Complex trauma in war veterans

Unfortunately, post-traumatic stress disorder and complex trauma were not yet discovered and described when Europe was full of traumatized people after World War II. Many still know the stories of fathers and grandfathers who came back from war and never again became the happy, loving people their families knew them to be. Even today people experience complex trauma during war. We describe here how these look and can be treated in the meantime.

What is Complex Trauma?

Complex trauma can arise when a person is exposed to persistent psychological stress from persistent experiences of violence, serious injuries or a particularly drastic confrontation with death. These experiences of extraordinary threat cannot, of course, only take place in war situations. Other events can also lead to complex trauma. Examples could be political imprisonment or repeated sexual violence and child abuse.

Affected people have symptoms such as reverberation memories in which they relive the trauma in the here and now and are often haunted by the stressful memories in their dreams. In situations that resemble or are related to the stress, they get into inner distress and often try to avoid such situations at all costs. This is often accompanied by social withdrawal and dysfunctional relationships.

In contrast to the better known post-traumatic stress disorder, the traumatizing situation in a complex trauma lasts for a longer period of time. The resulting symptoms are also different.

Complex traumas in war situations

If you look at the development of complex traumas, it quickly becomes clear that they can arise especially in crisis situations with their extreme stress. In this context, complex trauma was also examined for the first time. Among other things, the work with war returnees from the world wars and Vietnam war veterans led to the original development of the concept.

Until then, complex trauma had been dismissed as weakness or “pension neurosis” and those affected were referred to as “war tremors”. It was not until 1980 that post-traumatic stress disorder was recognized as a diagnosis, followed by complex trauma.

Situations in wars in which complex trauma can arise include captivity and hostage, torture, escape and repeated (sexual) violence. Not only those who have experienced violence can suffer trauma in these situations. Those who use violence (often under duress) can also develop trauma. People who are neither involved as victims nor as violent perpetrators but witnessed the violence can also develop indirect trauma.

People with complex trauma

It is estimated that 5-10% of the population suffer from post-traumatic stress disorder or complex trauma. So it is not so unlikely that you have someone in your family or circle of acquaintances who is struggling with it. Although war trauma is widely viewed as a male disease, studies have shown that women in similar situations are twice as likely to develop complex trauma.

Although we often have stereotypes from US films and series in mind when it comes to this topic, many people in Germany also suffer from complex trauma. In addition to soldiers from the German Armed Forces, who fortunately often receive psychological support during and after their war missions, this can primarily be people who have fled their homes. Because of their situation, lack of information and the language barrier in the country of arrival, these people unfortunately often receive far too little support in dealing with their trauma.

Research has shown that understanding and support from the environment are of great importance in complex trauma. Treatment with methods of trauma-specific psychotherapy can also help those affected.


Hecker & Maercker: Complex post-traumatic stress disorder according to ICD-11 . (2015).

Roestel & Kersting: Simple and Complex Post-Traumatic Stress Disorders. (2008).