What is Trauma?
Trauma refers to an emotionally painful, or distressing event or situation that has overwhelmed the individual to the point of not being able to cope. The most common traumas include physical and sexual assault, motor vehicle accidents, terrorist attacks and life threatening illnesses. In fact any event or situation that is experienced as life-threatening is in itself a trauma. People respond to traumatic situations with adrenaline and a “fight, flight or freeze” response. This surge of adrenaline, coupled with the emotional distress caused by the traumatic event or situation result in a post-traumatic reaction or response. This response frequently continues for a while after the event and includes the experience of fear and possibly nightmares or flashbacks as well as feeling irritable and easily distracted. Some people may even withdraw completely – all of which are completely normal responses to a traumatic event or situation. This response should resolve within around a month. If the signs and symptoms of the post traumatic reaction do not resolve, then that person may be struggling with post-traumatic stress disorder.
The word “trauma” is used to describe experiences or situations that are emotionally painful and distressing, and that overwhelm people’s ability to cope. Such experiences or situations can include sexual and physical assault, motor vehicle accidents, being taken hostage or attacked, torture, natural disasters, and life threatening illnesses, as well as witnessing death or serious injury by violent attacks, accidents or war. Experience of a traumatic incident usually results in a post-traumatic stress response.
Post-Traumatic Stress Response vs. Post-Traumatic Stress Disorder
The most common signs of post-traumatic stress disorder is experiencing the following symptoms for over a month past the incident. The individual experiences intrusive memories about the event such as flashbacks or nightmares and experiences intense emotional distress when thinking about the trauma. The person may begin avoiding any activities, places or people that remind them of the trauma, may begin forgetting aspects of the event or situation, begin feeling detached from others in their lives and feel emotionally numb.
The person may also experience a disturbance in their sleep, experience irritability or uncontrollable outbursts, have difficulty concentrating and find themselves easily distracted and constantly ‘on edge’. When these symptoms are experience long after the trauma has occurred, then there is a need to find professional assistance in dealing with, and processing, the trauma.
Signs and Symptoms of PTSD
The symptoms fall within three categories of experience – re-experiencing of the traumatic event, an attempt to avoid all reminders of the event and an increase in emotional arousal and anxiety.
- Intrusive, upsetting memories of the event
- Flashbacks (acting or feeling like the event is happening again)
- Nightmares (either of the event or of other frightening things)
- Feelings of intense distress when reminded of the trauma
- Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating
- Avoiding activities, places, thoughts, or feelings that remind you of the trauma
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Feeling detached from others and emotionally numb
- Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hyper vigilance (on constant “red alert”)
- Feeling jumpy and easily startled
If you have been experiencing most or all of these symptoms for a period of more than a month following the traumatic event then a diagnosis of post-traumatic stress disorder can be made.
How is Trauma and PTSD treated?
Earlier intervention is always preferable, particularly because post-traumatic stress disorder can be so debilitating and impair functioning. Sometimes medication is used in the treatment of the condition, especially when the client is experiencing symptoms of depression or struggling to cope with their anxiety. The therapy will more than likely focus on the trauma itself and allow the person a safe space in which they can talk about what happened and process the trauma properly so that it ceases to affect them in such an emotionally arousing way. Cognitive Behaviour therapy is used when anxiety around similar events or situations is very high.
After counselling, the client can expect to feel less hypervigilance and anxiety. They will more than likely be able to re-tell the event without any significant emotional or psychological distress. The trauma counselling will have re-processed the memory in such a way that it no longer affects the person in a negative and distressing way. In some cases, where severe anxiety or depression are experienced, the counselling will help the client find more effective coping skills that allows them to manage their emotions in a more controlled and positive way. The client will likely leave therapy with a more rational outlook, having challenged any distortions on their thinking that contributes to general distress. Counselling also helps the significant family and friends of the client to understand the difficulties the client is facing. In this way the client can also expect to receive more empathic support and the family and friends can feel more comfortable in their handling of the situation.
Things you can do to manage your anxiety and traumatic response:
The very first thing you can do is learn more about anxiety and PTSD and realise that anxiety is a normal and adaptive system in the body that alerts us to danger. Understanding the different ways in which the body responds to trauma is essential to realising that you are not going crazy. Flashbacks, although frightening, are a normal response to trauma but still require professional assistance to help you through this difficult phase.
There are a variety of ways that you can manage the anxiety and increased emotional arousal that you are experiencing. The first effective way is relaxation through deep breathing techniques. Here you can close your eyes and focus on your breathing for the count of 10 breaths. Make sure you breathe in enough air to fill your lungs completely, hold it for a second or two and then slowly release – making sure that each breath in lasts exactly as long as each breath out. Other relaxation methods include muscle relaxation and visualisation techniques. Make sure that you learn at least one method to help you relax when you need it.
Re-experiencing such as having flash-backs can be a really frightening experience. Grounding techniques will help you when you feel like you are losing touch with the present moment. You can start grounding yourself by touching an object around you, like a chair or table for example. As you touch the object begin describing the texture, look and feel of the object. You could do the same with running cold water over your hands and, again, describing how it feels for you. Alternatively you could wiggle your toes in your shoes and begin to focus on the feel of shoes around your feet, pants or skirt on your legs, sweater sleeves on your arms and so forth. Lastly, you could use a technique whereby you name as many animals you can think of or try to spell your name backwards.
Get back into your life
When you are struggling with post-traumatic stress disorder there is a strong tendency to withdraw and isolate yourself. Perhaps leaving home feels too daunting and scary. You have to get back onto the proverbial horse, so to speak and engage with people around you. Find supportive friends and family that can help you through this difficult time, but resist the urge to withdraw yourself completely.
If you feel like you are under trauma and stress, or you are concerned about someone you love, talk to us about our counselling services.