Psychological trauma is a person’s experience of one or more events that is too overwhelming for the person to emotionally, physically and intellectually react to, and integrate into his/her memory and sense of self. The experience is that of as sense of threat to life, integrity or sanity.
Psychological Trauma is not only PTSD
Traumatic events are varied. It can be one major event (as in the case of PTSD), a series of events or living conditions that persists. In traumatic events the person is vulnerable and loses sense of agency or control. Since vulnerability is the feeling, young children and babies are more prone to being traumatized than healthy adults.
Symptoms of Psychological Trauma
Sufferers of PTSD tend to be more aware that they suffer from trauma than individuals who suffer developmental trauma or complex trauma.
Symptoms of trauma are often experienced as: irritability, depression, numbness, fogginess, lack of concentration, sleeping disorders, nervousness, panic disorder, chronic pain, addictions and addictive behavior, self-harm and suicidality, and eating disorders.
Trauma-focussed psychotherapists would check childhood experiences of individuals with these symptoms for sources of traumatic experiences.
It is not unusual for such clients who are not suffering PTSD but complex or developmental trauma to be baffled at the idea that they are manifesting symptoms of trauma, since these experiences are either forgotten, or because the memories in themselves are not recorded as traumatic.
Traumatic experiences that happen in infancy and early childhood lead to what is termed developmental trauma.
Developmental Trauma
The younger the child, the more dependent they are on their caretakers for survival. Children get traumatized by neglect, separation and abandonment, exposure to domestic violence, parents fighting, witnessing violence, fearful caregiving, threats to them (meant or not), medical crises and accidents, death in the family, especially of parents and siblings.
Developmental trauma are more insidious than adult onset trauma because young children are not able to process the memories of the event(s) fully.
These memories are not integrated into learning experience, and remains out of awareness. As the child develops these memories become physiological and psychological symptoms.
Developmental Trauma presents itself also as generalized symptoms. Patients experience difficulties in areas like : 1) affect dys-regulation, 2) having a deep sense of self devaluation, 3) having difficulties forming relationships, and 4) dissociating from experiences.
“Getting Triggered” in the present as sign trauma
Since memories of traumatic experiences are not adequately integrated, the body remembers the traumatic experiences without the brain understanding what they are about. Such memories of traumatic past experiences are called implicit memories, or memories without language.
Implicit memories are sensed. These are memories of the past. However, in the present, harmless events can happen that are similar in feeling to these traumatic past memories. The body reacts to these harmless present events like it did during the traumatic event. The individual is unaware of the past memory hijacking the present moment and gets triggered.
When the dust settles, the sufferer and those around him/her cannot understand how or why the person over-reacted to the present event in such an exaggerated manner.
We may all be familiar to getting triggered or witnessing someone being triggered. It can be disturbing and sometimes destructive.
Understanding that these triggered states of emotionality, fear or rage are rooted in past traumatic experiences can provide for some relief to all involved, because this condition can be treated with psychotherapy.
Psychotherapeutic Treatment of Psychological Trauma
Psychotherapeutic treatment for trauma is an individual process. The condition of the patient and the extent of trauma first needs to be understood. Since traumatic experiences involve a deep sense of threat to life, the therapist needs to create a safe secure setting for the patient.
Trauma therapy can take months to years, depending on the condition of the patient and the trauma. There are five main phases involved:
- The first phase of trauma therapy is to establish security for the patient in the session as well as in the patient’s daily life outside therapy.
- The second phase would be to work with the client to build resilience, self support, orientation and self awareness. This phase requires the moment-to moment tracking of sensations and emotions that occur in the body before, during and after triggers.
- This third step includes psycho-education in which the client learns the nature of his/her traumatic experiences and how his/her symptoms align with the theory underlining. Though this learning he/she learns to dis-identify from his/her symptoms.
- The fourth phase is trauma memory processing. This step is only done when the patient has his/her agency and can see his/her triggers as they happen. EMDR is a technique that can be applied in this this phase.
- The fifth phase is about integrating the memories and experiences. The patient learns to move on, make new affirmations and begin to live a life that is more in the present and not held back by the trauma symptoms.
Trauma therapy has its contra-indications. Patients can get re-traumatized if the groundwork of phases 1 and 2 are not adequate. The building of the therapist-client working alliance is thus very important to ensure safe, effective trauma treatment.