Trauma
Traumatic Incidents
What is trauma? Trauma is narrowly defined in diagnosing mental illness as actual or threatened death, serious injury, or sexual violence which either occurred to, or was witnessed by, a person.
Trauma can also be defined more broadly. As one expert described, “(A) traumatic event or situation creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death, annihilation, mutilation, or psychosis. The individual may feel emotionally, cognitively, and physically overwhelmed. The circumstances of the event commonly include abuse of power, betrayal of trust, entrapment, helplessness, pain, confusion, and/or loss.” (sidran.org)
If you have survived trauma, your whole system has been through a shock. Common reactions to trauma include mentally re-experiencing the event, numbing, avoidance, hyperarousal and hypervigilance. Someone who has been traumatized can feel hopeless about ever getting better. I have personally experienced many traumas and can hold hope for a client that they will heal, even when they cannot see it for themselves.
Trauma and Acute Stress Disorder are sometimes confused with Post Traumatic Stress Disorder (PTSD), which is a longer term condition. If someone has PTSD, their traumatic memory is not remembered in the past, it is re-lived in the present. While PTSD always begins with a trauma, not all traumatic incidents develop into PTSD. Prompt treatment can help prevent the development of PTSD in some people.
Trauma therapy can be tricky because simply talking about the event can retrigger difficult reactions, which can then become hard-wired in the brain and body. Effective trauma therapy gives the client control (which they did not have during the event), and allows the trauma to resurface in a safe, comforting environment. Trauma therapy can help change the story surrounding the trauma to one of survival and strength, and can also reprogram the responses of the sympathetic and parasympathetic nervous systems. There are many techniques for working with trauma. Some do not require retelling the story, but rather deal with the accumulated effects of the trauma. A trained therapist can help a client work with thoughts, stories, emotions, bodily sensations, relaxation, sensory reprocessing, integration, memory, fears, worldview and more.
There is hope for healing from trauma and even becoming a stronger, more resilient person. While trauma therapy is rarely short, with a good fit between therapist and client, happiness and equanimity can eventually be restored for many people.
(See below for EMDR.)
Developmental Trauma
“Developmental trauma describes childhood abuse, neglect or other adversity that is chronic. When a child is exposed to overwhelming stress and their caregiver does not help reduce this stress, or is the cause of the stress, the child experiences developmental trauma. Developmental traumas could include having a parent with mental illness or substance abuse, losing a parent due to divorce, death, abandonment or incarceration, witnessing domestic violence, feeling unloved ... or not having enough food or adequate clothing, as well as direct verbal, physical or sexual abuse.” (porticonetwork.ca)
Developmental trauma can impact brain development since the frequent presence of stress hormones can interrupt normal developmental stages. Developmental trauma can also impact emotional and mental development. A child may develop coping mechanisms, such as denial, submission or aggression, that function to keep him or her safe when young but may be dysfunctional when the child grows up.
Many of us have some developmental issues stemming from important needs that did not get met consistently when we were children. These needs might include trust, mattering, positive regard, safety, compassion or others. Each of us is unique in terms of our particular met and unmet needs as well as the magnitude of our deficits.
Some of the more common effects of developmental trauma include trouble maintaining healthy relationships, low self-esteem, chronic physical problems, addictions, inability to regulate emotions, dissociation, difficulty focusing, memory lapses and not living up to one’s goals, values or potential.
A trained therapist can help a client work through developmental trauma using a variety of techniques. This is nearly always long-term work. If the threats were major and overt, many of the techniques are similar to those used for traumatic incidents. If the deficits were more subtle, a therapist might help a client with worldview assumptions, automatic thoughts, stress reactions, and creating internal safety and positive self-regard. Many people find peace, new possibilities and a sense of autonomy in their lives after identifying, mourning and healing from developmental trauma.