Reflection II – Complex Trauma

APSY-GE 2500 Trauma: Theoretical and Clinical Perspectives

Student: Shahreyar Khan

Professor: Olivia Verhulst, LMHC, PMH-C

Institution: New York University

Date: 17h March 2025

When reading Pearlman and Courtois's (2005) Integration of Childhood Attachment and

Trauma, I cannot help but return to my childhood. The discussion of childhood abuse remains

particularly salient for me, not as a distant concept but as something that has shaped the

architecture of my psyche. I grew up in Pakistan, in a household where my parents' marriage was

fraught with conflict, volatility, and emotional unpredictability. Their relationship was a

battleground; as a child, I had no choice but to exist within its crossfire. The screaming, the

threats, the verbal abuse—these were not isolated events but recurring patterns, playing out in

enclosed spaces, inescapable and unrelenting. My parents' fights, especially during long car rides

to my grandmother's house, were so predictable in their inevitability that I learned, over time, to

brace for impact. There was no refuge. The car would stop multiple times as my mother

attempted to leave mid-journey, her distress manifesting as an external rupture in an already

fractured environment.

Despite their efforts to provide in tangible ways, the emotional climate remained

unstable, leaving us to adapt differently. My younger brother withdrew into avoidance, my sister

into disorganization, and I into fawning. Pearlman and Courtois (2005) illustrate how attachment

wounds become encoded into the very structure of a person's relational existence, shaping how

one responds to immediate threats and navigates intimacy, trust, and self-perception throughout

life. For me, caretaking became a survival mechanism to preempt conflict and earn safety. Even

now, remnants of that adaptation persist—I find myself tolerating more than I should, absorbing

distress even when it costs me, bending toward the chaos of others as though it is a gravitational

force too strong to resist. The paradox is that this ability to withstand dysregulation has also

become a clinical strength. I excel at creating a supportive environment for others and can endure
uncomfortable situations without flinching—the connection between parentified children and the

caring profession is significant. However, as Courtois (2008) warns, this same sensitivity can

lead to over-functioning, eroded boundaries, and unconsciously repeating past roles. Therapy is

not about absorbing another's pain but bearing witness without merging. It is a distinction I must

remain vigilant in maintaining.

Much of my work in therapy has involved unlearning the reflex to scan my environment

for rejection, to constantly assess whether I have offended, disappointed, or alienated someone.

That hypervigilance was not self-imposed; it was an adaptive response to an unpredictable world,

a learned necessity rather than a conscious choice. When one grows up in a chaotic, emotionally

dysregulated environment, survival often depends on anticipating the needs and moods of others

before they escalate. However, what is helpful in survival often becomes maladaptive in

relationships. The moment I step into uncertainty, my mind immediately searches for ruptures,

for small shifts in effect that signal impending rejection. It is an exhausting way to live, and

Pearlman and Courtois (2005) emphasize how early relational trauma embeds itself into the

psyche, shaping fundamental beliefs about safety, belonging, and self-worth. My attachment

wounds do not just exist in my relationships but also surface in clinical spaces, where the desire

to be effective, to be attuned, can sometimes slip into a compulsion to over-deliver.

At the intersection of this experience is the layered complexity of being autistic, bisexual,

and existing outside normative frameworks of social belonging. I have spent much of my life

attempting to bridge the gap between myself and a world that often feels foreign, indifferent, or

impenetrable. A particular loneliness comes with inhabiting a mind that functions differently,

with experiencing attachment through a lens others do not fully understand. Being blunt,

contemplative, and deeply analytical often repels more than it attracts. Some appreciate it, but
many do not. The world does not reward those who speak plainly, who lack the social impulse to

mould themselves into something more palatable. I have learned, through experience, that

kindness is not always reciprocated and that being good to people does not ensure their goodness

in return. This realization has forced me to refine my understanding of where to invest energy,

who is worthy of care, and how to differentiate between relationships that nourish versus those

that extract.

In therapy, this has translated into a shift from seeking to be liked to seeking to be

respected. Respect is rooted in integrity, self-awareness, and consistency, whereas likability is an

external, unstable variable dictated by subjective perception. This distinction is critical, mainly

when working with clients who grapple with attachment wounds and people-pleasing tendencies.

Many equate self-worth with external validation, believing rejection is an indictment of their

inherent value. Therapy becomes an opportunity to deconstruct this illusion to help clients

recognize that self-worth is neither transactional nor contingent upon approval.

The risk, however, lies in countertransference, particularly with clients who mirror my

own past experiences. I must remain conscious of my tendency to over-identify with highly

dysregulated clients, to feel an almost gravitational pull toward their chaos. I must ensure that I

do not unconsciously reenact old attachment dynamics by tolerating too much, offering too

much, or extending beyond what is therapeutically appropriate. Likewise, I must also examine

my impatience or disengagement with clients who are more rigid, avoidant, or emotionally

distant. If a client is overly detached, do I lose interest more quickly, subconsciously dismissing

them as unengaged or emotionally stagnant? Therapy is not just about holding space for those

whose wounds mirror my own but about expanding my capacity to sit with experiences that are

unfamiliar or even antithetical to my history.

Trauma healing is not about forcing integration but allowing the self to exist in contradiction,

holding both fragmentation and cohesion without forcing resolution. In my work, I have been

learning to tolerate the discomfort of non-linearity to relinquish the belief that healing is a

destination rather than an ongoing process. In doing so, I also extend that same permission to my

clients. Many come to therapy expecting wholeness to be something they achieve, a final

endpoint indicating they have arrived at stability. However, healing is not about eliminating

wounds but developing the capacity to carry them differently. Just as Ian McGilchrist's

hemispheric model suggests that the right hemisphere is designed to hold ambiguity while the

left seeks order, the therapeutic process must balance fluidity with structure, movement

(McGilchrist, 2009) with meaning, and contradiction with coherence.

This realization—that there is no endpoint, only motion—has reframed how I see myself

and my work. Therapy is not about guiding clients toward a singular truth but helping them

private through selfhood's shifting, evolving terrain. Suppose trauma is a layered configuration

composed of genetic, epigenetic and environmental sediments. In that case, healing is not about

returning to some imagined original form but about learning to exist within those layers without

the compulsion to resolve them. The loss of fixed unchanging coherence is not the loss of self. It

is simply an invitation to reimagine what wholeness means. In a universe of perpetual motion,

there are no actual objects, only events that our minds perceive as distinct and bounded.

Ultimately, there is only time; we are only time. We are not particles but waves in motion. We

embody wholeness in motion. These insights do not exist in isolation. They actively shape how I

engage with clients, regulate my presence in the room, and navigate the inevitable complexities

of countertransference.
 What remains crucial is the commitment to self-examination, to recognizing where my

past informs my work in ways that serve rather than hinder, and to ensure that my presence in the

therapeutic space is an offering rather than a reenactment. Therapy does not require me to be

fully healed, but it does require me to be self-aware enough to know when my wounds are

speaking and when I need to step back and listen instead.

Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment.

Psychotherapy: Theory, Research, Practice, Training, 41(4), 412–425.

McGilchrist, I. (2009). The master and his emissary: The divided brain and the making of the

Western world. Yale University Press.

Pearlman, L. A., & Courtois, C. A. (2005). Integration of childhood attachment and trauma in

adult psychotherapy: A relational self psychology perspective. Psychoanalytic

Psychology, 22(3), 406–431.