Monday, June 02, 2008

Emotional and Psychological Trauma: Recognizing the Symptoms and Getting Help

From: www.helpguide.org

If you’ve gone through a traumatic experience, you may be struggling with painful emotions, frightening memories, or a sense of constant danger that you just can’t kick. Or you may feel numb, disconnected, and unable to trust other people. But you can overcome trauma’s paralyzing hold on your present life. With treatment and support, you can heal and move on from psychological and emotional trauma, putting it in the past where it belongs.

What is emotional or psychological trauma?

Trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless and vulnerable in a dangerous world. Traumatic experiences often involve a threat to life or safety, but any situation that leaves you feeling frightened and alone can be traumatic, even if it doesn’t involve physical harm. Experiences involving betrayal, verbal abuse, or any major loss can be just as traumatizing as a life-threatening catastrophe, especially when they happen during childhood.

Whether the threat is physical or psychological, trauma results when an experience is so overwhelming that you freeze, go numb, or disconnect from what’s happening. While this automatic response protects you from the terror you feel, it also prevents you from moving on. Despite being cut off from your trauma-related feelings, you can’t escape them completely. They remain outside of conscious awareness in all their original intensity, influencing the way you see the world, react to everyday situations, and relate to others.

Causes of emotional or psychological trauma

Emotional or psychological trauma results from experiences that make you feel:

  • Terrified
  • Helpless
  • Unprepared
  • Alone

Not all potentially traumatic events lead to lasting emotional and psychological trauma. Some people rebound quickly from even the most tragic and shocking experiences. Others are devastated by experiences that, on the surface, appear to be less upsetting. It’s not the objective facts that determine whether an event is traumatic, but your subjective emotional experience of the event. The more endangered, helpless, and unprepared you feel, the more likely you are to be traumatized.

The types of events that can cause trauma are numerous. Emotional trauma can be caused by single-blow, one-time occurrences, such as a house fire, a plane crash, a violent crime, or an earthquake. Psychological and emotional trauma can also be caused by experiences of ongoing and relentless stress, such as fighting in a war, living in a crime-ridden neighborhood, enduring chronic abuse, or struggling with a life-threatening disease.

Though, people respond differently to stressful experiences, a traumatic event is most likely to cause negative effects if it is:

  • Inflicted by humans
  • Repeated and ongoing
  • Unexpected or unpredictable
  • Sadistic or intentionally cruel
  • Experienced in childhood

People are also more likely to be traumatized as adults if they have a history of childhood trauma or if they’re already under a heavy stress load.

Attachment or developmental trauma

Stressful experiences in childhood—whether a one-time event such as a car accident or an ongoing situation caused by an unavailable or abusive parent­—can be traumatizing. Childhood trauma, known as attachment or developmental trauma, results from anything that disrupts a child’s sense of safety and security. This includes such things as an unstable or unsafe environment, separation from a parent, or a serious illness. Attachment trauma is most severe, however, when it involves betrayal or harm at the hands of a caregiver.

Attachment trauma has a negative impact on a child’s physical, emotional, cognitive, and social development. Children who have been traumatized see the world as a frightening and dangerous place. When childhood trauma is not resolved, this fundamental sense of fear and helplessness can carry over into adulthood, setting the stage for further trauma.

Attachment BondHow childhood trauma affects adult relationships

The quality of the attachment bond between mother and baby affects the child’s ability—even as an adult—to feel safe in the world, trust others, handle stress, and rebound from disappointment. Early-life trauma disrupts this important attachment bond, resulting in adult relationship difficulties.

Read: Attachment and Adult Relationships

Normal responses to traumatic events

When it comes to recognizing psychological and emotional trauma, it’s important to distinguish between normal reactions to traumatic events and symptoms of a more serious and persistent problem.

Following a traumatic event, most people experience a variety of emotions, including shock, fear, anger, and relief to be alive. Often, they can think or talk of little else other than what happened. Many others feel jumpy, detached, or depressed. Such reactions are neither a sign of weakness nor a positive indicator of lasting trouble. Rather, they represent a normal response to an abnormal event.

Common reactions to trauma:

  • Guilt and self-blame
  • Anxiety and edginess
  • Mood swings and irritability
  • Feeling disconnected or numb
  • Distressing memories about the event
  • Insomnia or bad dreams
  • Withdrawing from others
  • Loss of appetite
  • Difficulty concentrating
  • Feeling sad or hopeless

These symptoms and feelings typically last from a few days to a few months, gradually fading as you process the trauma. But even when you’re feeling better, you may be troubled from time to time bym painful meories or emotions—especially in response to triggers such as an anniversary of the event or an image, sound, or situation that reminds you of the traumatic experience.

