Have you experienced or witnessed an event that involved actual or threatened death or serious injury, sexual violence, or a threat to the physical (or psychological) integrity of yourself or others?
And have you experienced a response to that event involving intense fear, helplessness, or horror?
Then the event was probably a trauma for you.
Have you been thinking a lot about a particularly disturbing event? Have you had flashbacks of it? Have you been especially depressed and/or fearful? Have you experienced an increase in worries? Have you been feeling numb? Have you had trouble sleeping or concentrating? Do you get startled easily?
Reactions to traumatic events typically include the following (you may not have all of them):
- Intrusive symptoms – a reexperiencing of the event, such as intrusive memories of the event through images, thoughts, dreams, perceptions, feelings, and body sensations associated with the event. A person can act or feel as if the event were actually recurring and he/she were reliving the event. This is often accompanied by emotional or physical distress triggered by reminders of the event. These experiences can take the form of “flashbacks”.
- Avoidance symptoms – physical and psychological numbing following the event, accompanied by attempts to avoid thoughts, feelings, and behaviors associated with the event, as well as places, activities, or people who are reminders of the event. There can be difficulty in recalling certain aspects of the event and diminished ability to function normally. And there is often an experience of dissociation.
- Arousal symptoms – sleep difficulties, outbursts of anger, difficulty concentrating, hypervigilance, and a big startle response.
- Negative mood – new negative beliefs and expectations about the self or others, accompanied by cognitive distortions, a persistent negative emotional state (such as fear, horror, anger, guilt, or shame), low self esteem, and other signs of depression
Have you had some of these symptoms?
You may be having a trauma reaction, and you may be in need of professional help.
People can be traumatized by various kinds of events.
- There are big traumas, such as 9/11 and there are small traumas, such as falling down a flight of stairs.
- There are “one shot” traumas, such as an auto accident, and there is chronic, repeated trauma, such as sexual or physical abuse.
- There is trauma that is caused by people, such as rape, and there is impersonal trauma, such as that caused by fire, hurricanes, or tornadoes.
- Seeing (or hearing about) a trauma can be traumatizing, too, in addition to experiencing the trauma first hand. For example, some people who watched the horrors of 9/11 on TV have been traumatized, themselves, and have exhibited trauma symptoms.
- Disturbances in childhood, care-taker relationships can be traumatizing, especially when they affect the child’s development. This is often called relational trauma.
- Some traumas are easily recognizable as trauma, and other traumas are more subtle, covert, and harder to recognize.
- Some traumas are more hurtful than others.
There are two trauma/stress-related disorders described by the Diagnostic Statistical Manual for Psychiatric Disorders, Fifth Edition (DSM - 5):
- Acute Stress Disorder, which is diagnosed from the above symptoms from three days to one month following the traumatic event(s)
- Post Traumatic Stress Disorder (PTSD), in which the duration of the above trauma symptoms is more than one month
- Dissociative Disorders inclduing deperonalization, derealization, memory problems, dissociative identity disorder (DID), and Dissociative disorders not otherwise specified (DDNOS)
Milder forms of trauma exist in abundance, without qualifying for the label “disorder”. They deserve the attention of survivors and therapists, as well.
Individual, group, and family therapy are available for the survivor.
The basic goal of therapy is to re-record the memories of the trauma so that they are not so disturbing. And this process improves the way the survivor functions, feels, thinks of him/herself and deals with the real world.
Stages of Psychotherapy
- Stabilization – this involves learning and using coping strategies that help the person manage his/her emotional reactions
- Processing – this involves telling the story of the traumatic event(s)
- Reworking meaning – this involves changing cognitive distortions and illogical conclusions about the self or others, dealing with the existential issues, such as safety and predictability in the world, finding a new way to think of oneself, and developing new behavior patterns.
- Resolution – assuming a new way of living and moving on
Types of Psychotherapy
Various types of therapy help the survivor resolve the trauma:
- Telling the story to a skilled and understanding therapist in words
- Telling the story using art, play, movement, and music
- Using Hypnosis to tell the story and to manage the emotional reactions triggered by the story
- Using Mind-Body psychotherapy to help process early life experiences
- Using EMDR