What is Trauma?
In general terms, trauma is defined as a response to an event or ongoing conditions that are deeply distressing, painful or disturbing. It is a mental health issue and can occur as a result of either witnessing or directly experiencing such events.
Any situation that is perceived by our nervous system to be life-threatening – to ourselves or others – can make us feel overwhelmed and isolated. When our ability to process our emotional experience is overpowered by the stressful situation, our capacity to cope becomes diminished. This can result in trauma, even if it doesn’t cause us any physical harm.
It is not the circumstances that determine whether an event is traumatic, but our emotional experience of the event. A traumatic experience is capable of shocking and affecting all our systems – mental, physical, emotional and spiritual.
There are no objective criteria to assess which situations will trigger trauma in any individual, but typically the experience will involve a loss of control, betrayal, abuse of power, fear, helplessness, pain, confusion and/or loss. The situation may occur just once, or be repeated and ongoing – and can be categorised as Big T Trauma or Little t Trauma:
|Big T Trauma examples||Little t Trauma examples|
|childhood abuse / neglect||losing a job|
|life threatening illness / medical intervention||moving home|
|physical, emotional or sexual abuse||being harassed or bullied|
|sudden loss of a loved one||divorce|
|witnessing acts of violence||financial or legal worries|
|serious accidents||being threatened or ignored|
|war and other forms of violence||conflicts at work|
|natural disasters||conflict with family members|
The experience does not need to be a Big T Trauma – such as war, natural disaster, or personal assault – to affect us profoundly. It is very subjective and important to remember that trauma is defined more by our individual response than by the trigger. We all have unique capacities to handle stress, known as resilience, which impacts our ability to cope with trauma. Everyone will respond and be affected differently.
While traumatic events can happen to anyone, we’re more likely to be traumatised by them if we have recently suffered a series of losses, are already under a lot of stress, or have been traumatised before, especially if the previous trauma occurred in childhood.
Trauma is often a direct cause of mental health problems or can make us more vulnerable to developing them. It is a risk factor in nearly all behavioural health and substance use disorders.
There is also a direct correlation between trauma and some physical health conditions, such as COPD, heart disease, cancer, diabetes and high blood pressure.
Emotional trauma is a normal response to a disturbing event, and recovery takes time. However, if months have passed and our symptoms are persisting and interfering with daily functioning, we may be suffering from PTSD. PTSD develops when our nervous system gets ‘stuck’, and we remain in psychological shock, unable to make sense of what happened or effectively process our emotions. It is important to seek professional help to integrate the trauma and restore us to a state of emotional wellbeing.
What are the Different Types of Trauma?
Trauma has no boundaries and can affect anyone, regardless of age, race, or gender. Most people will experience at least one traumatic event in their life at some time. However, not all trauma responses will be the same:
- Acute trauma: is usually associated with a one-time, stressful or dangerous event, such as a car accident, natural disaster, single event of abuse or assault, or witnessing a violent event. These experiences can have a lasting negative impact on our lives if symptoms are left untreated.
- Chronic trauma: results from exposure to multiple, repeated and prolonged stressful events. Examples include childhood abuse, bullying, exposure to war or combat situations, and domestic violence. Symptoms may not rise to the surface for an extended period of time – sometimes even years after the events. Chronic trauma can also be a result of several acute traumas happening one after the other. Like acute trauma, if left unresolved, chronic trauma can have long-term negative effects on our quality of life.
- Complex trauma: results from exposure to multiple and varied traumatic events or experiences. The experiences or events are recurring, extended and cumulative and often happen within specific contexts, such as an interpersonal relationship. Forms of complex trauma can happen during domestic abuse, community violence, multiple military deployments, exploitation by an authority figure or a person in power and all forms of child abuse. Unresolved complex trauma can have a lasting negative influence on our lives if symptoms remain untreated.
Other types of trauma, that fall under these three main categories, include:
- Collective trauma: this is a trauma that affects a whole community or country, for example, acts of war, natural disaster, forced displacement and acts of terrorism.
- Secondary trauma: also known as vicarious trauma, is when a person develops trauma symptoms from having close contact with a person who has been directly affected by a traumatic event. Family members, mental health professionals, and others who care for those who have experienced a traumatic event are at risk of vicarious trauma. The symptoms often mirror those of PTSD.
- PTSD: this can develop when the symptoms of trauma persist or get worse in the weeks and months after the stressful event and seriously affect our ability to function. It occurs when our nervous system remains on high alert after the trauma, in order to protect against further harm. Our alert systems respond to reminders of the traumatic memories as a threat, and additional triggers may be added to a growing list of stressors.
PTSD is distressing and negatively impacts our daily life and relationships. Symptoms can escalate into panic attacks, feelings of isolation, depression, suicidal thought and feelings, addictions and an inability to complete basic daily tasks. PTSD may last for many years, but effective treatments are available to help us to manage symptoms and improve our quality of life. The majority of people who experience a traumatic event will not develop PTSD.
- Developmental trauma: this occurs during a child’s first three years of life, as the result of abuse, neglect and / or abandonment. When stress responses are repeatedly activated over an extended period in children, they disrupt normal sequences of brain development. As a result, other aspects of development such as emotional, physical, cognitive, and social are also impacted. Experiencing trauma in childhood can result in severe and long-lasting effects. Unresolved developmental trauma can manifest in many ways. The most common mental health diagnoses that emerge are bipolar disorder, personality disorders, depression, anxiety, eating disorders, PTSD and ADHD.
