What is Trauma?
Trauma is related to disturbing experiences of an extreme type. Examples include terrorist incident, air-line crash, assault, rape (or other sexual abuse), and natural disaster. Milder examples include (non-injurious) car accident, getting trapped in a lift, or personal accident. Exposure to such incidents produces trauma, which is an upsetting memory linked to the event. Trauma may be accompanied by shock, anxiety and emotional distress.
However, most people with trauma (whether mild or serious) do not develop post-traumatic stress disorder. In the majority of cases the shock will fade between 4-6 weeks, and symptoms of post-traumatic stress disorder may never appear at all. Psychotherapy can help to get a larger perspective on the matter, and to work through emotions. This can prevent PTSD from developing.
The symptoms of post-traumatic stress disorder.
Symptoms of PTSD include:
- Flash-backs, in which the traumatic incident is vividly replayed in the mind
- Hyper-vigilance for danger
- Impaired concentration
- Hopeless thinking patterns
- Detachment/Emotional numbness
- Avoidance of activities and sites associated with trauma
If any of these symptoms appear and get worse after 6 weeks following the traumatic incident the individual is classed as having post-traumatic stress disorder. However, only around 20% of people exposed to a traumatic incident develop the disorder. In most cases that do the individual may have:
- Previous unresolved trauma episodes
- A prior history of anxiety and other mental health issues
- Poor resilience
- Poor social support
Some survivors may experience intense guilt if the incident involved children, partners and friends who died, or were seriously injured. Others may experience shame over what they see as a failure to act. These feelings complicate the underlying problem, and intensify the symptoms. In a few cases suicidal thoughts may appear.
What causes post-traumatic stress disorder?
Simply put, the cause of the problem lies in the mind and its judgments about what happened, why it happened, and what this means to the individual. When these judgments are catastrophic each flashback, nightmare or return of distressing feelings are seen as evidence of breakdown. Triggering states of anxiety, dread and helplessness.
Getting over trauma
Psychotherapy helps people view the trauma (memory) in a different way. Viewing the original incident in context in the past- as a tragic life event rather than as a personal threat in the present. (Note: this does not apply to domestic abuse, in which the survivor will require safe-guarding measures). In this way clients normalise their experiences, rather than catastrophising them.
When people are able to view the incident impersonally they are less likely to fuse with the memory.
Resilience coaching helps clients improve their coping mechanisms in recovery:
- Reaching out for support
- Taking time out
- Keeping to a routine
- Calming techniques
- Maintaining focus on purposeful activity in personal, work and family life
- Personal growth: reflecting on what can be learned from terrible experiences
Treatment of post-traumatic stress disorder
Psychotherapy can assist in re-contextualising and normalising the traumatic experience. As well as creating a channel for the discussion of emotions, and mapping a path to recovery. Along the way addressing the catastrophic thoughts that lead from an experience of trauma to PTSD. Leading, in turn to improved resilience and re-orientation to life.
Where the client is overwhelmed by the traumatic memory itself Eye-Movement Desensitisation & Reprocessing (EMDR therapy) is of proven effectiveness in such cases. EMDR is a technique that neutralises painful memories. In the EMDR process random hand signals are used to distract eye-movements as the client recalls the traumatic memory. This interrupts the brain’s attempt to re-process the memory. After several repetitions the link between anxiety and the trauma memory is broken.
For a short video on the EMDR technique click here.