August 18, 2017

Trauma

“Expecting life to treat you well because you are a good person

is like expecting an angry bull not to charge because you are a vegetarian.”

~ Shari R. Barr


Psychologist NH | Treatment for TraumaTraumas are unexpected, unpreventable events for which the person experiencing them is unprepared. It is not so much the event that determines whether something is traumatic to someone, but the person’s experience of the event.

Trauma associated with Posttraumatic Stress Disorder (PTSD) that I have had extensive experience treating include life-threatening medical conditions, physical/sexual abuse, childhood/adult abuse, and accidents, with or without co-morbid substance abuse.

Trauma differs from stress in that trauma is stress run amuck. Stress disregulates our nervous systems – but for only a relatively short period of time. Within a few days or weeks, our nervous systems calm down and we revert to a normal state of equilibrium. This return to normalcy is not the case when we have been traumatized. One way to tell the difference between stress and trauma is by looking at the outcome – how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing how quickly upset is triggered, how frequently upset is triggered, how intensely threatening the source of upset is, how long upset lasts, and how long it takes to calm down.

Psychological trauma can result from events long-recognized as traumatic, including:

  • Natural disasters (earthquakes, fires, floods, hurricanes, etc.)
  • Man-made disasters (plane crashes, forest fires, bridge/mine collapses, train derailments, etc)
  • War/terrorist incidents
  • Physical assault, including rape, incest, molestation, domestic abuse
  • Serious bodily harm
  • Serious accidents such as automobile or other high-impact scenarios
  • Experiencing or witnessing horrific injury, carnage or fatalities
  • Falls or work/sports injuries
  • Surgery, particularly emergency
  • Serious, life-threatening illness
  • Hearing about violence to or sudden death of someone close
  • Military combat

It is acknowledged that early life trauma creates a vulnerability for experiencing future traumatic responses.

There is no clear explanation as to why some people experience post-traumatic stress reactions and others do not, but it is likely that one or more of these factors are involved:

  • Severity of the event
  • Individual’s personal history
  • Larger meaning the event represents for the individual (which may not be immediately evident)
  • Coping skills, values and beliefs held by the individual (some of which may have never been identified)
  • Reactions and support from family, friends, and/or professionals

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop PTSD symptoms. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

There are common effects or conditions that may occur following any traumatic event. Sometimes these responses can be delayed for months or even years after the event. Often, people do not even initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

Physical

  • Eating disturbances (more or less than usual)
  • Sleep disturbances (more or less than usual)
  • Sexual dysfunction
  • Low energy
  • Chronic, unexplained pain

Emotional

  • Depression, spontaneous crying, despair and hopelessness
  • Anxiety
  • Panic attacks
  • Fearfulness
  • Compulsive and obsessive behaviors
  • Feeling out of control
  • Irritability, angry and resentment
  • Emotional numbness
  • Withdrawal from normal routine and relationships

Cognitive

  • Memory lapses, especially about the trauma
  • Difficulty making decisions
  • Decreased ability to concentrate
  • Feeling distracted
  • ADHD symptoms

The following symptoms of trauma experiences are commonly associated with a severe precipitating event, such as a natural disaster, exposure to war, rape, assault, violent crime, major car or airplane crashes, or child abuse. These symptoms, diagnostic of PTSD, are characterized into three primary categories: re-experiencing, avoidance/numbing, and hyper-arousal.

Re-experiencing symptoms

  • Intrusive memories of the traumatic event
  • Bad dreams/nightmares about the traumatic event
  • Flashbacks or a sense of reliving the event
  • Feelings of intense distress when reminded of the trauma
  • Physiological stress response to reminders of the event (pounding heart, rapid breathing, nausea, muscle tension, sweating)

Avoidance/numbing symptoms

  • Avoiding thoughts, feelings, or conversations associated with the trauma
  • Avoiding activities, places, or people that remind you of the trauma
  • Inability to remember important aspects of the trauma
  • Loss of interest in activities and life in general
  • Feeling detached or estranged from other people
  • Feeling emotionally numb, especially toward loved ones
  • Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Hyper-arousal symptoms

  • Difficulty falling or staying asleep
  • Irritability or outbursts of anger
  • Difficulty concentrating
  • Hypervigilance, or being constantly “on guard”
  • An exaggerated startle response, or jumpiness

The following effects of trauma experiences are commonly associated with a severe precipitating event. While not diagnostic of PTSD, these effects are often co-occuring with PTSD.

Common personal and behavioral effects of emotional trauma:

  • Substance abuse
  • Compulsive behavior patterns
  • Self-destructive and impulsive behavior
  • Uncontrollable reactive thoughts
  • Inability to make healthy professional or lifestyle choices
  • Dissociative symptoms (“splitting off” parts of the self)
  • Feelings of ineffectiveness, shame, despair, hopelessness
  • Feeling permanently damaged
  • A loss of previously sustained beliefs

Common effects of emotional trauma on interpersonal relationships:

  • Inability to maintain close relationships or choose appropriate friends and mates
  • Sexual problems
  • Hostility
  • Arguments with family members, employers or co-workers
  • Social withdrawal
  • Feeling constantly threatened

The following information has been provided with the kind permission of the National Center for PTSD (www.ncptsd.va.gov), HelpGuide.org (www.helpguide.org) and HealingResources.info (www.healingresources.info).

If you are having difficulty after experiencing a trauma, with or without PTSD symptoms, call me to see if I can help at 603-448-3588. You may also e-mail me at Karen@Psychologist-NH.com.