Complex Trauma may be caused by interpersonal stressors that are systematic and premediated and its effects may be cumulative, severe and long-lasting. Instead of a single traumatic incident, the victim experiences a process of traumatization that may produce feelings of helplessness, powerlessness and loss of control. Actual physical violence may be episodic or infrequent but compounded by other, less visible, forms of abuse.
In many cases, this form of victimization occurs routinely but may also be episodic or may escalate over time. In any case, the victim often does not