Trauma, an Overview.

What is trauma, anyway?

With the explosion of trauma-informed care came the overuse of the word “trauma” to the point of beating it into meaninglessness. You can hear every hack comedian or political commentator wringing their hands as they exclaim that, to this younger generation, everything is regarded as trauma these days. Like any societal correction, things can go too far, but I tend to think expanded awareness has more benefits than downsides. But let’s look at how we define trauma and explore what exactly happens to us when we develop trauma reactions.

The American Psychological Association defines trauma as “an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” This is a narrow definition, and we know less acute traumas can cause clinically significant impairment, especially when they pile up over time. Verbal abuse and emotional neglect shape a person’s self-esteem. In my practice, I have seen countless clients with significant trauma histories who did not even realize that their experiences were not typical. The chaos was the status quo, and they navigated it in survival mode. I have seen tremendous benefits from utilizing EMDR with the broad spectrum of different types of traumas.

Who it Impacts

Trauma is cumulative, with each subsequent event increasing the likelihood of an individual developing lasting trauma reactions. Clinicians remain divided on whether Complex posttraumatic stress disorder deserves its separate designation with CPTSD developing after repeated traumas. In my clinical experience, I do consistently see distinct patterns of symptomology with individuals who suffered from repeated traumas throughout essential periods of their development and individuals who suffered from a single event that caused their PTSD. A separate diagnostic category would be helpful, but that would be a longer blog for a different day. Currently, it has yet to be added to the DSM. For this blog, PTSD is the focus.

As with any disorder, why one individual develops PTSD and another who has gone through the same events without developing PTSD depends on a complex interaction of biology, previous exposure to traumatic events, substance use, and social support or lack thereof. PTSD is ubiquitous, with about 6% of men meeting the criteria at some point in their lives and 12% of women. This discrepancy is likely due to underreporting of symptoms by men, as they are less likely to seek mental health treatment.

Why are these symptoms happening?

Few things are as destabilizing and isolating as a traumatic event. An individual’s worldview becomes distorted as expectations of trust and safety are extinguished. A negative feedback loop of diminished mental health creates anxiety about leaving the house to seek help for the symptoms they are experiencing. The individual’s world becomes smaller and scarier as avoidant behaviors metastasize into every aspect of the individual’s life.

After we experience a traumatic event, our brain makes avoiding another traumatic event its top priority. We become hypervigilant as our brain constantly searches for connections between our current environment and the previous trauma. The emotional centers of our brain miscommunicate with the memory part of our brain, making it feel like those memories are happening in the present moment. The result spans a broad spectrum of symptoms from hyperarousal (panic, restlessness, paranoia, sleeplessness) to hyporarousal (depression, dissociation/derealization, and lack of initiative/motivation).

There is Hope

The good news is that PTSD is very treatable, and remission is possible for most people who get into therapy. EMDR and Exposure therapies remain the gold standard for reducing or eliminating symptoms. It is challenging work, but the improvements I see in the survivors I have the privilege to work with every day consistently show that it’s worth it. Call today for a free consultation to see if we are a good fit!