Understanding Trauma

 

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Stress

Most people will experience at least one traumatic event during their lives. Whilst all traumatic events are stressful, not all stressful events are traumatic.  Everyone experiences stress in their daily lives and is commonplace in our way of life. Stress is not always damaging if in small doses and experienced in the short term. It can help you perform under pressure and motivate you to do your best such as exam stress or attending an interview. Stress is usually experienced in short sharp bursts and once over, we can return back to a normal emotional and psychological sense of self. Overcoming low to moderate stress enables us to become resilient.

 

When Stress Becomes Trauma

When stress becomes unpredictable and prolonged, we can experience feeling vulnerable and powerless. During these times we do not have the capacity to regulate ourselves, so we are in a constant state of stress and our mind and our bodies are in a constant state of high alert. Common reactions may include anger, fear, guilt and feeling nervous/anxious most of the time. Trauma experiences can be difficult life events, something we have witnessed, or something that we have experienced as life threatening.

 

When Trauma becomes post-traumatic Stress Disorder

People with PTS experience persistent or increasing trauma reactions usually over a time frame of 1 month. They experience not being able to live a normal day to day lie and can be triggered by day-today events leading to flashback, bad dreams and being avoidant of situation which may remind them of the trauma.

 

TYPES OF TRAUMA

Trauma can be categorised into Acute Trauma, Complex Trauma and Developmental Trauma.

 

Acute:

Acute trauma can occur with the sudden, one-time application of force or violence that causes immediate damage to a living body. It is caused by a ‘single traumatic’ event. Examples of acute trauma include:

 

An accident

An act of violence

A natural disaster

The death of a significant person

Physical or sexual assault

Witnessing an event

 

Chronic / Complex Trauma:

Chronic or Complex trauma happens when an individual experiences multiple traumatic events and refers to traumatic stressors that are, premeditated, planned, and caused by other human beings. Examples of complex trauma:

 

Sexual Abuse

Domestic Abuse

War

Neglect

Bullying

 

Most recently, how people have been affected by the Coronavirus Pandemic can be classed as complex trauma as it is a long standing experience.

 

Developmental Trauma

Developmental trauma is often accompanied by repeated traumatic events. It focuses more on the underlying trauma in the young person’s history. Repeated instances of developmental trauma such as abandonment, abuse and neglect during a child’s early life can cause negative effects on cognitive development, neurological development, and psychological development as well as attachment development.

 

Interpersonal Trauma:

Interpersonal trauma occurs when an individual experiences multiple traumatic events that are caused by other human beings which are repetitive over time. It is where a person has been hurt by another person, they are then wounded by the experience. This can be childhood abuse, neglect, parental mental health, witnessing interpersonal violence (domestic abuse) or witnessing parental drug and or alcohol use.

 

 

Trauma is experienced on three levels, physical, cognitive, and emotional:

 

Physical:

When we experience a stressful/traumatic situation, our bodies shift into emergency mode which changes our physical responses. From being calm and regulated, the traumatic situation impacts on our physical functioning, our heart beats faster, blood pressure escalates, our muscles tense, we breathe faster.

 

Cognitive:

After experiencing a traumatic experience, how we think changes, we tend to think in a negative fashion and imagine all the worst-case scenarios. This causes us to be even more stressed or worried, causing us to function less effectively thus justifying our fears. Basically, this creates a self-fulfilling prophecy.

 

Emotional:

We experience a constant feeling of anxiety. We cannot always pinpoint what exactly is causing this; it simply exists. Concentration may be affected, and we may become easily annoyed or upset. This further limits our abilities to function effectively. Trauma can cause fear, sadness, guilt, blame and shame.

