In general terms, trauma is defined as a response to an event or ongoing conditions that are deeply distressing, painful or disturbing. It is a mental health issue and can occur as a result of either witnessing or directly experiencing such events.
Any situation that is perceived by our nervous system to be life-threatening – to ourselves or others – can make us feel overwhelmed and isolated. When our ability to process our emotional experience is overpowered by the stressful situation, our capacity to cope becomes diminished. This can result in trauma, even if it doesn’t cause us any physical harm.
It is not the circumstances that determine whether an event is traumatic, but our emotional experience of the event. A traumatic experience is capable of shocking and affecting all our systems – mental, physical, emotional and spiritual.
There are no objective criteria to assess which situations will trigger trauma in any individual, but typically the experience will involve a loss of control, betrayal, abuse of power, fear, helplessness, pain, confusion and/or loss. The situation may occur just once, or be repeated and ongoing – and can be categorised as Big T Trauma or Little t Trauma:
Big T Trauma examples
Little t Trauma examples
childhood abuse / neglect
losing a job
life threatening illness / medical intervention
moving home
physical, emotional or sexual abuse
being harassed or bullied
sudden loss of a loved one
divorce
witnessing acts of violence
financial or legal worries
serious accidents
being threatened or ignored
war and other forms of violence
conflicts at work
natural disasters
conflict with family members
The experience does not need to be a Big T Trauma – such as war, natural disaster, or personal assault – to affect us profoundly. It is very subjective and important to remember that trauma is defined more by our individual response than by the trigger. We all have unique capacities to handle stress, known as resilience, which impacts our ability to cope with trauma. Everyone will respond and be affected differently.
While traumatic events can happen to anyone, we’re more likely to be traumatised by them if we have recently suffered a series of losses, are already under a lot of stress, or have been traumatised before, especially if the previous trauma occurred in childhood.
Trauma is often a direct cause of mental health problems or can make us more vulnerable to developing them. It is a risk factor in nearly all behavioural health and substance use disorders.
There is also a direct correlation between trauma and some physical health conditions, such as COPD, heart disease, cancer, diabetes and high blood pressure.
Emotional trauma is a normal response to a disturbing event, and recovery takes time. However, if months have passed and our symptoms are persisting and interfering with daily functioning, we may be suffering from PTSD. PTSD develops when our nervous system gets ‘stuck’, and we remain in psychological shock, unable to make sense of what happened or effectively process our emotions. It is important to seek professional help to integrate the trauma and restore us to a state of emotional wellbeing.
What are the Different Types of Trauma?
Trauma has no boundaries and can affect anyone, regardless of age, race, or gender. Most people will experience at least one traumatic event in their life at some time. However, not all trauma responses will be the same:
Acute trauma: is usually associated with a one-time, stressful or dangerous event, such as a car accident, natural disaster, single event of abuse or assault, or witnessing a violent event. These experiences can have a lasting negative impact on our lives if symptoms are left untreated.
Chronic trauma: results from exposure to multiple, repeated and prolonged stressful events. Examples include childhood abuse, bullying, exposure to war or combat situations, and domestic violence. Symptoms may not rise to the surface for an extended period of time – sometimes even years after the events. Chronic trauma can also be a result of several acute traumas happening one after the other. Like acute trauma, if left unresolved, chronic trauma can have long-term negative effects on our quality of life.
Complex trauma: results from exposure to multiple and varied traumatic events or experiences. The experiences or events are recurring, extended and cumulative and often happen within specific contexts, such as an interpersonal relationship. Forms of complex trauma can happen during domestic abuse, community violence, multiple military deployments, exploitation by an authority figure or a person in power and all forms of child abuse. Unresolved complex trauma can have a lasting negative influence on our lives if symptoms remain untreated.
Other types of trauma, that fall under these three main categories, include:
Collective trauma: this is a trauma that affects a whole community or country, for example, acts of war, natural disaster, forced displacement and acts of terrorism.
Secondary trauma: also known as vicarious trauma, is when a person develops trauma symptoms from having close contact with a person who has been directly affected by a traumatic event. Family members, mental health professionals, and others who care for those who have experienced a traumatic event are at risk of vicarious trauma. The symptoms often mirror those of PTSD.
