhelm or reactivity.
  • Eye movement desensitization reprocessing (EMDR): During EMDR, the person being treated is asked to focus on distressing images and events. Their therapist then guides them through bilateral stimulation, such as side-to-side eye movement, and helps them reprocess the emotional reactions to past traumatic memories.

How Long Does Therapy Take?

Working through relational trauma can sometimes take years, and some people never completely heal from their trauma. Be patient with yourself and celebrate your progress as you do the hard work it takes to repair your relationship with yourself.

Healing After Relational Trauma

Building Trust

It will take time to build trust when coping with relational trauma. When significant trauma occurs in childhood, it changes the way we naturally see and interact with others. When you grow up with the reality that people will hurt you and cannot be trusted, that narrative doesn't easily change in adulthood.

Working with a therapist can help challenge the idea that all people cause pain and encourage slowly opening up to one person to see how it feels. This can be a long and uncomfortable process, and the help of a mental health professional can make it easier.

Intimacy

Intimacy likely won't come easy for those suffering from relational trauma. Letting people in, trusting them, and having healthy sexual relationships will probably be difficult. This can cause challenges in an intimate relationship, as it creates conflict and confusion. It might also feel uncomfortable to be with someone who is kind, warm, and caring, as this conflicts with the reality that was formed in childhood about what relationships should look and feel like.

Attending couples therapy with an intimate partner is one way to learn how to develop validation skills, healthy bonding, safety, and trust.

Parenting

Parents who provide a stable, supportive, and loving environment for children contribute to protecting that child from either developing relational trauma or having long-term mental health symptoms related to trauma. Those who suffer from relational trauma may worry that they will cause the same pain to their children.

Recovering from relational trauma is a lifelong process, and ongoing therapy can provide tools and an outlet to ensure that relationship trauma is managed in the most healthy ways.

Summary

Relational trauma forms after severe disruption in healthy attachments between a child and caregiver. Common causes of relational trauma are abuse, neglect, and other things that cause pain and suffering, like ongoing medical trauma.

When there is an unhealthy connection between adult caregivers and children, the child learns to adapt a way of coping that creates an inner dialogue of worthlessness and conflict between the true self and the imagined self. Therapy can help with providing the tools to develop self-worth, create a new healthier inner dialogue, and form healthy bonds with others.

A Word From Verywell

Coping with relational trauma may mean dealing with ongoing mental health issues and having difficulty forming trusting, meaningful relationships with others.

Though it can feel challenging, a therapist can help you restructure your thinking and behaviors and give you a path to forming healthy bonds. Therapy can also help children repair disrupted attachments and give them a way to cope and heal before they develop the effects of severe relational trauma.

Frequently Asked Questions

  • Do people in traumatic relationships ever let go of their trauma?

    The ability to heal from trauma without professional help depends on many factors, some of which include the severity of the trauma, coping mechanisms, and support systems. When trauma occurs in childhood, it becomes very difficult to heal from without professional help, because it changes the way the world is experienced.

    Those who continue to experience pain, suffering, and difficulty forming healthy relationships should seek professional help from psychotherapy experienced in dealing with the impact of relational trauma.

  • How do you find a therapist who specializes in relational trauma?

    There are many therapeutic approaches that can help heal relational trauma. For adults, finding a therapist who is an expert in helping with relationship trauma usually means the therapist has been trained in the types of interventions that are proven to heal the pain from past trauma. For children, therapists can help repair broken bonds that cause relational trauma. Family therapists can work with the whole family to restore healthy relationships.

    If you're unsure where to start, try calling your insurance company or asking your primary care provider for a referral to an appropriate mental health therapist.

  • Are PTSD and relational trauma the same thing?

    Although they share similar features, relational trauma and PTSD are not the same thing. Someone with relational trauma can be diagnosed with PTSD, but there isn't a diagnosis in the current DSM-5 for relational trauma or complex PTSD.

  • How common is relational trauma in childhood?

    According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than two thirds of children reported at least one traumatic event by the age of 16. Not all of these traumas are considered complex trauma and lead to relational trauma or other complicated mental health issues. The severity and length of the trauma, along with other factors like the number of stable adults in the child's life, impact its long-term effects.

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