So Just What Is Trauma?
When I speak of “trauma” I’m talking both PTSD and trauma. Trauma and PTSD are not necessarily the same thing under psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (DSM), although I work with both at The HAVEN Place. If I have PTSD I have been traumatized. However, I can have severe trauma symptoms yet not meet the psychiatric criteria for PTSD. That can leave people open to a host of misdiagnoses and inappropriate, unneeded, and potentially harmful treatment.
Trauma can be virtually anything we couldn’t cope with physically, mentally, emotionally, or spiritually at the time … anything that still interferes with our lives weeks, months, or even years later.
It’s not so much the event that’s traumatic, but the way we perceive and react to that event. Two people can experience the exact same event yet have totally different reactions to it … because they are different and unique people with different life experiences, values, perceptions, beliefs, histories, etc.
Sometimes we know what happened to us, and at times we don’t. We simply know we’re stuck, something is missing or wrong in our lives, and we haven’t been able to fix it on our own. Trauma can occur at any point in our lives and can cause life-long effects or problems.
Trauma is cumulative. Multiple traumas in life are not good but few people have experienced only one trauma. The more traumas we’ve experienced the more likely we are to be affected.
Types of Trauma
There are different kinds of traumas, some environmental and some that are man-made. Trauma can be acute (a one-time event), chronic (a series of small, cumulative events), or complex (a violation of trust and safety) and it is possible to have experienced and suffer from all three. Developmental trauma by definition occurs when we are babies, infants, young children. It can be acute, chronic and/or complex and can affect brain development, resulting in lifelong social, emotional, and cognitive impairment. Developmental trauma can also lead to risky behaviors later in life, result in increased disease and disability, and ultimately can contribute to early death. We often have no memories before the age of 2 or 3. As a result we may have no cognitive or verbal memories of trauma as an infant, but we can still have life-long physical and emotional reactions as a result of those events.
Families and caregivers can also suffer secondary trauma or vicarious trauma. Secondary trauma is an acute or sudden response to someone else’s story or experience of a traumatic event. Vicarious trauma or compassion fatigue, on the other hand, sneaks up on us. It is cumulative and insidious.
Trauma reactions people experience can be a bewildering mixture of behavioral, physical, mental, emotional, spiritual, relational and social reactions. Reactions can be sudden and acute but they are quite often gradual, showing up weeks, months, or even years after a traumatic event. Seeing those links between our current reactions and past experiences can be tough. Others may see the changes, but often a person with a history of trauma either doesn’t see it or tries a variety of ways to survive, to cope … suppression, repression, denial, alcohol, drugs, medications, emotional suppression, over-working, over- or under-eating, social withdrawal, self-harm, fighting, sexual acting out … ways that may work for the short-term but not for the long-term.
Trauma reactions are all too common. They are not disorders or mental illnesses, although they are often misdiagnosed as such. They are painful yet understandable reactions, survival behaviors, to abnormal events. And everyone can and does have their own unique patterns of reactions.
If you feel “stuck” in life, identify with some of these reactions, want to make some changes, or simply want more information then send us an email asking for a free consultation.
WHY I FOCUS ON TRAUMA
All of us carry baggage or burdens, the sum of our life experiences, both good and bad. Childhood trauma is very common according to the results of the ACE Study (see our Resources Page). A direct link has been established between childhood trauma and adult onset chronic physical and mental health problems, substance abuse, suicide, being violent and/or a victim of violence, as well as increased rates of medical and mental health care usage. The more traumas we experience the greater the risk we have for significant relationship, physical, mental, emotional, behavioral, social, and employment problems over the course of our lives. Despite what has happened to us all of these risks are just that – risks. All these risks are manageable, even if we’re stuck now.
Who has a history of trauma? Bluntly … everyone. The vast majority of those seeking help have experienced more than one trauma as a child, and often additional occurrences as an adult – trauma is rarely a one-time event and seldom involves only childhood neglect or verbal abuse. Approximately 66% of the general population has an ACE score of 1 with a substantial percentage having an ACE score greater than 1. Even if you have an ACE score of zero chances are very good you live, work, socialize with, or otherwise know someone who has a significant trauma history that is affecting their lives now … and possibly yours.
Trauma can occur at any point in our lives – from the womb to the present. And it causes damage. Damage to ourselves, to our relationships, to our ability to function, to our hopes and dreams for the future. It’s damage that hurts us on the physical, emotional, and spiritual levels. And all three levels need attention, often simultaneously, in order to recover.
The higher our ACE Score the greater the risk we have for relationship, physical, emotional, mental, social, and work-related problems. Those with chronic and persistent mental health problems commonly have experienced multiple, chronic and/or complex traumas. To learn more about the ACE Study and associated risks check out our Good Links page under Resources.
WHAT WORKS IN HELPING WITH TRAUMA
Resiliency is vital, and the most important factor in resiliency is secure attachment with others. Secure attachment helps build and maintain self-esteem, personal values, hope, self-control, enjoyment in life, an ability to trust others, and a sense of purpose. Other important factors in resilience are an adequate diet or nutrition, regular exercise, recreation, good sleep, and social support.
We can all learn and use resiliency skills. We can form secure attachments even if we had insecure attachment as children. We can build friendships and social support networks. We can address our diet and are in control of the type and amount of exercise we get each day.
Some people can do all this on their own. They struggle for a while but are eventually able to get where they want to be. Others, however, need a jump start or a hand up to help them get out of their rut or hole.
People can be reactive and stay “stuck” or they can be proactive, recognize they don’t have all the tools they need for life, and ask for some help. Asking for help isn’t weakness. Rather, it’s a sign of strength, acknowledging a need for more knowledge or skills, and doing something about it.
Very few people seek or need assistance for a one-time, acute traumatic event. They recover on their own and move on with life.
Others, especially those who experienced chronic, complex, and/or developmental trauma, aren’t able to recover on their own for a variety of reasons. They’re “stuck” and need some help. Trauma and PTSD can be effectively treated and people can and do recover. Just as each person and their trauma history is unique and different, so too are each person’s treatment needs. Effective trauma treatment should be tailored to the person, and structured. Chronic and complex trauma treatment should be multi-phased. All trauma treatment should include some form of body-work to address physical reactions to trauma, reactions we often carry around as chronic muscle tension and pain. Medication may be necessary for initial stability, but it doesn’t address under-lying causes and should never be used long-term or be the only form of treatment. More information about the benefits and risks of psychiatric medication is at Critical Think RX under Alternative Mental Health on our Good Links page.
Curious about all this, feel “stuck” in life, want to make some changes, or simply want more information? Send me an email asking for a free consultation. Include your availability in the coming week and I’ll respond within 24 hours with a day and time that works for both of us.