 

THE IMPACT OF TRAUMA

 

SLEEPNightmaresHaving problems falling asleepConstantly waking up during the nightSleeping too muchNot wanting to get out of bed     EMOTIONALA feeling of hopelessnessHelplessnessIntense fearGuiltInability to tolerate stress or shameInability to use language for feelingsReduced empathy    PHYSICALIntrusive thoughts and flashback of the traumaPanic attacksDifficulty concentratingOverly alertEasily startledBeing hyper-vigilantMedical complaints such as headaches   BEHAVIOURALBeing irritable or angrySelf-Harm or thoughts of suicideAggressionDestructivenessSubstance abuseSelf-harm including suicidal ideologiesImpulsiveness

WHAT IS POST-TRAUMATIC STRESS DISORDER?

This is when you experience symptoms for more than one month. A more comprehensive overview can be found on the 'post-traumatic stress disorder UK' website:

www.ptsduk.org

 

Follow these links for a full description of the National Institute for Health and Clinical Excellence (NICE)

www.ptsduk.org

www.nice.org.uk

REPAIR AND RECOVERY

 

Repair

The repair of Early Trauma: A Bottom-up Approach:

 

Recovery

The most significant factor in working towards recovery is that of the relationships around us.

 

“When a person has been hurt in a relationship, they can only be healed in a relationship”

Shemmings, D. (2017)

 

“recovery can only take place within the context of relationships…."

Herman, J. (1997)

 

 

The 3 Stages of Trauma Recovery

 

Stage One -Safety and Stabilisation

At the beginning stage, people experience symptoms as described in the impact of trauma page. Understanding the impact and to then learn how to become resilient, to learn strategies in overcoming the impact. This stage promotes creating a safe and stable life.

              

 

Stage Two - Coming to terms and processing the trauma

Becoming unstuck from the impact of the trauma and using differing ways of processing the trauma such as using trauma informed counselling and recognising the trauma is in the past and not in the here and now.

For some, there is a natural processing of trauma; when people experience safety, love, and positive attachments in all areas of their lives, they are able to integrate the trauma and come to terms with what has happened to them. The pages within this website will provide you with the tools and strategies to enable you to heal.

For those who are supporting family or friends who have been traumatised, the following pages will equip you with information to help your loved ones.

 

Stage Three - Integration and developing post-traumatic growth

Remembering all that has been learnt in stage 1 and being able to acknowledge the trauma is in the past so allowing you to live a healthy life in the here and now.

To be aware that during your life there will be challenges and potential triggers linked to your trauma, we term this a ‘trauma reminders’.

We will support you with strategies to enhance your safety and relapse prevention.

 

UNDERSTANDING YOUR BRAIN – THE SCIENCE BEHIND YOUR TRAUMA REACTIONS

 

Becoming unstuck from the impact of the trauma and using differing ways of processing the trauma such as using trauma informed counselling and recognising the trauma is in the past and not in the here and now.

For some, there is a natural processing of trauma; when people experience safety, love, and positive attachments in all areas of their lives, they are able to integrate the trauma and come to terms with what has happened to them. The pages within this website will provide you with the tools and strategies to enable you to heal.

For those who are supporting family or friends who have been traumatised, the following pages will equip you with information to help your loved ones.

 

Survival StateBrain Stem (Reptilian Brain) The Survival State represents the primal brainResponsible for keeping us safe, it detects and responds to threats by assessing familiar and unfamiliar experiences.         Emotional StateLimbic System (Mammalian Brain) The limbic system is the part of the brain involved in our behavioural and emotional responses, especially when it comes to behaviours we need for survival: feeding, reproduction and caring for our young, and fight or flight responses. You can find the structures of the limbic system buried deep within the brain, underneath the cerebral cortex and above the brain stem. The thalamus, hypothalamus (production of important hormones and regulation of thirst, hunger, mood etc) and basal ganglia (reward processing, habit formation, movement and learning) are also involved in the actions of the limbic system, but two of the major structures are the hippocampus (Responsible for memory, learning, storing information long term and spatial reasoning) and the amygdala (responsible for processing emotions, attaching meaning to memories).   Executive StatePre-frontal Lobes The Executive State represents the optimal state for problem-solving, learning, conscious, cognitive, thinking, language, choosing, planning, reflecting & empathy. It is responsible for reasoning, predicting consequences to your actions, anticipating events, managing emotional reactions, thinking through behaviours and being able to focus. 

