

Trauma Informed Care
We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as PTSD, acute stress disorder, anxiety, depression, and addiction.
There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.
People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.
We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.
Cognitive processing therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.
Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.
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With the suicide of two Hollywood Stars this week, both Kate Spade fashion designer, and beloved Anthony Bourdain, American chef and champion of human rights, we at the Counseling and Wellness Center of Pittsburgh wish to express our condolences to the families, friends, and all of those effected by these tragic losses. According to the National Institute of Health, suicide rates are rising, 40,000 people will die by suicide each year. As a nation, and as people who want to help, we should think about the signs, symptoms, and behaviors of the people around us so that we can do our best in having awareness to prevent suicide. Suicide is a topic which holds personal importance to me, many years ago, when I was an undergraduate student studying psychology, my boyfriend attempted suicide in my bed by placing a bullet into his brain, after months in a coma, he was lucky enough to survive. Yet the act was one which was shocking for all of his friends, his family, and something that impacted me to this day. As a woman who has devoted herself to studying and working in the mental health field, at the time, I did not see the signs that my boyfriend was suicidal.
Suicide is a taboo topic and product of dismal and ill mental health; major depression, bipolar disorder, borderline personality disorder, psychosis, and schizophrenia, are a few of the disorders which are typically associated with an increased risk for suicide. For those who are closest to someone suffering from mental health disorders, the symptoms are very difficult to see for what they are. The thoughts, behaviors, and feelings of a depressed person are a set of treatable symptoms which are a produced by mental illness. Our science and psychology hold diagnostic labels but for the human beings who act out suicide, these symptoms are a daily life experience, they are much more than a label. Mental illness is an often invisible disease causing people to suffer immensely, those who are in the depths of depression or other mental illness, often have not sought treatment with a therapist or mental health professional. A person may walk through life for many years, hollow and bleak, no longer able to experience the hope or purpose to continue living. They may become so overwhelmed that they can no longer imagine the purpose of surviving more days while struggling with their feelings of despair, sadness, conflict, and internal pain. Often the person who commits suicide is one whose self-esteem and thoughts have entered a place of such distortion that they imagine the people who survive them will be better off without them in their lives. Again, this kind of thinking is a product of the illness. Please spend a few moments looking over the suicide warning signs according to the American Foundation for Suicide Prevention.
Behaviors
Talk
Mood
Environmental Risk Factors
If this sounds like someone you know, or if you have been feeling these things recently, please seek help. Call your local crisis center, here is a number for a national suicide hotline 1-800-273-TALK. Remember that the emotions are temporary and life’s situations which overwhelm us are solvable. Mental health help is around the corner. If your loved one has expressed these things to you, or is exhibiting some of the warning signs, stay with them, ask questions and let them talk about their worries and problems, your presence will help, listen with patience and compassion and be with them while calling the suicide prevention hotline or getting them to a local hospital.
In love and life,
Stephanie Wijkstrom, MS, LPC, NCC
Counseling and Wellness Center of Pittsburgh
830 Western Avenue
Pittsburgh Pa, 15233
2539 Monroeville BLVD
Monroeville Pa, 15146.
Serving Western Pennsylvania with Individual, Marriage, Family, Counseling and Wellness Services.
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