What is trauma?
Trauma is an emotional shock caused by a traumatic experience that generates long-term negative psychological consequences. The trigger is usually an overwhelming, dreadful and hard to control situation that the person affected cannot confront. The fear may be so intense that it is complicated to handle.
However, not all traumas are the result of a particular event. Cumulative trauma results from exposure to frightful circumstances during an extended period, which the person hasn’t processed correctly.
The mechanisms underlying trauma in both cases are the same. Emotions feel overwhelming, and the traumatic experiences aren’t processed healthily and integrated into the self. Instead, they remain active, often unconscious, and often cause psychological and psychosomatic issues, anxiety or dysfunctional behaviours.
After having experienced a traumatic situation, the brain may suffer a shock, and it is possible to remember what happened once and again. Alternatively, the mind may erase the event from the conscious mind, as if it had no impact on the person. This happens when the trauma is too painful, and the person hasn’t the resources to deal with the trauma.
Dissociation mechanisms activate to protect the individual, and the emotional part of the brain disconnects the rational part. This dissociation can be partial or complete, and the person may remove the memory from the conscious mind. Nevertheless, the trauma remains recorded in the brain.
Types of trauma
- Sexual abuse: it is sexual behaviour forced upon another person. Sexual abuse is an act of violence and can include sexual assault, rape, or attempted rape.
- Post-traumatic stress disorder (PTSD): victims of PTSD have frequent nightmares about the traumatic experience lived in the past and can suffer hallucinations, extreme anxiety, or memory loss.
- Psychological abuse: psychological abuse is any persistent behaviour that causes emotional damage to another person. The objectives of these behaviours often are to intimidate, devalue and generate shame feeling in the victim.
- Physical abuse: physical abuse includes any violent act that causes injuries.
- Childhood traumas: examples of childhood trauma are neglect, abandonment, rejection, sexual abuse, psychological and physical abuse.
Traumatic experiences can overwhelm us and cause psychological issues. There are individual differences, though, and where an event can be traumatic for one person, it may not be for another.
There are traumatic events that have a tremendous emotional impact on most people, such as rape, abuse, a significant loss, complex diseases or a dangerous accident. This doesn’t mean that the individual will develop a trauma, as some people can process healthily negative situations and continue with their lives without suffering prolonged psychological outcomes.
Some factors increase the probability to suffer trauma after a traumatic experience:
- Previous psychological issues: having suffered from anxiety or depression before the event.
- Avoidance: using unhelpful coping mechanisms like avoiding the memories, thoughts or emotions of the traumatic experience prevents processing and healthily accepting the event and prolongs the suffering and pain.
The root of many of our psychological issues is the unprocessed emotional traumas suffered in the past. The symptoms of trauma are:
- Nightmares: the person may remember part of the whole traumatic event during sleep, making it hard to sleep and leading to insomnia in some cases.
- Irritability: victims may feel more sensitive and react to any situation, particularly those similar to the traumatic event.
- Fear: trauma can lead to fearful thoughts and fear of things that are not dangerous. A stimulus that is inoffensive may make you react disproportionately. You can read more about fears and phobias here.
- Stress: higher levels of stress, worry or anxiety can happen after a traumatic experience. You may be constantly alert, tense and hypervigilant to possible risks or problems.
- Guilt: people that suffered trauma may think that the traumatic event was their fault, feeling guilt and ashamed.
- Anger: sometimes, instead of shame, victims may blame other people and feel anger.
- Apathy: victims may feel detached or numb, losing overall interest in activities.
- Problems focusing: you are more distracted than usual, finding it hard to focus your attention, or even feeling confused.
- Social isolation: the fear of suffering a similar trauma again can lead the person to isolate. People may reduce contact with other people and social activities to avoid risks.
- Dissociation: dissociation is a symptom of trauma. It is an automatic brain response to protect from intense emotional pain.
In some cases, trauma can lead to other psychological disorders:
- Post-traumatic stress disorder (PTSD): PTSD is a disorder that affects people who have suffered or witnessed a traumatic event in their lives. Patients affected remember the trauma through flashbacks, having instant memories of the event throughout the day. In some cases, the person may lose complete contact with reality and believe that the traumatic events are happening in the present.
- Anxiety: anxiety is an adaptative mechanism that the brain uses to alert us when facing problems or complicated events. However, when the levels of anxiety are high, it affects negatively daily life. After a traumatic experience, people may develop a fearful and hypervigilant attitude that leads to anxiety.
- Depression: you may experience defencelessness and hopelessness after a traumatic event. It can cause the loss of motivation, life purpose, and interest in the activities that make you happy. Trauma can trigger major depression and, in the most extreme cases, suicidal thoughts.
It is not possible to prevent trauma since traumatic events happened unexpectedly, and it is not possible to predict how the victim will react or assimilate the experience. Treatment will be needed to stop the worsening of the symptoms.
Traumas are diagnosed by analysing the symptoms described by the victim of a traumatic event.
Therapy is a first-line treatment for trauma, and different types of psychotherapies can be used to treat this issue:
- Cognitive-behavioural therapy (CBT): trauma responds well to CBT. It helps you to become aware, process and evaluate your thoughts and emotions about a traumatic event. It challenges unhelpful and unrealistic beliefs and reframes them for other more helpful. Read here more about how CBT works.
- Eye movement desensitisation and reprocessing (EMDR): EMDR has proven successful for trauma and PTSD. Victims relive traumatic experiences while the therapist activates both brain hemispheres through eye movements. Activating the brain in this way help individuals to process traumatic events.
- Hypnosis: the therapist induces a state of high focus and relaxation in the patient that allows restructuring memories and reducing the impact of the traumatic events.