The Fight Flight Freeze Response (Video by Braive.com)

 

When we encounter a trigger to our past which can be conscious or unconscious, the brain responds in milliseconds. The reptilian brain responds on instinct, the instinct to survive the situation, fight/flight/freeze. If you experience a small trigger you will remain in the reptilian brain for a short period of time. When a person has countless times responding to triggers, our brain becomes hard wired to respond and remain in the reptilian brain. We can re-train the brain to shift back into the neocortex which enables us to create safe and positive thoughts and reactions. You are then able to reason with what has just happened.

 

“That person I saw was not the person from my past, the glasses reminded me of them”, that person is not here, and I am safe”.

 

When someone confronts a dangerous situation such as seeing a snake whilst walking in the woods, the eyes send the information to the amygdala which is an area of the brain for emotional processing. The image is processed and if the brain interprets this image as dangerous, it will automatically send a distress signal to the hypothalamus. From this part of the brain’s command centre, the rest of the body receives communication through the autonomic nervous system so that the body is prepared for a survival response; flight/fight/flop or to remain in freeze position. The amygdala has sent a distress signal to the adrenal glands which respond by releasing the hormone epinephrine (adrenalin) which then flushes through the body providing a rush of energy which enables you to run away or fight. The adrenalin will have physiological changes, the heart beats faster and you breathe more heavily which widens your small airways in your lungs which enable you to take in as much oxygen as possible as you breathe which is then sent to brain, increasing your senses to become sharper and therefore more alert. At the same time epinephrine triggers the release of glucose (blood sugar) which will supply extra energy to all vital parts of your body required to support your survival response.

 

The amygdala initiates the fight/flight/flop or remain in freeze response through imputing information into the hypothalamus activating the sympathetic nervous system and to the brain stem (primal brain). When your primal brain is engaged, your frontal cortex is not working, therefore you are unable to process rationale thinking, such as “it is not a snake, it is merely a coiled rope”.

These responses take milliseconds, the reptilian brain, which is the instinctual part of the brain, will respond before you have even processed the event such walking past a gate and hearing a dog barking at you, instinctively, you may jump away from the gate.

 

If the perceived danger continues, cortisol is then released which enables the body to remain on high alert continuing to active the sympathetic nervous system.

 

Once the danger is perceived as over, the body then puts on the brakes and shifts to a position of rest, calming the body down, the body now activating the parasympathetic nervous system.

 

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Tackling Trauma

              

Survival StateBrain Stem (Reptilian Brain) The Survival State represents the primal brainResponsible for keeping us safe, it detects and responds to threats by assessing familiar and unfamiliar experiences.         Emotional StateLimbic System (Mammalian Brain) The limbic system is the part of the brain involved in our behavioural and emotional responses, especially when it comes to behaviours we need for survival: feeding, reproduction and caring for our young, and fight or flight responses. You can find the structures of the limbic system buried deep within the brain, underneath the cerebral cortex and above the brain stem. The thalamus, hypothalamus (production of important hormones and regulation of thirst, hunger, mood etc) and basal ganglia (reward processing, habit formation, movement and learning) are also involved in the actions of the limbic system, but two of the major structures are the hippocampus (Responsible for memory, learning, storing information long term and spatial reasoning) and the amygdala (responsible for processing emotions, attaching meaning to memories).   Executive StatePre-frontal Lobes The Executive State represents the optimal state for problem-solving, learning, conscious, cognitive, thinking, language, choosing, planning, reflecting & empathy. It is responsible for reasoning, predicting consequences to your actions, anticipating events, managing emotional reactions, thinking through behaviours and being able to focus.