What Factors Determine How Trauma Affects Us?
Similar levels of exposure to traumatic events will affect individuals in different ways – some will exhibit resilient responses and continue life without any major disruption, whereas others will be significantly affected, emotionally, mentally and physically.
Many factors determine how a traumatic event will affect us and how we will respond, including:
- our personality / characteristics
- the presence of other mental health conditions
- previous exposure to traumatic events
- the type and characteristics of the event(s)
- our background and approach to handling emotions
- the level of other stressors or worries at the time (or later on)
- being harmed by people close to us
- whether we receive help or support.
What are the Signs / Symptoms of Trauma?
The symptoms of trauma range from mild to severe. They can also be short-lived or persist over several days/weeks / months. Symptoms typically fall into three general categories: physical, emotional and psychological, and behavioural:
Along with emotional reactions, trauma can cause a range of physical symptoms, such as:
- muscles soreness, including headaches, aches and pains and general tension
- digestive symptoms, including nausea, constipation or diarrhoea
- altered sleep patterns and fatigue issues
- sweating and / or heart palpitations
- weakened immune system – more susceptible to colds and illnesses.
Emotional and psychological
A person who has experienced trauma may feel:
- shock, denial or disbelief
- anger, irritability, mood swings
- fear and anxiety
- guilt, shame, self-blame
- confusion, difficulty concentrating
- feeling disconnected / numbness
- a desire to self-medicate.
It is common for the experience of trauma to affect our behaviour and self-image, for example.
- disruptions to usual routines, including sleep patterns, appetite and libido
- excessive startle reflex, in response to noises, imagery or unexpected touch
- erratic or hostile responses, such as outbursts of excessive anger or rage
- increased isolation – feelings of detachment and / or hopelessness
- difficulties in relationships due to low self-esteem and / or lack of trust
- diminished interest in / avoidance of everyday activities usually enjoyed
- increased use of alcohol or drugs, to self-medicate symptoms.
Recovering from trauma takes time, and everyone heals at their own speed. However, if months have passed and our symptoms are persisting or getting worse, we need to seek professional help.
Unresolved trauma can lead to post-traumatic stress disorder (PTSD) along with numerous other mental health issues, such as depression, chronic anxiety, and substance abuse problems.
While there is no cure for trauma, and no quick fix, a wide range of effective treatments exist.
How can Trauma be Treated?
Trauma is an injury, so it is impossible to expect that it will go away completely, but ‘integration’ is possible through a variety of treatments and therapies.
Trauma-focused or trauma-informed therapy has been shown to be by far the best approach. It uses a combination of therapy types to help resolve unpleasant feelings and memories, discharge pent-up ‘fight-or-flight’ energy, learn to regulate strong emotions, and rebuild trust.
Many effective therapeutic approaches and techniques can be used to treat trauma, including:
- Cognitive Behaviour Therapy (CBT), which teaches us to be more aware of our thoughts and beliefs about the trauma, and helps us to develop skills so we can react to emotional triggers in healthier ways. Evidence supports CBT as the most effective approach for many trauma types, including PTSD.
- Exposure therapy (In Vivo Exposure Therapy), which is a form of cognitive behaviour therapy that can be used to reduce the fear associated with emotional triggers caused by trauma.
Many treatments work on the memory portion (the unconscious) of the trauma, however research shows that the conscious brain must also be treated for recovery to be long-lasting and effective.
Recent studies have found that body-oriented approaches such as Mindfulness, Yoga and EDMR are powerful tools for helping the mind and body to reconnect.
- EDMR (Eye Movement Desensitisation and Reprocessing) incorporates elements of Cognitive Behaviour Therapy with eye movements or other forms of rhythmic, left-right stimulation that desensitise us and help us to reprocess and integrate memories and events. Several randomised controlled trials have demonstrated that EMDR is an effective treatment for many types of trauma, including PTSD.
- Somatic techniques. Some studies have shown that trauma imprints can be stored as physical movements and feelings in our bodies – not just as mental narratives about the traumatic events – which means that we can experience them as immediate threats in the present time. Some therapists, therefore, use somatic or body-based techniques, which can help the mind and body process and integrate trauma.
Other alternative / complementary treatments often used include massage therapy, pet or equine therapy, art therapy, craniosacral therapy, acupuncture and hypnotherapy.
- Medications. Medication alone cannot cure trauma or PTSD, but it can be used to reduce many of the challenging symptoms that accompany it, such as anxiety, depression and sleep disturbances. Once we are able to control our symptoms, it becomes possible to participate more effectively in other therapies and interventions.
Working through trauma can be distressing, painful and potentially re-traumatising, so any treatment needs to be carried out with the help of an experienced trauma specialist.
Trauma Treatment at White River Manor
Our professional, multi-disciplinary team and caring staff have one goal in mind: to support you in restoring balance to your mind, body and soul.
At White River Manor, we provide a holistic treatment programme for trauma disorders, which is shaped around your personal preferences and therapeutic needs and addresses any co-occurring conditions.
Combining intensive therapy, medical management, psychiatric evaluation, exercise options, healthy eating and nutrition – the White River Manor approach ensures deep transformational healing and recovery from your trauma.
You will also learn new practices, gaining valuable tools to help you deal with life’s challenges after treatment, to sustain long-term recovery.
If you’d like to find out more about trauma and the treatments we offer, please contact us.