What is trauma? 

Trauma is a very stressful or frightening experience in which the individual perceives they have limited (or no) resources to cope and lack control over the outcome. Trauma can be a one-off event, like a natural disaster or an accident, or it could be cumulative, such as the effects of chronic emotional abuse and neglect in childhood. 

 

Trauma Response

Humans have an instinctual response to trauma which has evolved from a need to survive. This response necessarily elicits strong emotions and physical responses - the fight or flee response - via the activation of the sympathetic nervous system to keep the individual safe from danger.

 

Stress hormones of cortisol and adrenalin are released. Muscles become tensed and ready to go and blood is directed away from the core and brain toward the limbs in preparation to fight or run away. After all, energy can’t be wasted digesting food (which is why people may feel nauseous) and there is no time to engage in step-by-step problem-solving.

 

After the event passes, the calm-down response (aka the parasympathetic nervous system) kicks in and the individual can settle down and think logically again.

 

Another way to survive traumatic events is to freeze. The individual shuts down or dissociates to protect themself from experiencing the brunt of the pain and distress they are enduring. This may happen during the event itself or become a normative state if the trauma is ongoing. 

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Depending on the severity and impact of the trauma, people often experience trauma symptoms months after the event such as:

• Intrusive memories

• Flashbacks (feeling as if you were “there”)

• Nightmares

• Negative thoughts and emotions

• Overactive startle response

• Feeling tense and on guard

 

This is a natural response in the aftermath of a trauma. In the majority of cases, the memory of the event recedes and the influence it has lessens over time. This happens when people can feel their emotions, talk it through with others, and come out on the other end okay with themselves and with their world. The trauma becomes successfully integrated into the package of one’s life experiences. 

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When does trauma become traumatizing?

Whether the trauma is traumatizing has little to do with the traumatic event itself, but the meaning people make of it.

 

Role of avoidance

The trauma may elicit or reinforce beliefs that the world and others are dangerous. This can lead to avoidance of trauma reminders (which can be people, places, events, thoughts). Paradoxically, this avoidance keeps the distress going: the more an individual attempts to avoid, the more their brain is convinced that the avoidance has kept them safe from real danger. Avoidance keeps the emotions and thoughts about the trauma going by shortcircuiting the natural alarm system for danger. It still sounds the alarm for danger, even though the individual may rationally know they are not actually in danger.

 

Heightened emotional and physical responses reinforce the thoughts that the world and others are not safe, as well as the negative belief about the self which leaves feelings of powerlessness, unworthiness, and shame. 

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Trauma as an embodied experience

There is more going on with unresolved trauma than simply avoidance, however. Research has more recently shown that trauma is embodied. People “feel” trauma. After all, how do you know you are experiencing emotion unless it is felt in the body? For children under 3 years of age, the body is the only way that they can perceive trauma as the parts of the brain responsible for language and rational thinking have not fully developed. As we age, our brain develops its capacity for logic and the ability to make sense of things. But this doesn’t mean the body no longer receives the impact of trauma.

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Lack of integration in the brain

Trauma researchers have discovered that unresolved trauma becomes trapped in the right side of the brain - the part that is dominant for processing emotions - as a disorganized array of pictures, feelings, and sensations without a way to connect to the rational, logical left side of the brain. This is likely why people can understand the trauma as a past event and that they are no longer in danger but still don’t feel as though they are.

 

Because trauma is not properly integrated into the part of the brain that can organize, plan, reflect, and generally make sense of things, the traumatic event lacks a coherent narrative, including a sense of time. The individual reacts to reminders of that trauma as though it still poses a threat in the present. 

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Physical effects of trauma

Living in a state of high alert leads to a stressed-out nervous system. Chronic elevation of stress hormones not only causes physical discomfort and pain but also breaks down the immune system, making people more susceptible to illness and autoimmune disorders. It can result in mental health disorders such as anxiety, depression, and PTSD (Post-Traumatic Stress Syndrome). People who are burdened with an underlying sense of inadequacy, helplessness, or hopelessness tend to have less capacity for managing daily stress and the big challenges that are an inevitable part of life. 

 

 

 

 

 

 

 

 

 

 

 

 

Hope for healing

Fortunately, there are ways to heal trauma. The first-line treatment for trauma is psychotherapy, specifically Cognitive Processing Therapy (CPT) - a CBT approach to trauma - and Eye Movement and Desensitization Reprocessing (EMDR), endorsed by the World Health Organization (WHO), International Society for Trauma Stress Studies (ISTFS), and the U.S. Department of Veteran Affairs.

 

For many individuals, CPT helps to identify and change unhelpful thoughts and beliefs that become “stuck” and inflexible. These stuck points result in behaviors that keep them from experiencing more adaptive ways of dealing with and integrating their experience. 

 

For others, working with cognition is not enough. They may benefit more from a therapy that attends wholistically to the cognitions, emotions, and the felt sense of these in the body. EMDR targets specific memories of the trauma while activating the brain’s natural processing abilities through bilateral stimulation of the body. Clients are guided to keep dual attention during this reprocessing of the event: they dip into the past while staying in the present. This allows the right and left brain to connect and integrate the experience so the individual can move forward with new, more adaptive responses.