Very frightening or distressing events may result in a psychological wound or injury. This trauma can result in difficulty in coping or functioning normally.
Everyone’s reaction to potentially traumatic experiences is different. Most people recover well with the help of family and friends and do not experience long-term problems. Some people experience problems directly after the traumatic event or much later.
Potentially traumatic events are powerful and upsetting incidents that intrude into daily life. They are usually experiences which are life threatening or pose a significant threat to a person’s physical or psychological wellbeing. An event may have little impact on one person but cause severe distress in another.
A person’s mental and physical health, available support at the time of the event or their past experience and coping skills can influence how they respond to a traumatic event. Situations and events that can lead to psychological trauma include:
- acts of violence such as an armed robbery, war or terrorism
- natural disasters such as bushfires, earthquakes or floods
- interpersonal violence such as rape, child abuse, or the suicide of a family member or friend
- involvement in a serious motor vehicle or workplace accident
Other stressful situations which appear less severe may still trigger traumatic reactions in some people.
It is important to remember that many people have strong emotional or physical reactions following experience of a traumatic event. For most, these reactions subside over a few days or weeks.
For some, the symptoms may last longer and be more severe. This may be due to several factors such as the nature of the traumatic event, the level of available support, previous and current life stress, personality, and coping resources.
Symptoms of trauma can be described as physical, cognitive (thinking), behavioural (things we do) and emotional. Physical symptoms can include excessive alertness (always on the look-out for signs of danger), being easily startled, fatigue/exhaustion, disturbed sleep and general aches and pains.
Cognitive (thinking) symptoms can include intrusive thoughts and memories of the event, visual images of the event, nightmares, poor concentration and memory, disorientation and confusion.
Behavioural symptoms can include avoidance of places or activities that are reminders of the event, social withdrawal and isolation and loss of interest in normal activities. Emotional symptoms can include fear, numbness and detachment, depression, guilt, anger and irritability, anxiety and panic.
As long as they are not too severe or don’t last for too long, the symptoms described above are normal reactions to trauma. Although these symptoms can be distressing, they will settle quickly in most people. They are part of the natural healing process of adjusting to a very powerful event, making some sense out of what happened, and putting it into perspective. With understanding and support from family, friends and colleagues the stress symptoms usually resolve more rapidly.
A small percentage of people go on to develop more serious conditions such as depression, post-traumatic stress disorder (PTSD), anxiety disorders, or alcohol and drug problems in response to trauma.
Most people are likely to experience a potentially traumatic event in their lifetime, and most individuals recover well, given time and adequate social support.
For some individuals however, the experience of a traumatic event or chronic exposure to trauma can trigger symptoms of posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) refers to a set of symptoms that can emerge following the experience of a traumatic event that involves exposure to actual or threatened death, serious injury, or sexual violence. Exposure to such events can be through:
- directly experiencing the traumatic event
- witnessing, in person, the event happening to someone else
- learning that the event has happened to a close family member or close friend
- repeated or extreme exposure to the aftermath of trauma (e.g., first responders to emergency situations).
Symptoms are characterised by a sense of reliving of the traumatic event, avoidance of reminders of the traumatic event, feeling numb, having negative thoughts and mood, and feeling agitated or wound up.
Without treatment, PTSD can become a chronic condition, and places the individual at greater risk of developing other mental health problems, such as depression or anxiety, or problems with alcohol or drug use. With sound psychological intervention however, the chances of recovery are good.
For more information about trauma and PTSD, you can visit the Australian Psychological Society’s website – https://www.psychology.org.au/for-the-public/Psychology-topics/Posttraumatic-stress-disorder
Complex post-traumatic stress disorder describes the long-term effects of severe, prolonged or repeated trauma, particularly due to child abuse or domestic violence. This has a wide range of effects on personality, identity, memory, mood change and emotional regulation.
Complex PTSD describes a more severe and long-term condition (compared with PTSD), that can occur after prolonged and repeated trauma, particularly in childhood. Trauma can cause problems with memory and disrupt the development of a person’s identity and their ability to control emotions and form relationships with others.
