What is Trauma?
Trauma as used in the modern context is an often misused term. People can refer to ‘traumatic experiences’ which although extremely stressful are not traumatic in the true sense of the word. When I refer to trauma in this article I am referring to ‘the often debilitating symptoms that many people suffer from in the aftermath of perceived life-threatening or overwhelming experiences’ (Levine).
While it is true that all traumatic events are stressful, not all stressful events are traumatic. No two people are alike and trauma can affect individuals in different ways depending on a number of factors. These include:
• Genetic make-up
• History of trauma
• Family dynamics
What is clear is that human beings are born with an innate ability to triumph over trauma. However, certain types of early childhood trauma can severely diminish our ability to cope and be fully functioning as adults.
Effects of Trauma
The effects of unresolved trauma can be devastating. Later in this article I will look at some of the symptoms that traumatised people can suffer from. We become traumatised when our ability to respond to a perceived threat is in some way overwhelmed. Trauma can lead to gradual undermining of our self-esteem, self-confidence, feelings of well-being and connection to life. Our choices become limited as we avoid certain feelings, people and situations and places. This severely curtails our options leading to a reduction in freedom and independence and a loss of vitality.
Causes of Trauma
Trauma does not have to stem from a major catastrophe. Some common triggering events include:
• Car accidents, even minor ones.
• Routine invasive medical procedures
• Loss of loved ones
• Natural disasters
Trauma is trauma no matter what caused it. People can be traumatised by any event they perceive (consciously or unconsciously) to be life-threatening. The critical factor is the perception of threat and the incapacity to deal with it.
Obvious causes of trauma include:
• Severe childhood emotional, physical or sexual abuse
• Neglect, betrayal, or abandonment in childhood
• Experiencing or witnessing violence
• Catastrophic injuries and illness
Less obvious causes include a variety of apparently ordinary events.
• Minor car accidents, particularly those which result in whiplash
• Invasive medical and dental procedures. This is particularly true with regard to children who may have been restrained or anaesthetised. For adults certain medical procedures, such as a pelvic examination, can be experienced as an attack, even though rationally we accept that they are necessary and beneficial to our health.
• Falls and other apparently minor injuries. This is particularly true with regard to children and older people.
• Natural disasters, including fires and floods.
• Illness especially if it involves high fever or accidental poisoning
• Being left alone. Young children and babies are particularly susceptible.
• Prolonged immobilisation, such as wearing a cast for a long period.
• Exposure to extreme heat or cold.
• Unexpected loud noises. This is particularly relevant to children.
• Birth stress, for both mother and baby.
Symptoms of Trauma
When you are threatened your body instinctively generates a lot of energy to help you defend yourself against the threat or escape from it. This energy can get frozen into the body and cause problems and symptoms later on. When our bodies are feeling uneasy they give us messages to inform us that something is not right and needs our attention. When these messages are ignored, trauma developes.
The first symptoms that are likely to develope immediately after an overwhelming event include hyperarousal, constriction, dissociation and denial. Feelings of helplessness, immobility or freezing are also common.
Hyperarousal: physical symptoms include increased heart rate, perspiration, rapid or shallow breathing, cold sweats, tingling and muscular tension. Mental symptoms can include repetitious thoughts, racing mind, and incessant worry.
When these thoughts and body sensations are acknowledged and accepted for what they are, they will peak, and then begin to dissipate.
Constriction: part of the human response to life-threatening situations is hyperarousal accompanied by constriction in our bodies and a narrowing of our perception. This is an instinctive response intended to focus our attention and channel all available energy into defending ourselves from the perceived threat. Non-essential functions in the body are switched off as our attention is focussed on either defending ourselves or escaping the danger. Constriction affects breathing, muscle tone, and posture. Blood is diverted away from the skin, extremities and internal organs and pumped into the muscles in preparation for defensive action or escape. The digestive system is inhibited and we may also feel numb or frozen.
Dissocation or denial: dissociation protects us from being overwhelmed by escalating arousal, fear and pain. It is a way of enabling a person to endure experiences that would otherwise be beyond endurance. Denial is a lower form of dissociation. After a painful or life-threatening event we may deny that the event took place at all or minimise its importance. To truly acknowledge what occurred we would have to allow ourselves to experience the emotions that come with the memory and often this is too painful. It is easier, at the time, to remain in denial. Dissociation can sometimes be experienced as part of the body being disconnected or the sense that it is no longer there.
Feelings of helplessness, immobility or freezing: these are also part of the instinctive response initiated during a threatening experience. When the body perceives that there is no possibility of defence or escape it appears to shut down. Not the ordinary feelings of helplessness one feels during stress. It is a real physical response, and because it is instinctive, it is outside of our control.
During or shortly after the event, the above symptoms appear. Subsequently, even years later, other symptoms can appear:
• Intrusive images
• Extreme sensitivity to light and sound
• Exaggerated emotional and startle responses
• Abrupt mood swings
• Shame and lack of self-worth
• Reduced ability to deal with stress
• Difficulty sleeping
If the trauma is not addressed, then a further set of symptoms can appear.
• Panic attacks, anxiety and phobias
• Mental blankness or spaced-out feelings
• Avoidance behaviours
• Attraction to dangerous situations
• Addictive behaviours (over-eating, smoking, drinking, etc).
• Exaggerated or diminished sexual activity
• Amnesia or forgetfulness
• Inability to love, nurture or bond with other individuals
• Fear of dying or having a shortened life
• Loss of sustaining beliefs (spiritual, religious or interpersonal)
The symptoms of trauma can be ever-present or they can come and go, remaining hidden for years and then suddenly surfacing. They can also be triggered by stress.
The symptoms can grow increasingly complex over time, and the connection to the original trauma experience can diminish, leaving us with the symptoms and no apparent cause.
Compulsion to repeat: this is a complicated symptom and can create life-long difficulties for trauma sufferers. This refers to the compulsion to repeat the actions that caused the trauma in the first place. People who have been subjected to physical or sexual abuse in childhood may find themselves repeatedly in abusive relationships and not understand why. The repetition compulsion is about recreating the original circumstances of the trauma in an effort to resolve it. Children who have experienced trauma will often re-create it in their play. Recurring accidents are another example of the compulsion to repeat, especially if the accidents have similar characteristics.
In order to heal trauma we need to learn to trust the messages our bodies are giving us. The symptoms of trauma are internal wake-up calls. The healing of trauma is primarily a biological process or bodily process often accompanied by psychological effects. This is especially true when the trauma involved betrayal by those who were supposed to protect us.
It is important to note that it is not necessary to consciously remember an event to heal from it. Trauma happens on an instinctual level, and the memories of it are stored as fragmentary experiences in our bodies, not in the rational parts of our brains. Successful healing methods inevitably involve establishing a connection to the body.
Levine, P. (2006). Healing Trauma – A Pioneering Program for Restoring the Wisdom of Your Body, Sounds True, Boulder, Colorado.