What is trauma?

 In life we can experience particularly stressful, frightening, distressing, or horrific events, which can be called traumatic. Traumatic events can be experienced as intense, short episodes or as an on going event that happens over a long period of time, often when things are outside our control. The effect of trauma is experienced in the mind and body and can affect our thoughts, feelings, behaviour, relationships and perspective on life. The effects of the traumatic event or events can emerge long after the event has happened and these events can happen at any age and stage of life. Traumatic events are experienced differently for everyone.

Trauma, therefore, is the imprint or legacy* that remains in our psyche following these events. It’s how we react to these events that is crucial for understanding how an individual can recover.

 Types of trauma

 Childhood trauma might include physical, mental and emotional neglect, physical and sexual abuse, bullying, poor parenting, parental bereavement, abandoned by caregivers.

Generational trauma or intergenerational trauma is trauma that is experienced over several generations of a family, culture or group. Past traumatic events such as war, famine, the Holocaust, sexual or physical abuse within the family can affect current generations.

Collective trauma is when a traumatic event happens to a large number of people at the same time. However, not everyone will be affected in the same way. This type of trauma might include acts of terrorism, environmental disasters, automobile, train, or aeroplane accidents.

Moral injury happens when you are put in a situation that goes against your values, beliefs and morals. For example, moral injury can happen in the workplace if equality, working in a system that is failing and you have no way of fixing it, or when safety practices are compromised.

The impact of racism can be traumatic and can affect the individual’s perspective of their self, their thoughts, feelings and behaviour.

Vicarious trauma is when you witness a traumatic event or you are closely connected to it. Vicarious or secondary trauma can affect people working in the emergency services, or journalists/photojournalists reporting from a war zone or a country experiencing genocide or famine.

Post Traumatic Stress Disorder (PTSD)

 PTSD is a mental health condition an individual might develop following a traumatic event. Traumatic situations might include being involved in a car crash, being raped or sexually assaulted, being abused, harassed or bullied, being kidnapped, or any event where you fear for your life, experiencing violence, including military combat, terrorism, or a violent attack.

PTSD is characterised by vivid flashbacks, like the past event is happening in the present moment, nightmares, disturbed sleep patterns, intrusive thoughts and images, physical pain – muscle aches, sweating, nausea, trembling, anxiety or a deep fear of the future, intense distress when reminders of the past event occur. An individual can also feel a range of feelings and emotions, including intense and sudden anger, irritability at seemingly minor things, aggressive behaviour, defensiveness, panic at times when reminded of the traumatic event, an overwhelming sadness, difficulty focusing on day-to-day tasks and a heightened startle response.

An individual experiencing PTSD symptoms is typically ‘stuck’ in survival mode. The amygdala or threat detector in the brain has been switch on during the traumatic event and has failed to switch off. Therefore, because the body is constantly being flooded with stress hormones adrenaline and cortisol, a person is continually reacting from their trauma responses.

Complex Post Traumatic Stress Disorder (C-PTSD)

 C-PTSD is similar to PTSD but an individual can experience additional symptoms such as difficulty controlling emotions, a sense of distrust of people and the world, feelings of emptiness, helplessness or hopelessness, difficulty with relationships, dissociative symptoms – depersonalisation or derealisation, physical symptoms and suicidal thoughts. With C-PTSD an individual might experience an emotional flashback - intense feelings originally felt during the traumatic event. Feelings such as fear, shame, sadness or despair might creep into the present as a reaction to something that has reminded the person of that event. Emotional flashbacks happen without the person realising they are having a flashback. Traumatic events similar to the examples listed earlier can cause C-PTSD. However, an individual is more likely to develop C-PTSD if they have experienced trauma at an early age, if the trauma has lasted for a long time, or if you have experienced multiple traumas or if someone close to you has harmed you.

The effects of traumatic events

Trauma affects our mind and body and when we are under extreme stress the body releases the stress hormones adrenaline and cortisol. It’s the body’s way to prepare us for treat or danger; we have no control over it. It’s a primal reaction.

Typical trauma responses are:

Freeze – feeling paralysed and unable to move

Flight – escaping, hiding, or running away

Fight – fighting, protesting

Flop – doing what your told; not being able to protest

Fawn – trying to please someone who typically harms you

A reaction to a traumatic event can continue long after the event is over. We can experience a traumatic event in the past, but our body can react to it as if it’s happening in the present. Trauma responses happen when we are reminded of a traumatic situation. This can feel incredibly confusing, frightening and often debilitating for an individual experiencing the legacy of trauma.

Feelings associated with trauma

Some experiences an individual might feel during or after the event:

• Anger
• Numbness or difficulty feeling any strong emotions
• Like you have lost your identity or a sense of who you are
• Scared or panicked
• Grief
• Worried
• Irritable
• Confused
• Restless
• Unsure of what you need or want
• Hypervigilance - which is when you are very alert and aware of your surroundings because you feel something bad might happen
• Shock or horror
• Shame

All feelings are valid, even if the individual isn’t sure why they are feeling this way.

Caring for yourself following a traumatic experience

Following a traumatic event, caring for your self might be difficult or even seem impossible. Often, you might not realise the significance of what you’ve been through, you may still be experiencing shock. Time and space to care for your self may become limited. Trauma responses might be activated, which means the mind goes into survival mode. For example, an individual might shut off from their emotions, or avoid challenging aspects of relationships, which, in turn can affect our connection with others, leaving the person isolated, afraid and alone. Social interactions are crucial in trauma recovery. Mindfulness and therapies that focus on the body are becoming increasingly effective in recovery from trauma, as is seeking professional help from a qualified therapist.

Helpful contacts:

https://www.mind.org.uk/information-support/types-of-mental-health-problems/trauma/useful-contacts/

* Term used by Janina Fisher PhD, a clinical psychologist and world-renowned expert in the field of trauma theory and practice.