Trauma results from extraordinarily stressful events that overwhelm a person’s ability to cope. It is not necessarily the event itself that defines trauma, but rather the individual’s subjective experience of it. The more overwhelming the feelings of endangerment, threat to personal integrity, and helplessness that one experiences, the more likely it is that a traumatic reaction may occur. Furthermore, physical injury does not need to take place. In fact, any event that leaves someone feeling alone and helpless, such as witnessing another person’s trauma, can be traumatizing.
Estimates are that between 55% and 70% of people will experience at least one traumatic event in their lifetime. These can be one-time incidents, such as car accidents, fires, natural disasters, crimes, the break-up of a significant relationship, accidental losses of loved-ones, or they can be prolonged, repeated experiences, such as child abuse, neglect, or battering relationships.
Initial reactions to trauma may include some or all of the following:
- denial or disbelief
- mood swings or irritability
- self-blame or guilt
- sadness or hopelessness
- confusion, difficulty concentrating,
- withdrawal from people and normal activities
- nightmares or recurrent images
- tension, irritability,
- being easily startled
These are normal reactions to abnormal events, but can seem confusing and upsetting. Taking care of yourself during this time can be helpful.
- don’t isolate; participate in social activities
- ask for help when you need it
- avoid using alcohol and drugs. These may worsen feelings of anxiety and depression, and may further isolate you
- get plenty of sleep
- eat well - small, well-balanced meals frequently throughout the day
- exercise regularly, and try to maintain daily routines
People heal at their own pace. For some, symptoms may improve in a few weeks. If, however after several months, symptoms persist without improvement, and interfere with normal functioning at home or at work, you may be experiencing Post Traumatic Stress Disorder (PTSD). This is often the case with prolonged traumas, such as those deliberately perpetrated by others. Interpersonal traumas generally create more injury than one-time incidents, particularly where the victim has been dependent on the perpetrator, and has therefore, been helpless (e.g. parent-child relationships).
Survivors of such trauma often struggle with some or all of the following:
Re-experiencing symptoms –
- recurrent nightmares or distressing dreams of the trauma
- recurrent, unwanted, intrusive memories of the trauma
- flashbacks (a sense of re-living the trauma)
- intense emotional distress when reminded of the trauma (e.g. extreme anxiety)
- intense bodily reactions (e.g. sweating, heart racing or pounding).
Avoidance or numbing symptoms –
- avoidance of people, places, or things that are reminders of the trauma
- avoidance of thinking or talking about the trauma
- inability to recall important aspects of the trauma
- diminished interest in previously enjoyed activities
- emotional detachment from others
- difficulty establishing trusting relationships with others
- restricted range of feelings (e.g. love, joy)
- sense of foreshortened life
Hyper-arousal symptoms –
- sleep disturbances - difficulty falling or staying asleep
- impaired concentration
- irritability or intense anger
- pervasive sense of danger - always on guard
- exaggerated startle response - easily startled, jumpy
Alcohol or drugs may be used as an escape from the pain, confusion, and isolation that may ensue from trauma, but may ultimately exacerbate the situation. Thoughts of suicide are not uncommon, when life feels hopeless. If you believe that you or someone you care about may be struggling with suicidal thoughts, it is extremely important to consult with your physician, or a qualified mental health professional.
Help is available for trauma survivors. In fact, a number of therapies have been proven helpful.
Cognitive Behavioural Therapy (CBT) has different elements that can be effective.
- Exposure therapy involves exposure to the thoughts, feelings and reminders of the trauma, to enable trauma survivors to face their fear, and gain mastery over it. Exposure is done in a gradual and safe way, and may involve mental imagery, writing, or visits to the site of the traumatic incident.
- Cognitive restructuring. People often remember things in ways that may not accurately reflect what happened. As a result, they may experience painful feelings of guilt or shame over a situation that was really not their fault. Cognitive restructuring helps clients to re-evaluate these thoughts and feelings, and to develop a more realistic understanding of what actually took place.
- Stress inoculation training involves reducing PTSD symptoms through anxiety reduction strategies, such as breathing or relaxation training.
Dialectical Behaviour Therapy (DBT) was developed by Dr. Marsha Linehan. It is based on the concepts of acceptance and change, and on the Buddhist philosophy of mindfulness, which allows one to accept and tolerate powerful emotions. It is a skills-based approach which teaches clients distress tolerance, emotional regulation, interpersonal, and core mindfulness skills.
Eye Movement Desensitization and Reprocessing (EMDR) therapy (EMDR) was developed by Dr. Francine Shapiro. It employs eye movements or rhythmic left-right stimulation, in order to free up unprocessed traumatic memories, and allow for their resolution. Please visit the EMDR International Association: www.emdria.org for further information.
Medication can often be a helpful adjunct to therapy, targeting symptoms of anxiety and depression. Decisions regarding appropriateness of, and monitoring of medications must be done in consultation with a Psychiatrist, or Family Physician.
Healing from trauma is an emotionally difficult process, but within time, and with the assistance of a skilled therapist, it is possible to heal from the pain, and feel safe again.
American Professional Society on the Abuse of Children: www.apsac.org
American Psychiatric Association: www.psych.org
American Psychological Association: www.apa.org
American Psychological Association - Division of Trauma Psychology : www.apatraumadivision.org
Anxiety B.C.: www.anxietybc.com
Anxiety Disorders Association of America: www.adaa.org
Anxiety Disorders Association of Canada: www.anxietycanada.ca
Association of Traumatic Stress Specialists: www.atss.info
Australian Society for Traumatic Stress Studies: www.astss.org.au
Canadian Mental Health Association: www.cmha
Canadian Network for Mood and Anxiety Disorders: www.canmat.org
Canadian Psychiatric Association: www.cpa-apc.org
Centre for Addiction and Mental Health: www.camh.net
David Baldwin's Trauma Information Pages: www.trauma-pages.com
EMDR International Association: www.emdria.org
European Society for Traumatic Stress Studies: www.estss.org
Gift From Within: www.giftfromwithin.org
Info Trauma: www.info-trauma.org
International Society for the Study Of Dissociation: www.isst-d.org
International Society for Traumatic Stress Studies: www.istss.org
MedLine Plus: www.nlm.nih.gov/medlineplus
National Center for PTSD: www.ptsd.va.gov
National Child Traumatic Stress Network: www.nctsnet.org
National Institute of Mental Health (NIMH): www.nimh.nih.gov
Psych Central: www.PsychCentral.com
PTSD Gateway: www.ptsdinfo.org
Sidran Foundation: www.sidran.org
Van der Kolk’s Trauma Center: www.traumacenter.org
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