Help For Trauma
- Have you experienced something that overwhelmed or shocked you and now you’re finding it very difficult to get past it?
- Do you find yourself regularly watching over your shoulder wondering when the next bad thing is going to happen?
- Does what happened to you rarely leave your mind and even haunt you in your dreams leaving you sleep deprived and chronically exhausted?
- Do your emotions feel “chaotic” and “uncontrollable?
- Do you feel on edge, irritable, snappy, constantly angry, or like you might explode at any moment?
- Do you feel disconnected from life or even “numb”?
- Do you feel like you have no sense of control over your life?
- Are you no longer able to be the person you used to be or who you want to be?
- Does what happened to you now make it hard for you to be close to your loved ones?
- Do you find it hard to experience joy or laughter? To enjoy the good things that happen now?
- Do you find that your health is deteriorating and that you have many physical complaints such as stomach aches, racing heart, backaches, headaches, or digestive issues?
- Are you using drugs or alcohol or other destructive behaviors just to cope or numb the pain?
- Has it gotten painful enough that you have even considered suicide or that you would be better off dead?
- Do you experience an immense amount of shame about what happened and how you now are and are afraid that even a counsellor will judge you?
If you have answered YES to one or more of the above questions, then you may be suffering from traumatic stress.
What is Trauma and What Causes Traumatic Stress?
Trauma can be caused by any experience that you were unprepared for or which you found overwhelming.
When this happens, these types of experiences can create high levels of emotional and physical stress, which can continue to impact you and have lasting negative effects - even when the experiences are over and the actual danger is gone.
Shortly after a traumatic or stressful event, you may find yourself:
- In a state of shock
- feeling disconnected from others or finding it hard to relate to them anymore
- having difficulties in falling or staying asleep
- finding it difficult to relax
- feeling at times like panic is setting in
- experiencing moments of grief or guilt
Often, these experiences can shake your beliefs about yourself, others, and the world. If you already held negative beliefs about yourself, others, or the world, then these adverse experiences may serve to only strengthen your negative beliefs. For example, you may now firmly believe that you are a bad/worthless person, that others can’t be trusted, or that bad things will always happen. If so, then it is likely also very difficult for you to believe or have any hope that that you will ever feel better or that there is any good left in the world.
Some life experiences that can lead to traumatic stress include (but are not limited to):
- Physical, mental, or emotional abuse
- Domestic violence/abuse
- Losing a loved one/unexpected or expected death
- War, combat exposure, concentration camps
- Witnessing atrocities and/or being a part of them
- Serious illness, major surgeries, or near death experiences
- Serious accidents
- Natural disasters
- Helping others who have experienced personal tragedy
- Learning about a shocking/terrifying event that is hard to digest and understand
- Being robbed/mugged
- Invasive dental work or major surgeries
- Complicated birth experience or loss
- Separation from a parent or abandonment
When these types of experiences occur, they can cause you to have a surge of emotions and physical reactions (like an adrenaline rush) or to “shut down” and go numb.
Your body’s natural responses to these types of events are protective and can even be life-saving. When these responses continue after the event has passed, however, they can disrupt your ability to recover, understand what has happened to you, and also prevent you from moving forward with your life.
Although these experiences can be traumatic, they do not necessarily lead to Post Traumatic Stress Disorder (PTSD) in all people. When someone has PTSD, they often experience high levels of anxiety, phobias, nightmares, flashbacks, and difficulties functioning at home and at work. They can also begin to have a sense of a foreshortened future, feeling like there is not much time left or that they won’t live for much longer.
If you have survived an adverse experience, you may notice that you are unable to respond appropriately to your life’s demands, the people you interact with, and perhaps even find it hard to manage work stress. Some people agree that when this happens, it can almost feel like a double wounding….the “events already hurt you once before, in the past, and now those events continue to keep hurting you in your everyday life, not giving you any freedom to leave those experiences behind.”