Grieving is normal following a traumatic eventCoping with grief and loss

Whether or not a traumatic event involves death or physical harm, survivors must cope with the loss, at least temporarily, of their sense of safety and security. The natural reaction to this loss is grief. Like people who have lost a loved one, trauma survivors go through a grieving process. This process, while inherently painful, is easier if you turn to others for support, take care of yourself, and talk about how you feel.

Read: Coping with Grief and Loss

Recovering from a traumatic event takes time, and everyone heals at his or her own pace. But if months have passed and your symptoms aren’t letting up, you may be experiencing emotional or psychological trauma.

When to seek professional help

It’s a good idea to seek professional help from a therapist or doctor if you’re:

  • Having problems at home or work
  • Living in constant fear and anxiety
  • Haunted by overwhelming memories or emotions
  • Avoiding more and more things that remind you of the trauma

Signs and symptoms of psychological or emotional trauma

Recognizing psychological and emotional trauma may be difficult, especially if the traumatic event occurred in your childhood. Further complicating the picture, the signs and symptoms of unresolved emotional trauma are often mistaken for other metal health problems, including depression and anxiety.

Unfortunately, antidepressants, anxiety medications, and other conventional therapies and treatments won’t heal trauma-induced wounds, so it’s important to get to the root of the symptoms.

Is Emotional Trauma a Factor in Your Life?

Respond yes or no to the following to determine if you might be living with the aftermath of a traumatic event:

  • Can you stand to be alone without turning on your cell phone, computer, or TV?
  • Do you rely on coffee, cigarettes, or alcohol to lift and/or calm you?
  • Are you plagued by physical conditions for which there appear to be no cures?
  • Do you “lose it” with certain people or in certain situations?
  • Do you avoid things you wish you could do?
  • Do you have to be accomplishing something in order to feel good?
  • Do you frequently behave in ways that you regret?
  • Do you suffer from mysterious ailments that come and go?
  • Do you find it impossible to focus on some things for more than a time?
  • Is it hard for you to trust people?
  • Do you feel depressed or anxious although you have tried conventional treatments?
  • Is it difficult for you to commit to a relationship?

If you answered “yes” to 3 or more questions, you might be suffering from emotional trauma.

Source: Emotional Intelligence by Jeanne Segal

While the potential signs and symptoms of unresolved emotional trauma are numerous, the most common indicators include:

  • Emotional numbness and detachment
  • Inability to form close, satisfying relationships
  • Sense of the world as a cold and dangerous place
  • Hair trigger stress response (dizziness, pounding heart, nausea)
  • Disturbing memories, nightmares, or flashbacks
  • Sense of a foreshortened, limited future

Post-traumatic stress disorder (PTSD)Coping with grief and loss

PTSD is the most severe form of trauma. Its primary symptoms include intrusive memories or flashbacks, avoiding things that remind you of the traumatic event, and living in a constant state of “red alert”.

Read: Post-Traumatic Stress Disorder (PTSD)

Healing from psychological or emotional trauma

In order to heal from psychological and emotional trauma, you must face and resolve the unbearable feelings and memories you’ve long avoided. Otherwise they will return again and again, unbidden and uncontrollable. The healing journey involves two interrelated steps:

  1. Processing the memory of the trauma
  2. Discharging pent-up “fight-or-flight” energy

Working through trauma can be scary, painful, and potentially retraumatizing. Because of the risk of retraumatization, this healing work is best done with the help of an experienced trauma specialist.

Processing the memory of the trauma

Traumatic memories are very different from normal memories. Extreme stress functions like a pause button on your brain, preventing you from integrating your experience into a coherent memory of what happened. Without a “story” that you can revisit and interpret, it’s impossible to put the experience in the past.

As a result, traumatic memories are relived rather than simply remembered. They may exist only in split-off fragments—raw emotions, bodily sensations, frightening images, smells and sounds, physical pain—that feel just as real as they did during the original trauma. Reconnecting to these emotional fragments allows you to process the memory and put it in perspective at long last.

Discharging fight-or-flight energy

When confronted with a threat, your body instantly prepares for emergency action in an automatic, biological process known as the fight-or-flight response. The fight-or-flight response gives you extra energy to either fight or escape the threat. Once the danger passes, you gradually return to a relaxed and normal state.

But when a threat is so overwhelming that survival seems impossible, the natural response is to freeze. This frozen state of shock traps the intense energies of the fight-or-flight response in the body. In essence, your nervous system gets stuck in overdrive.

The symptoms of trauma are the result of your body’s attempts to control this pent-up energy. To heal from trauma, this excess energy must be discharged in a physical way, such as:

  • Trembling
  • Shaking
  • Crying
  • Sweating
  • Breathing deeply
  • Laughing

Treatment and therapy for emotional or psychological trauma

The following therapies are used in the treatment of emotional or psychological trauma.

