As it is defined, trauma is the response that a person has to an event or experience that is disturbing or distressing. More so, it is the psychological and emotional impact that a person feels, though physiological impact is also a common symptom and experience of trauma. It is interesting that the trauma is not necessarily the event, but rather the response or experience that a person has after the event. There is true subjectivity in this, as two people can experience a similar catastrophe, yet only one may have a trauma impact. Despite this level of subjectivity, we are increasingly aware of the long term impact that trauma has on a person, and it helps to know the criteria, the conceptualization, and the techniques that are used to overcome trauma.
In the psychological sense, the term trauma may evoke thoughts of the diagnosis, Posttraumatic Stress Disorder (PTSD). We often hear PTSD spoken about with veterans and military members, though any person who has been exposed to a life-threatening event can develop PTSD. Yet not every soldier, not every veteran, and not every survivor of a life-threatening event develops PTSD. PTSD is a mental health diagnosis that involves the factor of the triggering event, as well as life experiences, perspectives, and level of distress tolerance among many other variables. Resilience, as we spoke of last week, is also a factor in the brain and body’s response to trauma. PTSD criteria includes symptoms lasting longer than four weeks, impacting daily functioning, and symptoms that can include re-experiencing the event, avoiding situations that trigger reminders of the event, negative beliefs and feelings, and hyperarousal, such as being overly alert, vigilant, or irritable.
Trauma reactions can also occur from a build up of many smaller traumas, or as psychologists commonly differentiate, “little t” and “big T” traumas. While they are described as diminutive, the “little t” impacts are often anything but, and can include factors such as divorce, loss of job, legal difficulties, financial difficulties, or conflict. Even conventionally celebratory events, such as planning a wedding or having or adopting a child can bring with it many “little t” reactions; the disruption on ones’ life is significant, and can have major and cumulative effects. Conversely, “bit T” traumas are what we typically associate with danger to bodily integrity. A natural disaster, terrorist attack, sexual assault, war zone experiences, or a car accident are all considered “big T” traumas, and there is often a sense of powerlessness or helplessness that is a differentiating factor between the big and little traumas.
Not every trauma experience evolves into full fledged PTSD, though addressing the trauma reaction can help prevent some of the cumulative effect that may lead to a PTSD diagnosis later in life. In a therapy environment, your therapist will likely use cognitive and behavioral techniques to help address some of the cognitive distortions, or faulty thought patterns, that are associated with the trauma. A common reaction to trauma is to personalize, or blame ones’ self, and a therapist will help identify these thinking errors and reframe towards acceptance. Behaviorally, individuals who have experienced trauma will often avoid things that may trigger. In a safe and therapeutic environment, a provider may use exposure therapy to help gradually retrain your brain to have a more mindful and calm approach to stressful experiences. Medications may also be used, to help process the initial “fight or flight” reaction differently in perceived stressful environments. Group support is also helpful, to know that you are not alone, that others understand and have lived through it as well.
The bottom line is that we cannot always control the experiences that we have, and sometimes these experiences are so significantly stressful or distressing that we develop a psychological response. There are tools and techniques that can help, and we would love to help you along that journey!