PTSD: this can develop when the symptoms of trauma persist or get worse in the weeks and months after the stressful event and seriously affect our ability to function. It occurs when our nervous system remains on high alert after the trauma, in order to protect against further harm. Our alert systems respond to reminders of the traumatic memories as a threat, and additional triggers may be added to a growing list of stressors. PTSD is distressing and negatively impacts our daily life and relationships. Symptoms can escalate into panic attacks, feelings of isolation, depression, suicidal thoughts and feelings, and an inability to complete basic daily tasks. PTSD may last for many years, but effective treatments are available to help us to manage symptoms and improve our quality of life. The majority of people who experience a traumatic event will not develop PTSD.
Developmental trauma: this occurs during a child’s first three years of life, as the result of abuse, neglect and / or abandonment. When stress responses are repeatedly activated over an extended period in children, they disrupt normal sequences of brain development. As a result, other aspects of development such as emotional, physical, cognitive, and social are also impacted. Experiencing trauma in childhood can result in severe and long-lasting effects. Unresolved developmental trauma can manifest in many ways. The most common mental health diagnoses that emerge are bipolar disorder, personality disorders, depression, anxiety, eating disorders, PTSD and ADHD.
What Factors Determine How Trauma Affects Us?
Similar levels of exposure to traumatic events will affect individuals in different ways – some will exhibit resilient responses and continue life without any major disruption, whereas others will be significantly affected, emotionally, mentally and physically.
Many factors determine how a traumatic event will affect us and how we will respond, including:
our personality / characteristics
the presence of other mental health conditions
previous exposure to traumatic events
the type and characteristics of the event(s)
our background and approach to handling emotions
the level of other stressors or worries at the time (or later on)
being harmed by people close to us
whether we receive help or support.
What are the Signs / Symptoms of Trauma?
The symptoms of trauma range from mild to severe. They can also be short-lived or persist over several days / weeks / months. Symptoms typically fall into three general categories: physical, emotional and psychological, and behavioural:
Physical
muscles soreness, including headaches, aches and pains and general tension
digestive symptoms, including nausea, constipation or diarrhoea
altered sleep patterns and fatigue issues
sweating and / or heart palpitations
weakened immune system – more susceptible to colds and illnesses.
disruptions to usual routines, including sleep patterns, appetite and libido
excessive startle reflex, in response to noises, images or unexpected touch
erratic or hostile responses, such as outbursts of excessive anger or rage
increased isolation – feelings of detachment and / or hopelessness
difficulties in relationships due to low self-esteem and / or lack of trust
diminished interest in / avoidance of everyday activities usually enjoyed
increased use of certain substances, to self-medicate symptoms.
How can Trauma be Treated?
Cognitive Behaviour Therapy (CBT), which teaches us to be more aware of our thoughts and beliefs about the trauma, and helps us to develop skills so we can react to emotional triggers in healthier ways. Evidence supports CBT as the most effective approach for many trauma types, including PTSD.
Exposure therapy (In Vivo Exposure Therapy), which is a form of cognitive behaviour therapy that can be used to reduce the fear associated with emotional triggers caused by trauma.
EMDR (Eye Movement Desensitisation and Reprocessing) incorporates elements of Cognitive Behaviour Therapy with eye movements or other forms of rhythmic, left-right stimulation that desensitise us and help us to reprocess and integrate memories and events. Several randomised controlled trials have demonstrated that EMDR is an effective treatment for many types of trauma, including PTSD.
Somatic techniques. Some studies have shown that trauma imprints can be stored as physical movements and feelings in our bodies – not just as mental narratives about the traumatic events – which means that we can experience them as immediate threats in the present time. Some therapists, therefore, use somatic or body-based techniques, which can help the mind and body process and integrate trauma.
Medications. Medication alone cannot cure trauma or PTSD, but it can be used to reduce many of the challenging symptoms that accompany it, such as anxiety, depression and sleep disturbances. Once we are able to control our symptoms, it becomes possible to participate more effectively in other therapies and interventions.
Trauma Treatment at White River Manor
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