  • Somatic experiencing takes advantage of the body’s unique ability to heal itself. The focus of therapy is on bodily sensations, rather than thoughts and memories about the event. By concentrating on what’s happening in your body, you gradually get in touch with trauma-related energy and tension. From there, your natural survival instincts take over, safely releasing this pent-up energy through shaking, crying, and other forms of physical release.
  • EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation. In a typical EMDR therapy session, you focus on traumatic memories and associated negative emotions and beliefs while tracking your therapist’s moving finger with your eyes. These back-and-forth eye movements are thought to work by “unfreezing” traumatic memories, allowing you to resolve them.

Find a trauma specialist

Cognitive-behavioral therapy helps you process and evaluate your thoughts and feelings about a trauma. While cognitive-behavioral therapy doesn’t treat the physiological effects of trauma, it can be helpful when used in addition to a body-based therapy such as somatic experiencing or EMDR. Cognitive-behavioral therapy for trauma typically includes exercises and homework designed to help you challenge irrational thoughts about the traumatic event, cope with and control painful memories and emotions, and reduce stress and self-blame. Cognitive-behavioral therapy may also include education about the nature of trauma-related disorders.

Related links on emotional or psychological trauma

General information on emotional and psychological trauma

Coping with Trauma – Comprehensive overview of emotional and psychological trauma, including the causes, symptoms, effects, and effective treatments. (The Menninger Clinic)

Emotional Trauma Webpage – Learn how to recognize and heal from emotional or psychological trauma. Includes an overview of effective treatments. (Dr. Jeanne Segal)

What is Psychological Trauma? – In-depth introduction to emotional or psychological trauma, including the causes, symptoms, treatments, and effects. (Sidran Institute)

Dealing With Trauma: Frightening Events Can Have Lasting Effects – Learn about the causes, symptoms, and effects of emotional or psychological trauma. (National Institutes of Health)

Causes and symptoms of emotional or psychological trauma

Common Reactions After Trauma – Guide to the common symptoms, effects, and problems that can result form emotional or psychological trauma. (National Center for PTSD)

Trauma Symptoms – Extensive list of the emotional, physical, cognitive, and behavioral symptoms of psychological trauma. (University of Saskatchewan)

Trauma: Sudden Traumatic Loss – Overview of emotional or psychological trauma due to the sudden or traumatic death of a friend or family member. (Tragedy Assistance Program for Survivors)

Trauma treatment and recovery

Managing Traumatic Stress: Tips for Recovering From Disasters and other Traumatic Events – Tips for healing and recovering from natural disasters and other traumatic experiences. (American Psychological Association)

Recovering from Trauma – Article on the necessity of processing emotional trauma if we are to recover and heal. (Psychology Today)

Nature's Lessons in Healing Trauma – Article by Peter Levine, the creator of the somatic experiencing approach to trauma. Learn about the theory behind the treatment and how it works.

A Brief Description of EMDR Therapy – Covers the eight phases of EMDR therapy involved in the treatment of trauma. (EMDR Network)

Coping with psychological or emotional trauma

Self-Care and Self-Help Following Disasters – Offers coping strategies for dealing with painful experiences and healing from emotional and psychological trauma. (National Center for PTSD)

Bouncing Back: How You Can Help – Article stresses the natural resilience of human beings in the face of trauma. Includes tips on how to help someone who has gone through a recent emotional trauma. (Psychology Today)

A Recovery Bill of Rights for Trauma Survivors – When you’re feeling overwhelmed or frightened, this list of your rights as a trauma survivor may help you stay on the recovery track. (Sidran Institute)

Dealing With the Effects of Trauma: A Self-Help Guide – Guide to the healing journey, including coping strategies, where to find help for emotional trauma, and how to support recovery. (SAMHSA’s National Mental Health Information Center)

Trauma in children and adolescents

Trauma, Attachment, and Stress Disorders: Rethinking and Reworking Developmental Issues – Explains the brain-based view of emotional trauma and how it affects child development. (Trauma Resources)

Understanding Child Traumatic Stress – Learn how emotional or psychological trauma in children differs from trauma in adult. Includes causes, symptoms, and recovery factors. (The National Child Traumatic Stress Network)

Helping Children and Adolescents Cope with Violence and Disasters: What Parents Can Do – Parent’s guide to helping a child heal from emotional or psychological trauma. (National Institute of Mental Health)

Parenting in a Challenging World – Advice on how to help your child recover and heal from traumatic events. Includes clips from a documentary about families coping with the trauma of 9/11. (The National Child Traumatic Stress Network)

Helping a Child Manage Fears – Article on helping a child cope with traumatic events. Includes tips for helping your child and a list of common childhood reactions to trauma. (Sidran Institute)

Melinda Smith, M.A., Jaelline Jaffe, Ph.D., and Jeanne Segal, Ph.D. contributed to this article. Last modified on: 1/29/08

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