How does trauma impact our lives? Does trauma affect our body? How can I deal with trauma? How does therapy help trauma? What is Post traumatic growth?
Welcome to our exploration on trauma. This is the first of a series that will examine what trauma is, the impacts this can have on our lives and available treatment options.
Writing about trauma is a gnarly task, especially if you have experienced it first-hand. I was in an earthquake, a big one. 6.4 on the Richter scale. I was situated on the fourth floor of an old building. In the worst moments I thought, this is it, my life is ending. It obviously didn't end. But my psyche took a long time to recover.
I experienced aftershocks on a regular basis, which didn't allow for space to reflect, as I was always being re-triggered. It was some time before I realised that I was being deeply affected by trauma.
Trauma facilitates pivotal life changing experiences that leaves us forever changed.
Life Changing Events
Perhaps the easiest to understand are the obvious "Large- T traumas " events, such as natural disasters, war, human made disasters, mass violence. Large "T"traumas often impact communities and groups.
Judith Herman (1977) talks about Complex traumas which includes ongoing effects caused by the Large-T events, such as ongoing war, sexual abuse and violence.
So to be clear Large-"T" trauma is an initiating event such as a wildfire, earthquake or mass violent event.
Complex Traumas are caused by the prolonged nature of the trauma - so in the case of wildfires, it would be the possible: losing your house, death of a neighbour, dealing with insurance companies and relocating etc. Complex trauma deals with the chronicity and drawn out process of dealing with the large, initiating event.
Unacknowledged Small-T traumas
More difficult to understand are what is termed "Small-t" traumas such as bullying, divorce, being stalked by someone, discrimination due to race, sexuality or religion and living in poverty (This list is not exhaustive). Many of us experience these types of trauma. Some of us don't carry these experiences as trauma and are able to shrug it off. Some of us are deeply affected by these events. Often people can experience many of these Small-t traumas, which can have a cumulative effect resulting in a complex reaction.
A distinction to realise is that these small-T traumas often go unrecognised and unacknowledged.
Developmental trauma
Perhaps the least understood form of trauma is developmental trauma.
Whilst it is obvious that childhood neglect and abuse experienced as a child is detrimental to the wellbeing of the child. The consequences can be disastrous for our adult selves.
Adverse events - (a fancy term for bad shit that happened to us) in this context are things that happened to us in childhood at times when we needed safety and attachment from our parental figures and we did not receive that.
Children need to form secure bonds with their parents, they need love, safety and the consistency of good boundaries and routines. When this is interrupted by an adverse event, funny things start occurring in the brain. Children start to rewire their brains to be on the look out for danger.
Being always alert for danger can impact how we operate in the world. For example, a child who has experienced trauma, is sitting in a class room and gets called by a teacher in the middle of class. This child is more likely to assume that they have done something wrong, and a strong fear response is likely to ensue. A child that has a secure sense of the world will walk to the teacher with no assumptions about why the teacher is talking to them, perfectly relaxed.
You can imagine what the traumatised children's day would be like if they have two or three of these events in a day! They arrive home stressed, fatigued, and emotionally confused. When this happens day after day you can start to understand the implications of this type of trauma on the adult self.
What is so pervasive about developmental trauma is that we often don't understand as a child what is happening to us.
We don't have the capacity to heal ourselves or even recognise that we need help. Imagine my surprise whilst seeing a psychiatrist that they said I had trauma from going to 8 different primary schools ! I had no idea, I thought it was only the obvious abuse and neglect that would cause this type of trauma.
Different Reactions to Trauma
We know that there are long-ranging and devastating impacts caused by trauma. But at the same time not all of us react in the same way. I felt deeply traumatised by the earthquakes I experienced. To my absolute disbelief others seemed to be fine. I remember experiencing an aftershock and my whole body reacted, adrenalin racing, I leapt under my desk whilst a colleague of mine didn't even stop eating their lunch! And even worse he grinned at me, while I was cowering under my desk.
Sraussner & Calnan (2014) explains why:
...what might be a traumatizing, life-shattering event for one individual might have minimal effects on another. Such differential reaction is based on many factors, including the individual’s age, gender identity, pre-morbid ego strength, previous traumatic experiences, the chronicity of the trauma, family history of trauma, current life stressors, social supports, and one’s cultural, religious or spiritual attitude toward adversity...
Its perfectly natural that we handle traumatic events in different ways. My colleague wasn't phased by earthquakes. His life experiences and his "make up" as a human didn't see this as life threatening. As for me I was a quivering wreck!
What happens to us when we are traumatised?
Its really important to understand that trauma is experienced emotionally, psychologically and physically.
Our initial reactions to trauma are the responses of fight, flight or freeze. When this happens our physiology changes rapidly to prepare our bodies for dealing with danger. Our brains are triggered into a primal state of instinct to survive what is coming. Our emotional state turns to fear. Psychologically we are making instantaneous decisions about our reactions to what is occurring.
Our breathing becomes rapid, our thinking becomes acutely focused, we release adrenalin from our brains to prepare the body for action.
These actions come in what ever form is going to help us. For example if a person is coming at us we may choose to fight or run really fast. If we are being stalked by a tiger, freezing will help us because the tiger is less likely to chase us. Our bodies have been evolutionarily designed to react in this way to trauma.
The normal healing and recovery process involves the body coming down out of heightened arousal. The internal alarms can turn off, the high levels of energy subside, and the body can re-set itself to a normal state of balance and equilibrium. Typically, this should occur within approximately one month of the event.
