What is trauma pt. II
Welcome back! This is the second part of my two-part series about how we define and understand trauma. I’m a trauma therapist several approaches to help my clients work through traumatic experiences.
I’d like to take a moment to explore the word trauma. Trauma is one of these words that we hear and use in our daily lives, but how do we know what experiences are actually traumatic?
This question doesn’t always have a straightforward answer and it’s best practice as a provider to allow survivors to define their own experiences. Telling individuals that their experiences are not traumatic can be re-traumatizing to the person seeking support. When looking for clarity in defining the trauma factor, I think it’s important to consider whether this experience is stressful or traumatic?
Is the experience stressful or traumatic?
For example, did you spill your coffee on a rushed commute? Did you get into a car accident on the way to a big meeting? These situations may be more complicated than face value, but, in general, I would say spilling coffee is a bummer and stressful, and the car accident would more likely lead to symptoms of trauma.
The symptoms a person experiences may vary based on an individual’s personal history as well as intensity and persistency of the traumatic experience. This is why it’s important to discuss your history when we work with trauma. Stress and trauma both warrant working with a professional but we do want to delineate the nature of the event and the personal factors contributing to how the event was experienced.
An easy definition:
trauma is a deeply distressing or disturbing experience
trauma is also considered the response to a deeply distressing or disturbing experience
What’s the difference between trauma and PTSD?
If you’d like to know if your current symptoms and experiences meet a diagnosis for Post-Traumatic Stress Disorder (PTSD), there are very specific criteria that must be met. You’ll need to see a qualified mental health practitioner or doctor to formally diagnose PTSD.
According to the DSM 5, the first factor that needs to be present is:
Exposure to death, threatened death, actual or threatened serious injury, actual or threatened sexual violence;
By direct exposure, witnessing the event, learning that a relative or close friend was exposed to trauma, or indirect exposure to aversive details of trauma in the course of professional duties e.g., first responders, police, military, medics, crisis counselors, doctors, nurses, etc.
So, in a way, the DSM 5 acknowledges that these extreme experiences - whether lived or by proxy - may lead to the development of trauma symptoms. PTSD symptoms also include but are not limited to:
Unwanted upsetting memories, nightmares, flashbacks; avoidance of thoughts, feelings or experiences; negative thoughts or feelings that began or worsened after the trauma; irritability, risky behavior, and hyper-vigilance to name a few.
This is not the full picture of PTSD but a few snapshots of what it can look like. Duration of symptoms, impairment in functioning, and other exclusions are also part of the diagnosis. I’ll talk more in depth about these symptoms in future posts.
To make things more interesting, trauma can have an even broader context than exposure to a specific event.
The Adverse Childhood Experiences Research study (ACES) conducted by Kaiser and the CDC, identified that experiencing adverse experiences in childhood had negative consequences on the long term physical and psychological health of survivors. This study looked at factors in childhood like divorce, parental incarceration, mental health issues of a parent or caregiver, and enduring physical, emotional, or sexual abuse and neglect. Our research tells us that all of these experiences have a considerable impact on people later in life.
Dr. Nadine Burke does a great job of summarizing these points and speaking about trauma:
Laura Van Dernoot Lipsky also provides an excellent perspective on trauma and its impact on individuals:
https://www.youtube.com/watch?v=uOzDGrcvmus
Additionally, for individuals who have experience these childhood traumas, there can be re-activation of trauma symptoms when a situation feels similar, even if no threat is actually evident. This reaction is adaptive in the way that it is wired to help us survive (think preparing for the worst, hyper-vigilance, and the body’s mechanism to protect itself via fight or flight). However, the reaction can get in the way of our daily lives and goals if it is activated when there is not a current threat.
I would like not to note that this does not make anyone broken or flawed, but instead this person is having a survival response and would benefit from support.
If you believe that you have experienced trauma and need support in resolving distress from past experiences, counseling can help. Traditional talk therapy, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Schema Therapy and Eye Movement Desensitization and Reprocessing (EMDR) Therapy can be helpful. EMDR, specifically, is an empirically supported trauma therapy that uses a structured protocol to help individuals resolve symptoms related to trauma. I will be writing more in depth about how EMDR works and what to expect in an EMDR session in future posts