After any of the potentially traumatizing events listed above, most people will feel stressed and experience some of the trauma-related stress symptoms (i.e., feeling fearful, having bad dreams, finding it difficult to stop thinking about the event, etc) associated with PTSD as these are normal reactions to abnormal or unexpected events. For most people, however, these symptoms will eventually begin to resolve on their own. If these symptoms haven’t begun to resolve for you, and it’s been at least one month since you experienced a potentially traumatizing event, then you might have post-traumatic stress disorder (PTSD).
When to seek professional support?
- Having difficulty functioning at home or at work
- Experiencing significant anxiety, fear, or depression
- Finding it difficult to trust others and to be close to them
- Can’t get what happened off of your mind
- Avoiding anything that reminds you of the traumatic event (people, places, or things)
- Experiencing intense physical reactions when reminded of the event (pounding heart, rapid breathing, nausea, tensed muscles, sweating)
- Experiencing flashbacks (feel like it’s happening all over again) and nightmares
- Becoming disinterested in life or activities you used to enjoy
- Using alcohol or drugs or other non-helpful ongoing behaviors just to cope
- When your symptoms don’t seem to be getting better and you are starting to feel even worse
Types of Trauma
Big “T” Trauma
Big “T” traumas typically involve a threat to yours or someone else’s life, integrity, heath, and well-being. Big “T” traumas are the negative experiences that most people readily think of being traumatic, such as abuse or natural disasters.
In its most severe form, it can often lead to the development of Post-Traumatic Stress Disorder (PTSD).
Little “t” Trauma
Little “t” traumas are more common and are usually experienced just because they are a part of living life, even if they should not have happened (i.e., non-abusive but still unsupportive parental care as a child).
The term little “t” traumas is not meant to imply that these traumatic events are any less painful or frightening. Rather, these traumas are classified as little “t” traumas more because the average person is not likely to easily identify them as experiences that could have a traumatic impact.
Both big “T” and little “t” traumas have less to do with what the event was and more to do with your subjective experience of it. It’s about how the event(s) impacted you, rather than what the actual event was. Therefore, the same negative experience may be experienced as traumatic by one person and not by another.
To say it another way, small “t” traumas are not minor or insignificant and they do NOT feel small to the person who experienced them. These experiences tend to be insidious and like the big “T” traumas, little “t” traumas can change how you think about yourself, your self-esteem and level of confidence, your ability to connect comfortably with others, and your ability to pursue and/or reach your goals. They can reduce the quality of your life and overall functioning.
It is possible to experience small “t” traumas and big “T” traumas.
Some examples of common little “t” traumas are:
- Ongoing bickering between parents
- Being ridiculed or picked on
- Sudden break up with a significant other
- Discovering an affair
- Being embarrassed publicly
- Unexpectedly losing a job/career
- Not being accepted or being left out
- Small non-life-threatening injuries
- Feeling unwanted
- Feeling you are a burden and you are just being tolerated
- Incarceration of a parent
Here are three case examples to illustrate what I am trying to describe above.
Let’s say that as a child, maybe 4-6 years of age, you were struggling to put on your shoes. One of your parents came back inside the house and barked at you to hurry up. You tried to say that you were trying but that you need help getting your shoes on. In your parent’s frustration, he or she yelled back,
“I don’t care what you need, what’s important right now is getting into that car and doing it fast. Let’s go!”
So you scrambled as fast as you could and in a clumsy fashion, you moved towards the car with that one shoe feeling like it is not quite on right. As a child, you don’t have a lot of life experiences to make sense of what just happened, plus due to your young development and your age at the time, you had egocentric thinking and were prone to believe that what happened was your fault. As a result, this experience, which really upset you, was stored in your body with all the sensations, emotions, and thoughts that arose at that time. The sensations may have been feeling rushed, feeling tension in your chest, or a gulp in your throat. The emotions may have been frustration, sadness, feeling alone or feeling unheard. The thoughts that arose may have been:
“What I need is not important,”
“No one listens to me,”
“I’m not good at what I try to do,”
“I can’t get things done…fast enough.”