Complex PTSD can be caused by any type of severe and long-term trauma, and usually involves situations where the victim is held captive and unable to escape.
The types of traumatic situations which can cause this disorder include:
- long-term childhood physical or sexual abuse
- long-term domestic violence
- concentration camps or prisoner of war camps
- prostitution, brothels or sex trafficking
- organised child exploitation rings.
Symptoms of complex PTSD are similar to the symptoms of PTSD, as well as the following:
- difficulty controlling emotions
- periods of losing concentration (dissociation)
- blanking out or losing memories
- difficulties with a sense of identity or body image
- physical symptoms that can’t be explained medically, such as headaches, stomach aches, dizziness and chest pains
- disturbed relationships and cutting oneself off from other people
- an inability to trust others
- being vulnerable to abuse or exploitation
- self-harm, suicide attemptsand substance abuse
- feeling ashamed or guilty
- difficulty controlling emotions.
The main form of treatment for complex PTSD is long-term psychological therapy. This helps people slowly regain their trust in others. Then they can gradually start making friends, finding a job and finding hobbies. People with complex PTSD often have problems with drug and alcohol use, anxiety and depression. These will need usually treatment too.
Stabilisation and symptom reduction
Trauma recovery is best to be looked upon as a process that is worked on over time and in intentional stages. Recovery is the primary goal for people who have experienced trauma, their families, and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic affects. Recovery is an individual experience and will be and look different for everyone. In general recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.
The first stage of treatment for trauma involves learning strategies to regulate or soothe difficult emotions in everyday life, which individuals might or might not associate directly with the trauma/s. We call this stage of treatment stabilisation. In this stage we also focus on establishing or regaining a sense of safety within the therapeutic relationship, as well as learning to manage symptoms such as sleep disturbance and flashbacks.
Once stabilisation and symptom reduction is achieved, the focus may then move to the second stage of treatment, which involves processing trauma. This usually involves revisiting traumatic memories in order to reduce their impact on an individual’s life, and helping them to recover.
At The Glow Centre, we acknowledge that there is a vigorous debate in the field of traumatic stress as to whether revisiting traumatic memories is necessary for healing or whether it may in fact even be harmful. Obviously this is an individual matter; many may find it beneficial to tell and retell their experiences of trauma where others may find that destructive to their well-being. We will work with you and develop a treatment plan that either finishes with Stage 1, or moves into Stage 2 treatment – depending on your preferences and your goals.
According to the WHO Guidelines for the Management of Conditions That Are Related to Stress (2013), EMDR therapy and CBT trauma-focused therapy are the only psychotherapies recommended for children, adolescents and adults with PTSD. We are trained in both Prolonged Exposure (PE) therapy, which is a DBT trauma-focused therapy; and EMDR therapy. Both of these treatments involve progressive exploration and processing of traumatic memories within specific frameworks.
“The experience of emotional overwhelm [trauma] is similar to that of a shaken bottle of soda. Inside the bottle is a tremendous amount of pressure. The safest way to release the pressure is to open and close the cap in a slow, cautious and intentional manner so as to prevent an explosion”. (Rothschild, 2010).
Prolonged Exposure (PE) therapy
Prolonged Exposure (PE) therapy was originally developed in the 1990s, to treat PTSD. The name Prolonged Exposure reflects the fact that the treatment program emerged from the long tradition of exposure therapy for anxiety disorders in which clients are helped to confront safe but anxiety-provoking situations in order to overcome their fear. To date, treatment such as PE that use exposure therapy have received the most research support for their effectiveness in treating PTSD, and have been designated by expert consensus as a first-line treatment for PTSD. The strong effectiveness of exposure therapy has been demonstrated in a wide range of trauma populations.
For more information about PE therapy, you can visit:
Eye Movement Desensitisation and Reprocessing (EMDR) therapy
EMDR therapy has been shown to be effective in over 25 scientific studies and numerous independent reviews as an effective and efficient psychological intervention. The eye movements in EMDR have been shown to be important in producing neurological changes in the brain which cause rapid reductions in the vividness and emotional charge of distressing memories.