Manage Trauma

What is Trauma?

According to Dena Rosenbloom, PhD, and Mary Beth Williams, PhD, trauma is defined as “a bodily or mental injury caused by an external agent” (2010). Trauma can also occur on a physical, mental, emotional, and spiritual level.

An event is considered traumatic when a person feels their life is threatened or they are in danger, however, the meaning of the event determines the level of trauma more so than the event itself. In this way, two people could go through the same event and one person could find the experience traumatic while the other person does not. Trauma also has an emotional component to it whereby situations that trigger large emotional reactions could also be considered traumatic, such as, being teased and bullied as a child.

“Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence or death. They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe. The common denominator of trauma is a feeling of intense fear, helplessness, loss of control, and threat of annihilation.” - Judith Herman, MD, Trauma and Recovery

Types of Trauma:

There are a variety of traumatic experiences one can have. Trauma can result from:

  • Natural disasters
  • Physical abuse
  • Psychological/emotional abuse
  • Sexual abuse
  • Neglect
  • Medical issues
  • Loss
  • Death
  • Crimes
  • Accidents

As mentioned, any experience can be considered traumatic depending on the individual’s biological response and the subjective meaning derived from the experience. However, there are common types of trauma one can experience.

Trauma can either be direct or indirect, meaning that the traumatic experience either happens directly to you or around you or it does not. Indirect trauma can include vicarious trauma, whereby one is traumatized through the experience of others. Vicarious trauma could occur through hearing stories of abuse from your clients or witnessing natural disaster coverage on the media.

In general, there are three basic types of trauma. Acute trauma refers to a traumatic experience that happens only once, for a limited period of time, such as experiencing a car crash or a physical assault. Chronic trauma refers to traumatic experiences that occur in succession, over a pro-longed period of time, potentially making you more susceptible to other forms of trauma. Chronic trauma could include domestic violence or dealing with a long-term illness. Finally, complex trauma is the result of experience multiple forms of trauma over a pro-longed period of time, resulting in issues with the person’s overall functioning and sense of well-being.

Reactions to Trauma:

Trauma can impact every part of a person, including their body, thoughts, emotions, behaviours, and belief systems; depending on their biology, environment, personal history, and unique personality traits. Dena Rosenbloom and Mary Williams, in their workbook Life After Trauma, outline some common reactions a person may have to trauma:

Table 1.1. Some Common Reactions to Trauma

Physical Reactions

Mental Reactions

Emotional Reactions

Behavioural Reactions

Nervous energy, jitters, muscle tension

Upset stomach

Rapid heart rate

Dizziness

Lack of energy, fatigue

Teeth grinding

Feeling out of touch with your body

Risk of health problems

Changes in the way you think about yourself

Changes in the way you think about the world

Changes in the way you think about other people

Heightened awareness of your surroundings (hypervigilance)

Lessened awareness, disconnection from yourself (dissociation)

Difficulty concentrating

Poor attention and memory problems

Difficulty making decisions

Intrusive images

Nightmares

Fear, inability to feel safe

Saddness, grief, depression

Guilt

Anger, irritability

Numbness, lack of feelings

Inability to enjoy anything

Loss of trust

Loss of self-esteem

Feeling helpless

Emotional distance from others

Intense of extreme feelings

Feeling chronically empty

Blunted, then extreme, feelings

Becoming withdrawn or isolated from others

Easily startled

Avoiding places or situations

Becoming confrontational and aggressive

Change in eating habits

Loss or gain in weight

Restlessness

Increase or decrease in sexual activity

Source: Rosenbloom & Williams, 2010, p. 15

 

For more information on immediate and delayed reactions to trauma, please check out: https://www.ncbi.nlm.nih.gov/books/NBK207191/table/part1_ch3.t1/?report=objectonly

It is important to learn how to “check in” with yourself to be able to notice changes in your functioning and well-being, as well as, to learn how to sooth yourself. When a person who has experienced trauma feels triggered, a variety of physiological and emotional reactions can occur that leave the person feeling overwhelmed. It is important to learn how to contain these reactions, manage triggers, and work through uncomfortable sensations and feelings that come up. A gentle way to begin this practice is to schedule some time every day to ask yourself questions, like, “how am I feeling today?” “do I feel uncomfortable?”, “where am I physically holding the discomfort?”, and “what do I need today to feel safe and taken care of today?”

