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/
5 Ways to Help Newly Adopted Children During the Holidays
When most people celebrate the holidays, they are surrounded by loved ones telling stories and laughing over mugs of hot cocoa as they exchange gifts. During this time of holiday cheer, many children who were adopted are faced with the realization that they will not see any of their biological family during the holidays. It is a stark reminder of the grief and loss they have experienced up to and including being removed from their biological family’s home. It is important for adoptive parents to prepare for and remain aware of what they can do to help their newly adopted children during the holidays. Here are some therapist recommendations to follow:
- Talk about the holiday. Help your child understand what holiday traditions and festivities your family participates in and allow them to ask questions. Do you celebrate over many days or just one day? Are there religious customs? Who will they meet and will there be gift exchanges? Avoiding surprises will help decrease anxiety.
- Incorporate traditions that the child celebrates into your holiday. Whether it is an annual watching of Frosty the Snowman or a snowball fight on Christmas Eve, bringing a cheerful memory to life may make a child feel more comfortable. You may even get a smile. Through conversation, you may discover that your child doesn’t celebrate the same holiday you do. Make it a point to learn about their customs and show interest in celebrating them.
- Allow them to grieve. Despite your best efforts, your child may still pull away. This is not intended to be a reflection of their feelings toward you or their new family, but instead a way of coping through this difficult time. Make one-on-one time with your child to talk through what they may be feeling. Be prepared if they shut down the conversation or not know exactly what they need. Give enough space for “downtime” and do not force them to participate in any activities.
- Don’t chase the “perfect” holiday. This not only creates unnecessary stress for you, but also for your child. Be flexible, be realistic, and have a sense of humor when things don’t go as planned! This can also include unexpected responses from extended family who do not understand the child’s behavior.
- Stay Trauma-Informed. Educate yourself on trauma and the impact it has on the dynamics of a family. Trauma can often look like anger, hyperactivity, and defiance. Without an understanding of the effects of trauma, it is likely you will misinterpret your child’s behavior resulting in feelings of anger and resentment. There are many resources online to assist in Trauma-Informed Care such as attachmenttraumanetwork.org or childwelfare.gov.
In summary, there isn’t one right way to raise a child. Remember to give yourself grace and practice self-care! Your child will teach you more about yourself than you may have ever realized previously. With patience, knowledge, and empathy, you can create an open environment that allows an adoptive child to feel comfortable expressing their fears, triggers, and even their feelings about their biological family.
Written by: Teresa Gouch, a licensed professional counselor at the Counseling and Wellness Center of Pittsburgh. Teresa specializes in trauma counseling and foster care/adoption counseling.
Trauma Informed Care; We Have Evolved to be at risk for Trauma; Here is Why
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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