Traumatic experiences shake the foundations of our beliefs about safety and can shatter our sense of security and assumptions of trust. These experiences can cause us to feel helpless and overwhelmingly vulnerable in a world that seems even more dangerous and indiscriminate after the traumatic event.
Traumatic experiences usually involve a threat to life or physical safety, but any situation that leaves us feeling overwhelmed and alone can be traumatic, even if it doesn’t involve physical harm. Sometimes the traumatic event is a single incident such as a car accident or witnessing an assault, and sometimes it is a chronic or repeated experience such as enduring emotional abuse or domestic violence. Either way, traumatic circumstances and incidents fall outside the normal range of events for which one should be able to cope, thereby overwhelming the nervous system as it escalates into an intense fight-or-freeze-or-flight reaction.
An experience of trauma disrupts the body’s natural equilibrium and self-regulating tendencies. In essence, the nervous system gets stuck in a state of over-drive, and the mind’s capacity to provide balance and perspective is greatly diminished.
Experiencing trauma can lead to:
- Anxiety, fear, helplessness
- Edginess, agitation, irritability
- Being easily startled, constantly on guard
- Numbness, withdrawal, isolation
- Anger, aggression
- Mood swings, depression, hopelessness
- Guilt, shame, self-blame
- Confusion, difficulty concentrating
- Inability to cope with normal stressors
- Insomnia, excessive fatigue
- Flashbacks, nightmares
- Racing heartbeat, physical pain and tension
- Drug or alcohol abuse
- Extreme risk-taking, suicidal ideation
- Eating disorders
- Inability to form close, meaningful relationships
One outcome of experiencing trauma is to develop post-traumatic stress disorder (PTSD), which mainly includes being in a frequent state of hyperarousal (edginess, agitation, irritability), having intrusive memories, flashbacks or nightmares, and engaging in attempts to avoid internal and external stimuli that remind the trauma survivor of the traumatic experience. It’s important to note that symptoms of PTSD typically begin within three months of a traumatic event but in some cases symptoms of post-traumatic stress disorder may not occur until years later.
Though psychological and physical effects of trauma can be quite distressing and even debilitating, it is important to keep in mind that psychotherapy can be an effective treatment for survivors of trauma, including those with PTSD. At its heart, psychotherapy exists as a method for healing the mind and body from the effects of psychological wounding. Effective trauma treatment is founded upon establishing a strong sense of safety, and usually includes increasing the capacity to access healthy internal and external resources, re-balancing the nervous system, and integrating the traumatic experience into the client’s sense of self in an adaptive and empowering way.
At APPLE FamilyWorks, our licensed Marriage & Family Therapists have a tremendous amount of experience and training in working with individuals who have experienced trauma. Our Marriage & Family Therapist Interns receive training in contemporary and time-tested ways of helping clients process their trauma and heal. If you or someone you know has experienced trauma, or is exhibiting symptoms of PTSD, please don’t hesitate to call us for help.
For your general information, below are the professional diagnostic criteria for PTSD. It is always best, however, to have a mental health professional determine whether or not the diagnosis of a psychiatric disorder is warranted. We recommend you seek the expertise of a professional who can apply reliable assessment tools to make that determination.
Criterion A: stressor
The person has been exposed to a traumatic event in which both of the following have been present:
- The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
- The person’s response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.
Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one of the following ways:
- Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
- Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content
- Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.
- Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
- Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
- Efforts to avoid thoughts, feelings, or conversations associated with the trauma
- Efforts to avoid activities, places, or people that arouse recollections of the trauma
- Inability to recall an important aspect of the trauma
- Markedly diminished interest or participation in significant activities
- Feeling of detachment or estrangement from others
- Restricted range of affect (e.g., unable to have loving feelings)
- Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hyper-vigilance
- Exaggerated startle response
Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.
Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
