When someone talks about “trauma” and “Post-Traumatic Stress Disorder (PTSD),” what comes to mind? You may envision a battlefield full of brave soldiers or a young lady who was raped in the past. But what truly is trauma, and exactly what does it look like?
Unfortunately, the world around us is full of trauma. The World Health Organization (WHO) conducted a survey that showed 70.4 percent of respondents reported they had experienced some type of trauma in their past (Keller, et al., 2017). Many times, though, PTSD did not develop after trauma. PTSD was mostly associated with interpersonal trauma such as a loved one dying or a sexual assault.
What constitutes trauma? According to Merriam-Webster, trauma is “(a) “an injury…”, (b) “a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury,” or (c) “an emotional upset.”
Most of the time, people who think about trauma imagine situations like sexual assault, physical abuse, near-death experiences, or trauma experienced during war. However, many other things can cause trauma reactions.
Examples include medical conditions and surgeries, divorces and breakups, abandonment, a major life change, and neglect. The emotions that come with trauma can be overpowering and tend to affect someone’s relational, career, and spiritual functioning.
The U.S. Department of Veterans Affairs released a report in 2015 that indicated some common symptoms people who have experienced trauma exhibit are:
- Feeling disconnected
- Jittery and easily startled
- Terror and anxiety
- Problems with concentration and decision making
- Insomnia and Nightmares
- Rapid heartbeat
- Agitation and mood swings
- Loss of appetite
- A headache or stomach ache
Post-Traumatic Stress Disorder (PTSD)
After experiencing trauma, some people develop PTSD. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders indicates that PTSD can be subsequent to a threat or experience of severe physical harm or some form of sexual trauma (American Psychiatric Association, 2013). Of course, these situations can be experienced directly, but they can also be witnessed, learned of, or experienced second hand in the case of first responders and people in similar professions.
It is common for people to experience disturbing dreams and vivid memories that make them feel like the situation is happening again, and this can cause a lot of distressing reactions including physical, emotional, and cognitive reactions. Also, people with PTSD oftentimes tend to avoid environments that will remind them of the trauma they experienced.
It is widely known that PTSD is a consequence that follows trauma, but it there are other diagnoses associated with various kinds of trauma (Scheeringa, Zeanah, Myers, & Putnam, 2003).
One study found that the most widely reported diagnoses as a result of trauma were oppositional defiant disorder, attention-deficit/hyperactivity disorder, separation anxiety disorder, PTSD, and phobic disorders (Ackerman, Newton, McPherson, Jones, & Dykman, 1998).
Another study conducted by van der Kolk in 2005 found that trauma in early childhood leads to issues with the regulation of emotion and that childhood trauma disrupts the mechanisms our brains use for attachment.
Trauma is considered complex if there are more than one traumatic event and the effects of these build after each one over time (van der Kolk, 2005; Courtiois, 2008). This type of trauma typically occurs during childhood and manifests in an interpersonal context. Experiences such as childhood sexual abuse, chronic neglect, and maltreatment are some types of trauma that cause complex trauma.
A widely referenced study is the adverse childhood experiences (ACE) study done in collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente.
ACEs in the study included: domestic violence, living with someone who was mentally ill or abused drugs, a caregiver or parent in prison, separation between a child and his or her parent or caregiver, neglect, and childhood abuse (including physical, emotional, and sexual abuse).
The study identified a remarkable relationship between ACEs and a higher risk of negative factors including depression, substance abuse, suicide attempts, cigarette smoking, obesity, and sexual deviancy.
In addition to the above factors, an increase in ACEs also correlated with a higher association of negative effects. The study concluded that being exposed to adverse experiences throughout childhood was highly associated with an increased risk of death from common causes such as cancer and liver disease.
When children experience complex trauma, it can lead to development issues, which includes brain development. As one researcher put it, “the brain-based stress response systems of these children appear to become permanently changed as they focus attention on the need to ensure safety rather than on the many growth-promoting interests and activities that secure children find attractive and stimulating” (Bessel van der Kolk, 2005).
An additional trauma researcher noted that when children experience trauma, the arousal level peaks all of the time versus only in situations when there is a real threat (Bruce Perry, 2006).
An important thing to note is that hyperarousal does not only affect children, so adults can experience it too. One study showed that 5 years after September 11, people who were present in the area during the event continued to have overactivity in their arousal system that activates during a threat (Ganzel et al., 2007).
Finding Healing After Trauma
It is crucial to maintain patience when someone is going through the healing process after trauma. When you or someone you love has been through trauma, effective coping methods are available. Bath (2008) described “three pillars,” which refer to areas in need of attention after someone has experienced trauma. The pillars include “safety, connections, and managing emotions.”
Having a safe place is vital for people who have been traumatized. Of course, physical safety is important, but individuals who have been traumatized must also have a safe space where they can process the traumatic experience and express their emotions. Creating this safe environment is sometimes difficult, especially if the perpetrator was a trusted person or a caregiver.