This clip explains it brilliantly!
Common reactions to trauma
Sometimes when we experience a strong reaction to trauma, the effects can be more long term. As I said before we all react in different ways, but there are some common responses:
Flashbacks to the event/events
Nightmares
increased anxiety
sleep disturbance
fatigue
heightened emotions
feeling numb
startling easily
feeling constantly wired
When Trauma turns tricky
Complex trauma can be a result of experiencing a number of small "t" traumas. or not being able to fully process a large "T" response or trauma that occurs in a pivotal moment in our development.
In my experience it is difficult when a person is experiencing the more long term effects of trauma because the symptoms can slowly appear over time. So we learn to live with the symptoms without really knowing what is occurring for us.
Other times it can be very obvious - our lives seem to fall apart and we can't function like we used to. Maladaptive coping mechanisms (a fancy term for bad coping strategies) can develop such as drinking heavily to escape reality, using drugs to soothe yourself, seeking out sex for comfort, or in my case a combination of the above and shopping! whatever works to dull the pain.
Of course staying in these modes of coping does not help! We end up creating more pain for short term relief.
So what helps?
Post-Traumatic Growth
Trauma, being highly subjective, means coping will be determined by a person’s attachment of meaning to the traumatic event (Frankl, 1985).
In conceptual terms, Post-traumatic growth (PTG) posits that after trauma if we process the experience well and can reflect and incorporate our experiences, outcomes for living improve. In fact ,life can take on a whole new meaning. Research on this area of trauma study is relatively new, but gives hope to survivors of trauma.
"People develop new understandings of themselves, the world they live in, how to relate to other people, the kind of future they might have and a better understanding of how to live life,"Richard Tedeschi (cited in Collier 2016)
The PTG framework uses self-report scales (quizzes) to measure where people's growth is, in relation to the trauma experienced . The main focus is on these areas:
Appreciation of life.
Relationships with others.
New possibilities in life.
Personal strength.
Spiritual change.
I think what is useful is that this framework can give us guidance in what to strive for when recovering from trauma. In this theory we are not looking for a return to the person we were previous to the trauma. We are looking to incorporate a really awful experience to create a revised world-view , values and sense of self.
What is most powerful about the concept of PTG is the ability of the traumatised person to create meaning from our experiences. Dont get me wrong, we would rather have not experienced this in the first place!!! But endless suffering is horrible and finding a way to have meaning and satsifaction in life is priceless.
How do we achieve Post-Traumatic Growth?
There is a real relationship between time and healing from trauma. A person who has freshly experienced an adverse event, is not going to be in the frame of mind to experienced PTG. In order for PTG to occur there needs to be space for reflection. A guide is useful to be able to facilitate this. A therapist experienced in trauma is a great place to start. My next blog will discuss the different types of treatment for trauma.
Wrapping it up for now.....
warning: sad story about a bird follows
We can relate trauma to being like being a bird on a perch. If we are trauma free we happily bounce around on the perch, free to explore, peck and sing. Our feathers are glossy, we actively seek out activity and socialise with our owners. Conversely, a traumatised bird will not be happy on the perch, will not sing so readily.
If the bird does not recover well from the trauma they will end up on the bottom of the cage, alone and not eating. Sick birds put themselves on the bottom of the cage to end their suffering, they know that prey will find them and end it.
Trauma is like this but it also has complex layers of in-between.
Some birds will stay on the perch and spend a couple of days wobbling around the perch, having an occasional peck and a song here and there. Then the bird will process the injury and be back to its glossy happy self. Others have an injury, but are never quite the same.
There is no linear journey to curing the effects of trauma. But there is hope and having a satisfying and meaningful life is absolutely possible.
In this article I have tried to break down the some of the complexity of trauma. This is not an exhaustive review of all the current theories and research. I picked examples and research that I thought would help promote the understanding and give clarity for people wanting to gain some knowledge this vast subject.
Finally, if your life is falling apart because of the effects of trauma, there is hope! It is worth doing the work to heal and live a satisfying and full life. If you want to find out about treatment options my next blog addresses this topic.
Alisa Woodruff
Therapist
I am currently taking new clients online or in person.
Feel free to contact me for a chat!
Useful Youtube:
the body keeps score
what happens to our bodies during a trauma reaction
References:
Collier, L. (2016, November). Growth after trauma. Monitor on Psychology. Retrieved September 23, 2022, from https://www.apa.org/monitor/2016/11/growth-trauma
Slade, M., Rennick-Egglestone, S., Blackie, L., Llewellyn-Beardsley, J., Franklin, D., Hui, A., Thornicroft, G., McGranahan, R., Pollock, K., Priebe, S., Ramsay, A., Roe, D., & Deakin, E. (2019, June 1). Post-traumatic growth in mental health recovery: Qualitative study of narratives. BMJ Open. Retrieved September 23, 2022, from https://bmjopen.bmj.com/content/9/6/e029342
Straussner, S. L. A., & Calnan, A. J. (2014, May 31). Trauma through the life cycle: A review of current literature - clinical social work journal. SpringerLink. Retrieved September 6, 2022, from https://link.springer.com/article/10.1007/s10615-014-0496-z
Trauma - reaction and recovery. Trauma - reaction and recovery - Better Health Channel. (n.d.). Retrieved September 14, 2022, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/trauma-reaction-and-recovery
van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408. https://doi.org/10.3928/00485713-20050501-06
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