What is Trauma?
Trauma usually follows a distressing or life-threatening event, which impacts on an individual’s mental and emotional stability. Trauma is a normal reaction to an extraordinary event and people often experience shock or denial which can fade naturally with time. A person may undergo a range of emotional reactions, such as fear, anger, guilt, shame, feelings of helplessness and vulnerability. In these cases, help may be needed to overcome the stress and dysfunction caused by the traumatic event and to restore the individual to a state of emotional well-being. They may have ongoing problems with sleep or physical pain, trouble with their personal and professional relationships, and issues with low self-esteem. For those who have existing mental health problems, events like these could trigger them or make them harder to deal with.
While many sources of trauma are physically violent in nature, others are psychological. Some common sources of trauma include:
- Violent attacks, such as sexual assault, mugging or robbery
- Domestic violence
- Natural disasters
- Severe illness or injury e.g. from a road accident
- The death of a loved one
- Witnessing an act of violence
- Traumatic birth
- Childhood abuse
PTSD and complex PTSD
Post-Traumatic Stress Disorder (PTSD) can occur following a severely traumatic incident, or a series of less severe incidents. The main symptoms of PTSD (not an exhaustive list) are listed here:
- Reliving the traumatic event through flashbacks, intrusive thoughts or nightmares.
- Physical sensations such as pain, sweating, nausea or trembling
- Constantly feeling on edge and alert, experiencing high anxiety, irritability, finding it hard to concentrate or panic attacks.
- Avoiding feelings or memories of the event through keeping busy or avoiding talking about the event or doing anything that reminds you of the trauma.
- This may also lead to using substances to numb the feelings, such as substance misuse.
- Not being able to remember the event, through dissociation or feeling physically or emotionally numb.
The symptoms of PTSD can be extremely difficult to deal with and the effects can become so severe that they interfere with an individual’s ability to live a normal life. It can be hard to maintain relationships, to work, enjoy leisure time, carrying out simple everyday tasks, remembering things and making decisions. Sometimes it can go unnoticed and this highlights the importance of talking to someone after a traumatic event has occurred, even if no initial signs of disturbance are shown. Trauma can manifest days, months or even years after the actual event.
Complex PTSD can be experienced as a result of repeated childhood traumas and is often more severe if the trauma was experienced early in life as this can affect a child’s development. Complex PTSD can cause similar symptoms to PTSD and may not develop until years after the event. Additional symptoms may be difficult beliefs or feelings: feeling like you can’t trust anyone, feeling like nowhere is safe, feeling like nobody understands, blaming yourself for what happened, overwhelming feelings of anger, sadness, guilt or shame.
Why does PTSD occur?
PTSD develops because the trauma experience was so distressing that we want to avoid any reminder of it. Our brains don’t process the experience into a memory, so the experience becomes ‘stuck’ as a current problem instead of becoming a memory of a past event. Each time we are reminded of the event (i.e. people, places or smells), the ‘flashbacks’ mean we experience the trauma again, as though it is happening again, right now. A flashback is a vivid experience which can sometimes be like watching a video of what happened; noticing sounds, smells, physical sensations or tastes connected to the trauma; experiencing emotions that you felt during the trauma. It can last for just a few seconds or continue for several hours. As this is very distressing, we do our utmost to stop the flashback, and avoid any further reminder of the event, so the event remains un-processed. We try to avoid all the situations, people, places and even thoughts, which are likely to distress us. This avoidance helps prevent us becoming distressed in the short-term, but it is one of the main factors which keep the problem going over a long time. Avoidance also interferes greatly with our everyday lives as our lives become very restricted. Because we become upset and avoid thinking about the trauma, the brain has not been able to process and file the memory away, so any trigger tricks the brain into thinking the event is happening again, right now, and we re-experience all the feelings and sensations as though it really was happening right now.
Why does PTSD have physical effects?
When we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat. Research has shown that someone with PTSD will continue producing these hormones when they’re no longer in danger, which is thought to explain some reported physical symptoms such as extreme alertness, being easily startled, fatigue, poor concentration, racing heartbeat, sweating etc. Unfortunately, it is not uncommon for victims of trauma to turn to drugs as a means of self-medicating and coping with its effects and this may turn into an addiction. Depression and anxiety are also commonly associated with PTSD.
Treatment of PTSD and trauma
Trauma-focused Cognitive Behaviour Therapy can help you to identify the factors that help keep the PTSD going. It can also teach our brain to process the traumatic event into a memory, filing it away in the appropriate part of the brain, so that it becomes a past event, rather than constantly reliving the trauma as happening right now. Our experienced therapists at Therapy Central will help you to think about or imagine the traumatic event in a safe, non-judgemental environment, and we can begin to gradually expose you to those situations that trigger a reminder of the event. Inevitably, thinking and talking about the trauma may be upsetting at the time, but it will reduce the overall distress and encourage resolution of the problem. We also acknowledge that trauma-focused work is not for everyone and every effort will be made to create an environment where you can control what direction the therapy takes. This could involve talking about and managing the depression and anxiety you may be experiencing as a result of the traumatic experience.