Over the years, experiences that cause similar sensations or emotions may serve to strengthen these negative beliefs about yourself thus building an unhelpful network of many memories, a network that gets triggered whenever you feel “less than.” Alternatively, this memory may be locked into its own capsule and not consciously remembered as you move through life until a later experience happens to ignite it…leaving you to wonder why you are over-reacting to this new experience.
I have heard of a term called “Complex Trauma.” What is that?
Complex trauma is also known as developmental trauma. Although it is not an official diagnosis (according to the newly revised DSM-5), it is a term first coined by the prominent psychiatrist, Dr. Bessel van der Kolk, and which has now been adopted my many trauma therapists to describe the impact of ongoing trauma or adverse experiences that occur during childhood.
Often, these negative ongoing events occur within the care-giving system, and lead to insecure attachments. This means, that while you were growing up, you were not able to consistently rely on the adults in your life to protect you and to meet your needs. You could not trust those who you needed to trust the most.
By using the term complex trauma, instead of PTSD (which is more appropriate for separate and distinct traumas), the cumulative impact of these adverse experiences on the development of the child is captured. Unlike one-time traumas or trauma that occurs later on in life, ongoing adverse experiences in childhood shape the development of children. It shapes the development of their brains, thier neurology, their nervous systems, how they think about themselves (self-concept), how they respond to other experiences in their lives, their ability to trust others and the world, and their ability to regulate and calm themselves.
Often, these children are identified as having emotional or behavioral problems, when in fact, they are simply responding to the world and their experiences from the traumas that have shaped them. If we understand the ongoing traumas a child has endured, then often their negative and seemingly inappropriate behaviors begin to make sense as it is usually these behaviors that have helped them to survive and make some sense of their worlds.
For example, a child may act in such a way that it can be difficult to enjoy them or even to like them, yet this behavior makes sense if the child has learned over time that it’s not safe to get close to others and risk getting attached and hurt again.
Negative childhood experiences that can lead to complex trauma include all forms of abuse (emotional, physical, mental, and/or sexual abuse), neglect, lack of caregiver warmth or support, absent or dismissive care-giving, abandonment, and multiple changes in caregivers. It can also result from lack of educational or intellectual stimulation, not being provided with the basic necessities of life, and repeated medical or surgical procedures.
As a teen or adult, complex trauma can leave you wanting to reach out for help but also being scared to do so, not trusting that help actually exists or that others can actually be trusted. It can be very difficult for you to know how to calm yourself (i.e., re-regulate), cope with stress, and to understand who you are or who you want to be. It may feel like you simply exist, living life more as a robot than as a full human being feeling the full range of healthy emotions.
You may also experience difficulties in being able to connect your thoughts, feelings, and body sensations. It can be very difficult for you to move from “being the emotion” to “having the emotion,” and therefore, you usually end up being completely overwhelmed and flooded or you are only aware of a few of your reactions (i.e., what you’re thinking) and not others (i.e., your bodily sensations, such as an increased heart rate or shallow breathing).
It is not uncommon for many clients to be unaware of their bodily reactions while discussing a recent or past negative event, such as barely breathing, using a quieter voice, clenching their fists, or talking faster and louder. At other times, clients are so acutely aware of their bodily sensations that it becomes important to do some calming and relaxation exercises before we continue with therapy. This is called staying within the “Window of Tolerance,” a term brought forth by the writings and teachings of a prominent trauma therapist and educator, Dr. Pat Odgen.
If you have experienced ongoing negative events throughout your childhood, then you also likely find it difficult to understand why you react to certain things the way you do, why you find it difficult to calm yourself down effectively, why you find it difficult to feel whole and grounded, and why you find it difficult to know what to do and who you can go to for help to solve a problem.
As a result, you may have learned to shut yourself off and ignore what you feel or what you think. Although coping this way helps to reduce the overwhelming pain you experience when you don’t know how else to reduce the pain, it doesn’t help you in the long-term.
