Trauma (PTSD)
The word trauma originates from the Greek language and means wound or hurt. Approximately 90 percent of the population will experience one traumatic event in their lifetime (Schwartz, A. (2021)). Trauma can be abuse, accidents, assaults, bullying, adversity, discrimination, lack of safety, neglect, poverty or violence, to name a few. There is a reasonable expectation that experiencing trauma will cause significant distress for the individual. We want to be careful not to pathologize natural reactions to trauma; it cannot be emphasized enough. The impact of trauma can be immediate and ongoing, especially if the trauma has not ceased, and it can continue to impact you long after the traumatic events occurred. Trauma significantly impacts functioning, such as difficulty sleeping or eating; having intrusive thoughts or memories of the trauma; and emotional instability. Trauma can also impact cognitive functioning, such as difficulty focusing, easily distracted, inability to complete tasks, which mimics symptoms we see in ADHD, but ADHD is an entirely different diagnosis. You can learn more about it here.
In treatment, we are either exploring acute / ongoing trauma or we are exploring past trauma. When someone is currently experiencing traumatic events our first goal is to ensure they are safe, physically and mentally. We will address different approaches to navigate these traumatic events based on individual needs and to reduce long-term effects of trauma. Imagine placing your foot on your car’s gas pedal and pressing down without letting up. Eventually you’re going to cause damage to the engine. Being in a constant state of trauma without resolution is turning on your body’s stress response and not taking your foot of the gas pedal which will adversely impact the body.
Over time, trauma can be stored in the body as a psychological and physiological experience of distress that can interfere with our capacity to view the world as safe. The body’s nervous system is made up of the parasympathetic (rest and digest) and the sympathetic (fight or flight) systems. A body experiencing trauma can become stuck in systemic extremes and may have difficulty with fluidly moving between the systems to maintain regulation and appropriate responses to stressors. The impact of trauma can be debilitating and can lead to maladaptive ways of reacting to the environment.
When individuals continue to relive their traumatic experiences, they may meet criteria for Posttraumatic Stress Disorder or PTSD. Everyone who has experienced trauma does not meet criteria for PTSD. The majority of people who are continue to experience distress more likely meet criteria for a Mood Disorder or Anxiety Disorder. Traumatic experiences can impact people in different ways and a mental health professional would be the best person to provide an accurate diagnosis.
To learn more about Trauma visit the American Psychological Association and the American Psychiatric Association.
All clinicians at Optimal Moments are Trauma-Informed Providers.
What Are Trauma Responses?
There are many symptoms, but most of them stem from three main trauma responses detailed below. Additional behaviors or emotional experiences we hear talked about are being codependent (the need to be in a relationship), passive or lacking assertiveness, feelings of inadequacy, perfectionism or a need for control, not being able to trust others, self-sabotage… To name a few.
Fight Response - You feel on edge and ready to protect yourself regularly. You may become defensive and/or aggressive in a uncomfortable situations or you may push others away to prevent yourself from getting hurt.
Flight Response - You feel the need to escape. This can present as a constant need for distractions (such as doom scrolling), overeating to quiet emotions, wanting to disappear or frequently leaving difficulty situation, or always wanting to stay busy so the feelings/thoughts don’t have space to exist. It can also present as addiction as it allows you flee the feelings that came from your trauma.
Freeze Response - You feel paralyzed in your life. You will notice you shut down in response to difficult situations, not usually able to speak up for yourself, or you may acquiesce to others in order to avoid conflict, i.e. people pleasing. You tend to procrastinate on even simple tasks and feel overwhelmed as though you cannot tackle the tasks so it is easier to “not do”. It becomes a feeling a complacency, fear of taking risks, and feeling stuck.
What is Posttraumatic Stress Disorder (PTSD)?
Posttraumatic Stress Disorder is a very specific mental disorder triggered by a life-threatening traumatic event. It is normal to experience extreme emotional reactions to trauma, especially within the first couple months of the traumatic event(s) or if these events are ongoing. For many people, relying on support systems, coping strategies, or with time, those feelings begin to ease. This is an expected process. We reiterate that we want to be careful not to pathologize natural reactions to traumatic experiences.
In rare cases, individuals will continue to be impacted by the traumatic event(s) for an extended amount of time and the symptoms cause significant distress and impairment in daily functioning. It is always best to have a mental health professional conduct an assessment for an accurate diagnosis. We strongly advise against using symptoms presented online through sources like WebMD to diagnose yourself or others. Diagnosing PTSD is a complex process that is best conducted by trained professionals, such as psychologist psychologists or clinical social workers or mental health counselors.
Mental health professionals will examine symptoms beyond a checklist to dive deeper into understanding whether the symptoms represent expected reactions to trauma, meet criteria for PTSD, or are better explained by a Mood Disorder, Reactive Attachment Disorder, Anxiety Disorder, Disinhibited Social Engagement Disorder, or Adjustment Disorder, or something entirely different. Mental health professionals can also recommend a treatment approach that would best address the symptoms and the root causes.
People with PTSD experience symptoms that fall into four categories:
Intrusions - Unwanted, involuntary memories, dreams or nightmares, or flashbacks related to the trauma. There may also be triggering events that lead to intense psychological or physiological reactions, such maybe a smell related to the trauma leading to intense fear, strong emotions, or increased heart rate. These intense experiences may be triggered or may be spontaneous, either way they create an intense reaction that significantly impacts functioning.
Avoidance - This is an active behavior to avoid talking about the trauma specifically or avoiding reminders of the trauma to reduce any triggering experiences. The avoidance has a significant impact on daily functioning and can limit one’s ability to work or go to school, can impact relationships, or completing every day chores or tasks.
Changes in Cognitions and Mood - There is a significant in how the individual is thinking about themselves or others, such thinking no one can be trusted or blaming oneself for the trauma. There is also a significant impact on mood, such as persistent feelings or fear or anger or sadness and difficulty enjoying activities one used to enjoy. A trained professional would be able to distinguish if these changes in mood or cognitions meet criteria for PTSD or are better explained by Major Depressive Disorder.
Changes in Arousal or Reactivity - This is similar to the fight response previously described. This is when someone is on edge, very aware of their surroundings, or easily provoked to defend oneself or be on guard. The sympathetic nervous system is heightened which can lead to difficulties with concentration and sleep as well. A trained professional would be able to distinguish if these changes in arousal or reactivity meet criteria for PTSD or are better explained by an Anxiety Disorder.
Is it possible to Heal from trauma?
Yes! It will take time and it will be a difficult process. Healing from trauma requires patience, commitment and courage. Your clinician works with you to help process trauma so it can stop impacting daily life. Your clinician is there to "hold your hand" and guide you along the way, so that you don't feel alone and overwhelmed.
Healing feels as though when you look at your past and the traumas you have experienced, it doesn’t feel as though it is your present or future.
All clinicians at Optimal Moments are trained to address Trauma. To learn more about Trauma-Informed Care click here.
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