Bath (2008) indicated that two important parts of creating safety in regard to a child include ensuring the child feels like he or she is in control of decision making as well as ensuring there’s consistency in the child’s life.
Traumatic experiences oftentimes cause the victims to prefer isolation, but this is usually not a conducive environment if someone is trying to heal emotionally. Instead, isolation leads to an increase in depression as well as loneliness.
Of course, many people who are healing from trauma do not want to talk about it; however, this is crucial and the event must be talked about whenever the person is ready. Sharing details about the event helps people heal and develop coherent narratives of the situations.
You may also be able to find a support group that addresses your particular experience with trauma.
In addition to finding a safe environment and building solid relationships with others, we can also learn to manage our emotions better. Examples include, but are not limited to:
- Breathing Techniques: Anxiety typically causes us to breathe more shallow than normal. This causes us to take in a decreased amount of oxygen and an increased amount of carbon dioxide. Anxiety symptoms worsen with this combination.
We have all heard the phrase, “take some deep breaths.” This is worth a try. There is a wide variety of breathing exercises as well as smartphone applications that can guide you through various breathing exercises. You should find whatever works best for you.
- Mindfulness: Taking control of your thoughts instead of letting them control you is very beneficial. Daniel Siegel is a clinical professor of psychiatry at UCLA and has written several works regarding practicing mindfulness.
- Relaxation: When our bodies are hyperaroused, there is an increase of cortisol in them. It has been shown that if cortisol levels are high, people experience negative health effects. Activities like muscle relaxation, yoga, or stretching can also be good for you in addition to breathing exercises.
- Sleep: Sleep is crucial to everyone, so trying to get enough sleep is very important
- Eating Health
- Physical activity is beneficial as long as your doctor approves it.
- Keeping a journal: It can help to express your feelings on paper instead of keeping them inside.
- Managing stress: If you need to, take time off. If you ask other people to help you with your responsibilities, most people are receptive and glad to help.
- Grounding: When you are feeling out of touch with your surroundings or yourself, be aware of your feet touching the ground, view your surroundings, and tell yourself where you’re standing.
- Avoid alcohol or any other illicit substances in the attempt to numb your emotions or try to escape. Consuming these substances does not actually let you process trauma. Also, they can result in unfavorable mood states, such as anxiety and deep depression.
Of course, it takes time to heal, and highs and lows should be expected. One day might be very good, and the next day you might feel really weak. Anniversaries of trauma and other triggers can cause negative feelings, but they are an opportunity for growth and continued healing.
Over time, most people who experienced trauma are able to heal without seeking professional help. Nonetheless, sometimes symptoms can be overwhelming and start interfering with a person’s life. Also, suicidal and sometimes homicidal feelings may be present. If you are experiencing any of these symptoms, look for a professional who can help you heal.
Effective Treatment Methods to Help You Heal from Trauma
There are many effective treatments that people who have experienced trauma can use to heal. These approaches include EMDR as well as cognitive behavioral therapy that focuses on trauma.
Eye Movement Desensitization and Reprocessing (EMDR)
Francine Shapiro (2012) indicated that the logic behind EMDR comes from the fact that memories are sometimes stored in an unprocessed and non-adaptive state. This can be caused by a high level of stress during the trauma, the decrease developmental capacity needed to process a traumatic experience, or any other situation preventing a person from processing the trauma in a healthy manner.
Memories become stored in the original state, which includes the images, thoughts, body sensations, and feelings that the person experienced during the trauma.
Research, including research from the EMDR Research Foundation, has found that using bilateral stimulation such as eye movement patterns, auditory stimulation, and tapping, can help memories become unstuck, which can allow them to be reprocessed into the adaptive memory. This treatment method has also been deemed an empirically valid method of treatment for people with PTSD.
EMDR uses protocols regarding recent events that are typically used if the traumatic experience happened more recently, ranging from one day to a couple months. These different protocols are used because it requires time for a person’s memory to consolidate. The exact time frame is highly debated, but it is believed to be either 3 months or 6 months.
Trauma-Focused Cognitive-Behavior Therapy (TF-CBT)
TF-CBT works to help someone who has experienced trauma process emotions and thoughts that he or she associates with the experience. Some components are emotion regulation, relaxation training, bringing out the thoughts about the trauma, as well as creating an in-depth narrative of whatever the person experienced.
Individual, couples, group, or family psychotherapy can all be beneficial. Also, a referral to a doctor or a full medical evaluation may be necessary.
Help exists for anyone struggling to get through traumatic experiences. Lasting healing can be achieved with the help of a counselor who understands the effects of trauma and can be with you while you work on healing and personal growth.
“16 Years”, Courtesy of Aidan Bartos, Unsplash.com; CC0 License; “Not in Public,” courtesy of Ezra Jeffrey, unsplash.com, Public Domain License; “Sad,” courtesy of Avenue G, Flickr Creative Commons; “Hair,” courtesy of Aricka Lewis, unsplash.com, Public Domain License