When people have had generally safe and predictable lives and then they experience a traumatic event, it can take less time to treat the trauma and reduce the associated symptoms. The treatment of complex trauma, however, due to the pervasive nature of ongoing and multiple negative experiences, usually takes longer and is more comprehensive. Therefore, it will be very important to find a therapist that you are comfortable with and who you can work with for a while. Treatment of complex trauma will not be a short-term endeavor.
Remember – Trauma is not what’s wrong with you but what HAPPENED to you!
How Many People Does it Impact?
Approximately 70% of the population will be exposed to a traumatic event within their lifetime.
Although most people recover from a traumatic event, about 20% of those impacted by stressful or traumatic events will experience symptoms that worsen and result in PTSD. If there is a history of repeated exposure to traumas and/or childhood exposure, then the risk of developing PTSD is higher, in addition to the likelihood that recovery will take longer.
Although it still remains unclear as to why, women appear to be more susceptible to PTSD than men, and about one in ten women will experience symptoms that meet the diagnostic criteria for PTSD in their lifetime.
Note: Statistics are based on American findings (Kessler, et. al., 1995 & Kulka, et. al., 1990) for both war veterans and civilian populations).
(References: Epidemiological Facts about PTSD, National Center for PTSD, 2002 @ www.ncptsd.org & Myths about PTSD, PTSD Alliance @ www.ptsdalliance.org).
How do I know if my kid has been traumatized?
Sometimes this can be obvious, especially if you are aware of the negative experience your child has had. At other times, however, it can be less obvious and all you can run on is that your child and his or her behaviors or level of functioning has changed.
Some questions you can ask yourself to help determine if they have been traumatized are
- Has your child lost skills they were previously able to do (i.e., toilet training)?
- Does your child experience sleep difficulties or nightmares?
- Is their play intense or compulsive or lacking joy?
- Is your child acting out parts of the trauma through their play, artwork, or through the stories that they tell?
- Does your child now have increased fears and anxieties?
- Are they now noticeably more irritable or aggressive?
- Does your child now have lots of fears from being separated from you or being alone?
If you answered yes to one of more of these questions, then it is possible that your child has experienced an adverse event that they are having difficulty overcoming. This could be true even if their symptoms do not meet the diagnostic criteria for post-traumatic stress disorder. By assisting your child now, you can reduce the likelihood that their difficulties continue and become worse.
Treatment from a therapist would include supporting your child with their own healing while also supporting you as a parent and teaching you how you can effectively help your child at home. By doing so, you will also be in a better position to help your child if they experience future struggles or your child experiences another unfortunate event.
Things Can Get MUCH Better and Effective Treatments do Exist!
Fortunately, effective treatments do exist that can help treat traumatic stress reactions. By tailoring treatment strategies to your specific needs, we can help you to:
- Bring the emotional charge of memories down to a tolerable level; thus reducing the power they currently have over you
- Retrain your body (and nervous system) so it operates effectively and “for” you, rather than “against” you
- Learn new ways of coping that are healthy and which match your goals
- Gain a new perspective on what happened to you and change what it means for you
- Learn how thrive in life and not just survive
- Learn how to talk about and explain what has happened to you so you can explain it to loved ones (if you choose to do so)
- Regain the parts of yourself you thought you lost and create a new and improved you
- And last but not least, learn how to end the pain in your life without having to end your life.
Can a person have another disorder in addition to trauma?
Yes. Often people who have experienced trauma may meet the diagnostic criteria for Post-Traumatic Stress Disorder, in addition to another mental health disorder, such as depression, anxiety, substance abuse or dependence, bipolar, etc. This is also known as co-morbidity. If this is the case for you, then it will be important for you and your therapist to assess which diagnosis or problems are causing the most difficulties for you right now and to have these addressed first. Therefore, treatment may not address trauma first, but rather, address the trauma once some stabilization and healthy coping skills have been established.