Your Body’s Survival Responses:

When a person is triggered, through a sensation, thought, or experience that reminds them of a traumatic experience, their body’s internal ‘alarm system’ is sounded. To learn more about how to body reacts when the internal ‘alarm system’ is sounded, please visit the stress section of the website *link to the physiology of stress section here*

Once a person is triggered and the sympathetic nervous system is activated, the body and brain prepare themselves to deal with a potentially dangerous or threatening situation. As such, there are 4 primary survival responses that a person may rely on to cope with the situation.

The Fight Response: When this response is activated, you immediately want to defend yourself, protect your space, and may feel aggressive, angry, and a desire to regain a sense of control and power. For example, if you feel insulted you may feel a desire to yell at the person who insulted you.

The Flight Response: When this response is activated, you immediately feel a sense of wanting to run away, avoid the situation, and escape to safety. For example, if you have an argument with a person you may feel the need to separate yourself and retreat back into your own space.

The Freeze Response: When this response is activated, you immediately feel like you can’t move or react in any way. Often times, you may shut down and disassociate from your body and the situation. For example, if someone is yelling at you, you may struggle to engage in the conversation and start to feel far away, not all there, or shut down.

The Fawn Response: When this response is activated, you immediately feel like you have to take care of the other person in order to survive or keep the relationship copasetic. With this response, you often feel co-dependent on the other person, struggle to assert boundaries, and are reliant on the other person’s sense of well-being to stay safe. For example, when you have a partner who gets emotionally/ mentally abusive when they’re stressed, you may be more likely to act in ways that try to make your partner happy so that they don’t take their stress out on you.

It is important to note that these survival responses are not necessarily linked to trauma. Anyone can experience a survival response, however, people who have undergone trauma are more likely to experience recurring survival responses to the point of debilitation. Likewise, while everyone has access to all of these survival responses, people with PTSD are more likely to only engage in one or two instead of adapting the survival response to the situation at hand. As such, it is important that people with trauma learn how to manage these responses and activate their parasympathetic nervous system. For more information on how to activate the parasympathetic nervous system, please visit: *link to stress section*

You may not always be consciously aware of when you have entered survival mode. The following signs are indicators that you have gone into a survival response:

  • Racing heartbeat
  • Difficulty breathing (rapid or shallow)
  • Flushed or pale skin
  • Sweating
  • Dilated pupils
  • Shaking and trembling
  • Feeling stressed or afraid

Rebuilding Your Life After Trauma:

 It can feel as though your entire life has been turned upside down after experiencing a traumatic event. The world can end up feeling like a scary and unpredictable place, leaving the person to feel unsafe in their own skin and with others. This can lead to feeling chronically depressed, anxious, burnt-out, and numb as you live in an almost constant state of fear, hyper-vigilance, and existing in survival mode.

In this way, many people’s trauma responses and coping strategies can become more of a hinderance than a help, as the person becomes dependent on a limited set of strategies that are not always helpful for the issue at hand; like constantly distancing yourself from any sort of conflict in order to maintain a sense of safety. While this strategy may work for certain situations, if it becomes the only way to cope, it can cause harm in the long-run, as the person becomes more isolated from everyone around them. People with PTSD are more likely to struggle with employing alternative coping strategies and may become reliant a small number of strategies; as such, it is important to be able to evaluate what your coping strategies are, what purpose they serve, and how they may relate to the survival responses you commonly rely on. The following questions may be helpful in determining what type of coping strategies you employ:

  • “Do you tend to take action, face things head on, and try to solve problems?”
  • “Do you tend to talk to somebody when you have difficulties?”
  • “Do you tend to lay low, avoiding, or distancing yourself from problems?”
  • “Do you tend to keep difficulties to yourself?”
  • “Do you tend to choose strategies with harmful consequences?”
  • If you employed this strategy every day, for one year, what would the benefits be? What would the costs be?

Rosenbloom & Williams, 2010, p. 33

As trauma impacts every aspect of a person’s life, in one way or another, there are a variety of arenas one will have to heal in order to rebuild their life after trauma. In general, the following aspects need to be addressed when working with people who have experienced trauma:

  • Safety
  • Trust
  • Control
  • Meaning & Purpose
  • Connection
  • Self-Esteem

Please note, when rebuilding these aspects of your life, you will have to take a holistic approach; working to heal on the micro, messo, and macro level. For example, when rebuilding a sense of trust, you will have to rebuild trust with yourself, with others, and with the world in general.

As working through trauma is a multi-layered, complex process that goes beyond the scope of this website, the following trauma-based resources are recommended: