What is Trauma? Types, Symptoms, and Treatments
When you hear the word trauma or trauma counseling what comes to mind? It is common for people to hear the word trauma and think of those one-time catastrophic events (car accidents, assault, robbery, natural disasters, etc.) that result in major injuries like broken bones, head injuries, or lacerations, and symptoms of post traumatic stress disorder such as flashbacks, nightmares, hypervigilance, increased startle response, etc. This perception of trauma causes people to minimize their suffering and postpone receiving treatment that helps them heal and increase their quality of life.
So, what is trauma, and who experiences it? Trauma is anything that overwhelms the mind and body and happens too fast, too soon, or too much. It causes physiological, neurological, chemical, and hormonal changes that impact memory and cognition; often resulting in:
- Emotional dysregulation
- Hypervigilance
- Lack of trust in yourself, others, and the world
- Mental health illness
- Chronic pain
- Inflammatory disease
What Types of Trauma Are There?
“Big T” traumas, like those catastrophic events listed above, are the most obvious and lead people to seek treatment to help them learn to cope and move past the event. “Little t” traumas are the things we experienced regularly throughout our lives that we may have been conditioned to accept as part of life or growing up. Some of these experiences may include:
- Being bullied
- Witnessing violence
- Lack of constant care during childhood
- Lack of emotional validation
- Having a caregiver who struggled with mental illness and/or substance use
- Incarceration or having a loved one who was incarcerated
- Experiencing discrimination due to race, gender, age, socioeconomic status, or religious affiliation
- Lack of autonomy
- Lack of affection
- Being isolated, yelled at, or controlled by others
This does not mean that everyone who has experienced these things is traumatized. Traumatization is dependent on several biological and environmental factors that influence perception and physiological regulation.
What Kinds of Trauma Counseling Can Help?
What kind of help is there? Trauma is a multifaceted and complex phenomenon that traps itself in the body and the brain keeping you in survival mode at a physiological level. Trauma treatment is an evidence-based technique that walks you through specific stages of treatment to ensure a felt-sense of safety, agency, and autonomy, empowering the client to take control of their lives leaving the past in the past. Certified trauma specialists and professionals can help unlock the trauma trapped in your brain, muscles, nervous system, and adrenal/endocrine system so that you can feel safe in your body and the world. Some of the effective treatments include but are not limited to:
EMDR (Eye Movement Desensitization and Reprocessing) targets upsetting life experiences that have not been stored properly in memory areas of the brain and are triggered more easily by similar events or negative personal beliefs. Unprocessed or blocked traumatic memories need help from therapies such as EMDR to become processed or unblocked.
IFS (Internal Family Systems) is an approach to psychotherapy that identifies and addresses multiple sub-personalities or families within each person’s mental system.
Sensorimotor psychotherapy (SP) integrates the body and movement into traditional talk therapy to address and heal ongoing psychological and physical difficulties.
Narrative Exposure Therapy: With the guidance of the therapist, a patient establishes a chronological narrative of their life, concentrating mainly on their traumatic experiences, but also incorporating some positive events. It is believed that this contextualizes the network of cognitive, affective and sensory memories of a patient’s trauma. By expressing the narrative, the patient fills in details of fragmentary memories and develops a coherent autobiographical story. In so doing, the memory of a traumatic episode is refined and understood.
Cognitive Processing Therapy (CPT) is a short term evidence-based treatment for PTSD and other related disorders. CPT is based in cognitive theory and helps individuals to recognize the impact that the traumatic event has had on their thoughts and beliefs, feelings and behaviors.
How Do I Know if I Should Seek Trauma Therapy?
If you experience any of the following it may be beneficial for you to see a professional who can help you sort through your experiences and move forward in life:
- You are easily startled
- Flashbacks or nightmares of the event
- Feeling afraid but not knowing why
- A generalized distrust in yourself, others, and the world
- Hypervigilance
- You notice a pattern of unhealthy relationships throughout your life
- Feelings of restment
- Unmanaged anger
- Avoidance of certain people, places, or things
- Unexplainable body aches and pains
- Chronic pain, inflammation, or fatigue
- Easily triggered
- Persistent feelings of sadness
If you are experiencing any of these symptoms, reaching out to a professional can help you determine if trauma therapy is right for you.
Written by Autumn Walsh, MSW. Autumn is accepting patients at our Pittsburgh location as well as online.
Interested in Starting Trauma Therapy?
Fill out the form below or contact us at 412-322-2129 to begin trauma counseling.
References:
Centers for Disease Control and Prevention. (2020, September 17). Infographic: 6 guiding principles to a trauma-informed approach. https://www.cdc.gov/cpr/infographics/6_principles_trauma_info.htm
Levine, P. A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. North Atlantic Books.
American Psychological Association (2017, July 31). https://www.apa.org/ptsd-guideline/treatments/narrative-exposure-therapy
Psychology Today (2022, May 20). https://www.psychologytoday.com/us/therapy-types/internal-family-systems-therapy
Bartella, A. (2011, October). Sensorimotor psychotherapy: A somatic path to treat trauma. The Trauma & Mental Health Report. Retrieved from https://trauma.blog.yorku.ca/2011/10/sensorimotor-psychotherapy-a-somatic-path-to-trauma-treatment/
Mindfulness for Social Anxiety, A Skills Group
Mindfulness for Social Anxiety, A Skills Group
This group is focused on helping clients practice mindfulness and cognitive behavior therapy (CBT) interventions for the treatment of social anxiety in a warm and accepting group environment. With the help and facilitation of Steven Mollura, LPC participants will address the impact of social anxiety on one’s thoughts, physical sensations, relationships, emotions, and behaviors and then learn skills which will teach them how to overcome their social anxiety. The skill group will meet for 90 minutes each Sunday for 8 weeks beginning August 18th.
Outline of Goals:
Decrease Shame around social phobia and self-identity.
Go from avoiding social anxiety feelings to going towards them.
Social skills training and practice.
Skills to decrease distress in social situations.
Identify and pursue valued social goals
Mitigate self-sabotage thoughts and behaviors
Screening Criteria:
Age: Over 18. No upper limit to age
No Gender requirements
Readiness for Group work: While the Counseling and Wellness Center of Pittsburgh is glad to work with all individuals who are experiencing a range of clinical diagnoses, some individuals who meet the diagnosis or criteria for personality disorder, severe mental disorders, avoidant or aggressive personality style, Autism Spectrum Disorder will not be the best fit for participation in this particular group. Please keep in mind, the interventions and processes are appropriate for the specific needs of those who hold the diagnosis of Social Anxiety Disorder or who experience some degree of social anxiety. Additionally, no one whose anti-anxiety medication effects will interfere with group processes will be allowed to participate in group, please call and speak with Steven Mollura LPC, NCC directly to assess whether this might be true for you.
All clients will in advance agree to;
Confidentiality; No talking about others in or outside of session.
Attendance; Clients will attend all sessions and arrive on time.
Participation: Clients will participate in session.
Clients will not come to session high or drunk, not under disruptive effects of anti-anxiety medication.
Outline per week.
Introduction, psychoeducation on the topic of irrational beliefs.
Icebreaker
Psychoeducation on social anxiety and social connection
Discussion of irrational or disruptive beliefs.
Psychoeducation and Challenging Irrational beliefs,
Process: 1.Social Situation 2. Identify Belief/s Triggered 3. Identify Feelings Experienced 4. Logical and compassionate reframes
Skill focus: eye contact and posture
Challenging irrational beliefs and reframing.
Skill: Assertive communication
I statements, eye contact, posture, firm body movements.
Assertive communication continued
Explain and practice assertive communication techniques
Mindful Acceptance: Describing VERSUS Evaluating. Acceptance of all experiences. Internal and external. Reframing.
Behavioral Flexibility (freedom to choose one’s behaviors despite noise of the brain/emotions)
Minimize suffering while doing so
Run Towards the Fear. Social Fitness Training
Use of fear as a tool to move towards goals.
Mitigating social self sabotage.
Termination session
Review of course.
If this is of interest to you, please call our center at 412-856-WELL
All participants will speak with Steven in advance for processing prior to groups start. Steven does accept United, Highmark, and UPMC insurance. Self paying clients will be charged 50.00 per group of 400 for all 8 weeks if purchased in advance.
Visit one of our other centers;
Counseling and Wellness Center of Pittsburgh
Counseling and Wellness Center of Pittsburgh- Wexford
How to Deal with Social Anxiety Event
Learn MoreTrauma; Honor For Your Healing Journey
Honor your healing journey
The four things your therapist wants you to know about your healing journey. When you’re healing from a grief, trauma, or resultant PTSD, you must be thinking about ‘how will I ever move on from this horrible, unexpected, agonizing reaction to the traumatic situation that I have experienced?’ Remember, PTSD is a reaction to witnessing or experiencing a sudden and unexpected event which caused one to feel powerless by delivering, threatening, or witnessing harm. How can I rise above these feelings and thoughts and create meaningful and complete healing? Maybe you want to go backwards in time and undo all of the harm that you have experienced. A common and reasonable response to all of these above disorders, particularly PTSD, is to try to avoid all triggers associated with the situation which evoked the trauma, hypervigilance, intrusive memories, nightmares, flashbacks and an increased risk for anxiety and depression. This disorder presents a mountain to ascend, and whether you have spend years in therapy or are only beginning to acknowledge the depth of the effects this has had on you, these are some points to keep in mind. These are the 4 things that your therapist wants you to know about healing that are not immediately evident.
Healed but not Forgotten
Some people have the unrealistic expectation that when they reach the end of their healing journey they shouldn’t have any emotional reaction to their memories of the traumatic event which led to grief and loss. That is not how healing works. It is quite likely that you will always have some sort of reaction to the memories and thoughts associated with your grief or trauma. In fact, according to a 2011 study published in NIH by Sherin and Nemeroff, and according to all of science and psychology support the fact that there is potential for long term neuroanatomical and neurochemical changes to the central nervous system resulting from trauma. These changes are especially evident in the way we respond to triggers or trauma associated stimuli. What we should be striving for in the healing from trauma is a ‘new normal.’ Healing means that you are able to function in professional or personal settings and that you are practicing resilience and positive coping when waves of thought and emotion do come.
Healing means Acknowledging Feelings
One of the ways that therapy works is by creating an intentional space for healing warriors to be honest with themselves, to create an understanding of their emotions. After an awareness has been formed adaptive responses to feelings and thoughts can be generated. We create psychopathology by being critical and attempting to repress our internal honest responses. For some people like first responders, police, and paramedics, there may be an extra layer of difficulty and stigma attached to acknowledging ones feelings and seeking mental health support to manage trauma. This can cause further damaging denial of the effects of traumatic experiences, One of the core tenets of psychological theory present in every form of therapy is that the more we repress, judge or avoid our feelings, the more we cause problems. Repression elicits tangled feeling constellations, blocked energies, incomplete and unintegrated shadows. Mindfulness based stress reduction, EMDR, Cognitive Processing Therapy, Cognitive Behavioral Therapy, and Exposure Therapy, have shown efficacy in treating PTSD. Our feelings can turn into psychopathology that are bigger and sometimes socially unacceptable forms of the original emotional response.
Healing Happens in Relationships. Find your Healing Tribe.
It is especially true for trauma that happens in relationships, that this same trauma is healed in relationships. When trauma survivors open up to those people who they consider to be safe, there is an incredible potential for healing to happen. Healing relationships are those that resonate compassion, gentle acceptance, warmth, and non-judgement. Think about it, we become close to those who we can be really honest with, those who ask about our feelings and can share in a compassionate interchange, (Mgrath, 2001). Sharing trauma should be exercised with caution. However well-intentioned our healing tribe may be, its members may inadvertently respond in less constructive ways that judge, shame, or put down the survivor for having the pain or scars of trauma. Another risk is not being able to hear or understand what is being shared. What is really needed is non-judgmental acceptance, understanding, and compassionate warmth.
Find your healing tribe
Positive Psychology, Pop Culture and Non-Reality
You may have survived a trauma but that doesn’t mean you have to fall victim to meme reality. Scroll through a social media forum and you will see many posts and memes which declare that everyone should be happy all the time. That isn’t honest or possible. The healthiest among us are those who are honest with themselves about what they experience and then respond to their vulnerable reality in a constructive way. According to a 2016 study by Elizabeth Kneeland, pop cultures layman positive psychology is damaging. When pop culture got its hands on positive psychology its representatives distorted the message, and now laymen perpetuate unrealistic and uninformed messages which imply that we can think our way into a good mood. It suggests that if we blink our eyes we can make trauma and psychological distress evaporate. Your therapist knows differently. Its ok to be outraged, disgusted, sad, hurt, angry, confused, and it is important to acknowledge where you are in your healing journey today.
No matter where you are today, the best we can do is to risk opening to ourselves, to create an honest internal dialogue that we are eventually able to share with others. We should unabashedly honor our own processes, giving relentless permission to feel, think and be; in reverence of joy, in honor of glorious fury, to the fullest expression of gaiety, to the utterance of insuperable hurt, to fully hone in on repugnant disgust. Keep developing your divine awareness, and eventually you will have created the unique meaning which understands with a lens of compassion, acceptance, and self love all that has happened to you.
With love and hope for resilience,
Stephanie Wijkstrom, MS, LPC, NCC
For More Reading
Kneeland, Elizabeth et al, Positive thinking Newsweek, 2016
https://www.newsweek.com/2016/09/23/positive-thinking-myth-498447.html
McGrath, Ellen. Psychology Today, published November 1, 2001
https://www.psychologytoday.com/us/articles/200111/recovering-trauma
Post-traumatic stress disorder: the neurobiological impact of psychological trauma
Sherin, Jonathan E, Charles B. Nemeroff
Dialogues Clin Neurosci. 2011 Sep; 13(3): 263–278.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182008/
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