Trauma and its Impact on Functioning
Most people tend to think that trauma and Posttraumatic Stress Disorder (PTSD) have to be associated with major events such as, near death experiences, sexual abuse, violence or war. Sad to say, but many people have experienced something traumatic in their life at some point. As a field we have expanded our view of trauma and PTSD. Historically, we (professionals) required a specific threat to one's life to meet the diagnosis of PTSD, but as we enhanced our understanding of trauma the diagnosis also adapted. The Diagnostic and Statistical Manual V (DSM V) altered the criteria to be more inclusive, it now identifies, "exposure to actual or threatened death, serious injury, or actual or sexual violence" (American Psychiatric Association, 2013). A person can meet criteria by directly experiencing the events, or witnessing events. The DSM also includes, "learning that the traumatic events occurred to a family member or close friend" and "experiencing repeated or extreme exposure to adverse details of the traumatic events." Some of this might sound like gibberish, but being able to include people who have repeatedly heard about traumatic events, known people who have experienced traumatic events and have been affected by it, can find some validation in this definition. As most clinicians would agree, we have all seen people with trauma symptoms that were not directly included in the 'traumatic event' itself.
To complicate things, a person can have problems with trauma without PTSD. I have seen many clients in my practice who do not meet criteria for PTSD, but in fact struggle with the emotional and psychological effects of trauma in their day to day lives.
To complicate things, a person can have problems with trauma without PTSD. I have seen many clients in my practice who do not meet criteria for PTSD, but in fact struggle with the emotional and psychological effects of trauma in their day to day lives.
Examples of traumatic events can include:
- Medical conditions/ diagnosis (new or chronic)
- Death of a loved one, or close friend- sudden or expected
- Hearing about death of a friend or close acquaintance
- Hearing about threats of violence or harm to others
- Suicide in your community or with a friend, or a family member
- War and being in a close relationship with someone who was in a war
- Hearing traumatizing stories
- Genetic trauma/ epi-genetics* (something far to expansive to cover here- way more complex)
- Abuse of any kind: physical abuse, sexual abuse, emotional abuse (yes this is real!)
- Car accidents
- Separation from parents, loved ones or caregivers
- Hearing stories of someone else's violent experiences or trauma
- Actual threatened loss of life
- Almost dying
- Dying and returning to life
- Overdoses
- Neglect
- Head injuries
- Adoption
- Witness to violence
- Religious abuse
- Community violence
- Severe poverty
Some people suffer from "Complex Trauma", which incorporates multiple experiences and repeated traumatic events. Individuals with this type of trauma usually require extensive treatment that addresses the various emotional and behavioral symptoms that accompany it. I have worked with people who have severe trauma symptoms from repeated traumatic events, which included emotional, psychological and physical abuse. The accumulation and repetition of traumatic experiences can have a significant impact on the functioning of an individual.
The symptoms of trauma vary depending on degree of trauma. The severity of trauma and acuity of symptoms are not equal in balance, everyone just responds differently.
The symptoms of trauma vary depending on degree of trauma. The severity of trauma and acuity of symptoms are not equal in balance, everyone just responds differently.
Some of the emotional and behavioral responses that people have after trauma can be:
- Avoiding situations or people that remind someone of the event(s)
- Not wanting to think about the event(s)
- Refusing to talk about it
- Having nightmares or recurring dreams about traumatic events
- Experiencing images or thoughts that pop in (intrusive) and are emotionally uncomfortable
- Being irritable when they are experiencing intrusive thoughts or images
- Depression (lethargy, sadness, wanting to isolate)
- Anxiety (fear, startle response)
- Anger (agitation, easily frustrated)
- Trouble finding happiness or satisfaction
- Concentration problems
- Problems sleeping
- Impulsive / reactive behavior
- Forgetting parts of the traumatic event(s)
- Hypervigilance
There are so many symptoms that people experience after traumatic events, that it is impossible to list them all. Sometimes individuals who experience Acute Stress Disorder (directly after an event) may never develop PTSD, but no one can say for sure how someone will handle a traumatic event. Everyone responds differently. Embarrassing enough, I clap or freeze! I had a coworker scare me and I clapped! I still laugh at that. The fight, flight, or freeze response is not a choice. A person's body does what it does. I have heard stories of people being seriously embarrased by their physiological responses when they were in a life threatening or highly stressful situations. It is not that uncommon to hear of people 'going in their pants' or freezing when danger is RIGHT in front of them. Most of us want to 'do the smart thing' or respond the best possible way. The body has an agenda when we are in shock and the front of the brain has very little control in those moments.
We are only in control of how and what we do to get help after the event. Sadly, many people fear looking at their emotions when it comes to trauma which usually causes them to avoid treatment. For some people, getting through trauma is okay on their own, they talk with friends and family and recover. Some stuff it down and go about life, operating as if it never happened and ignoring their feelings. However, it usually begins to interfere or show up somewhere in their life.
Trauma is not simple or straightforward, it harbors complicated emotional and behavioral symptoms that interfere with life satisfaction and sometimes functioning. Trauma impacts families, friends, partners, and communities. I provide treatment of trauma through the use of Eye Movement Desensitization and Reprocessing (EMDR). To learn more about EMDR follow this link to the other page.
For more reading on trauma I recommend the awesome book, "The Body Keeps the Score" by Bessel Van Der Kolk, MD.
We are only in control of how and what we do to get help after the event. Sadly, many people fear looking at their emotions when it comes to trauma which usually causes them to avoid treatment. For some people, getting through trauma is okay on their own, they talk with friends and family and recover. Some stuff it down and go about life, operating as if it never happened and ignoring their feelings. However, it usually begins to interfere or show up somewhere in their life.
Trauma is not simple or straightforward, it harbors complicated emotional and behavioral symptoms that interfere with life satisfaction and sometimes functioning. Trauma impacts families, friends, partners, and communities. I provide treatment of trauma through the use of Eye Movement Desensitization and Reprocessing (EMDR). To learn more about EMDR follow this link to the other page.
For more reading on trauma I recommend the awesome book, "The Body Keeps the Score" by Bessel Van Der Kolk, MD.