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Trauma is often misunderstood.
If you or someone you know has experienced trauma, it’s important to understand that it’s not just something that “happened.” People who are traumatized can’t just “get over it” because it’s not only a story of past experiences but a brain rewired. Danger can be felt where it doesn’t exist leaving the person stuck in a repetitive state of overreaction. Feelings are hijacked or numbed out. Traumatized people often unintentionally hurt the people they care about and themselves. Because of this, shame is a byproduct of trauma.
Because so many of us either have had traumatic experiences or know others who have, we should all be paying attention to it. Not everyone who has challenging experiences develops trauma but for those who do, it can leave a significant imprint.
Bessel van der Kolk, MD is an internationally recognized leader in the field of psychological trauma. Consider the following informational nuggets from Dr. van der Kolk’s workshop, “Trauma, Attachment, and Neuroscience.”
The Issues of Trauma
Trauma is like being stuck with a broken alarm system.
With trauma, the body keeps the score. Even if there is no cognitive narrative (no memory) around what happened, it’s imprinted on the body, down to the cellular level.
Trauma is a pervasive organic issue. The organism no longer feels safe.
A study demonstrated that the memory cells of the immune systems of women with incest histories were set to defend against unseen enemies.
There are two distinct forms of trauma; single incident and ongoing (particularly problematic is ongoing childhood trauma).
People with PTSD as a result of ongoing adverse childhood circumstances are the most challenging to treat and make up the bulk of therapy practices.
Child abuse (physical, sexual, emotional, neglect) is probably our largest public health issue, more expensive than cancer and heart disease.
PTSD is a state of terror and hyperarousal that can be minimized if you can find a place to be cared for.
A study showed that 5% of people in New York City who experienced 9/11 – vs 35% of people in New Orleans who experienced Hurricane Katrina – suffered PTSD because of the difference in how they were responded to by the government; it will be fascinating to see how the pandemic and the current issues regarding social justice/systemic racism impacts those numbers by comparison.
The problem with trauma lies in the reptilian (primal) part of the brain, that can get flooded with anger, fear, or hopelessness.
Overcoming trauma is about creating new realities.
Early childhood experiences of being a “good person” foster resilience. You are better able to bounce back from difficult experiences later. Someone who believes they are a “bad person” is more vulnerable to difficult experiences that might only serve to confirm how “bad” they are.
An important part of trauma therapy is helping the client be able to separate the adult from the wounded child part. This traumatized part often denied and isolated internally. The work involves feeling what it was like for that child and developing self-compassion.
The Issues of Attachment
Separation from the primary caregiver is the single most insult to the growing brain (in children up to six years old).
An out of tune parent can have disastrous consequences on brain development.
Our nature is to be interpersonally attuned. This system breaks down with neglect and abandonment.
A traumatized parent will struggle to care for their children in that being stuck in a fight or flight makes it hard to nurture care for others (just like a traumatized spouse will struggle with their partner, etc).
Thoughts on Working with Trauma
A traumatized brain is out of sync with itself. Here are some of the ways that have been shown to help:
A natural way for the brain to feel safe is experiencing being in sync with another (therapist, friend…).
Neurofeedback: A safe, painless, and noninvasive method for teaching the brain how to better regulate itself. See more in the Science Daily article.
Yoga: A Harvard, Brigham Young study demonstrated that yoga eases veterans' PTSD symptoms.
EMDR: A therapy treatment to relieve distress associated with traumatic memories. See more in Scientific American article.
Trauma is to be taken seriously. The sufferer can experience a great deal of psychological, physical, relational, and spiritual pain. There is a continuum of impact ranging from severe (flashbacks, substance abuse to cope, hopelessness, suicidal thinking, etc) to mild (irritability, occasional sleep disturbances, fatigue, etc). In any case, rather than the person getting “over it,” they ideally find a way to heal their traumatized brain and nervous system.
Healing from trauma
Trauma symptoms typically last from a few days to a few months, gradually fading as you process the unsettling event. But even when you’re feeling better, you may be troubled from time to time by painful memories or emotions—especially in response to triggers such as an anniversary of the event or something that reminds you of the trauma.
If your psychological trauma symptoms don’t ease up—or if they become even worse—and you find that you’re unable to move on from the event for a prolonged period of time, you may be experiencing Post-Traumatic Stress Disorder (PTSD). While emotional trauma is a normal response to a disturbing event, it becomes PTSD when your nervous system gets “stuck” and you remain in psychological shock, unable to make sense of what happened or process your emotions.
Whether or not a traumatic event involves death, you as a survivor must cope with the loss, at least temporarily, of your sense of safety. The natural reaction to this loss is grief. Like people who have lost a loved one, you need to go through a grieving process. The following tips can help you cope with the sense of grief, heal from the trauma, and move on with your life.
Trauma recovery tip 1: Get moving
Trauma disrupts your body’s natural equilibrium, freezing you in a state of hyperarousal and fear. As well as burning off adrenaline and releasing endorphins, exercise and movement can actually help repair your nervous system.
Try to exercise for 30 minutes or more on most days. Or if it’s easier, three 10-minute spurts of exercise per day are just as good.
Exercise that is rhythmic and engages both your arms and legs—such as walking, running, swimming, basketball, or even dancing—works best.
Add a mindfulness element. Instead of focusing on your thoughts or distracting yourself while you exercise, really focus on your body and how it feels as you move. Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of wind on your skin. Rock climbing, boxing, weight training, or martial arts can make this easier—after all, you need to focus on your body movements during these activities in order to avoid injury.
Tip 2: Don’t isolate
Following a trauma, you may want to withdraw from others, but isolation only makes things worse. Connecting to others face to face will help you heal, so make an effort to maintain your relationships and avoid spending too much time alone.
You don’t have to talk about the trauma. Connecting with others doesn’t have to involve talking about the trauma. In fact, for some people, that can just make things worse. Comfort comes from feeling engaged and accepted by others.
Ask for support. While you don’t have to talk about the trauma itself, it is important that you have someone to share your feelings with face to face, someone who will listen attentively without judging you. Turn to a trusted family member, friend, counselor, or clergyman.
Participate in social activities, even if you don’t feel like it. Do “normal” activities with other people, activities that have nothing to do with the traumatic experience.
Reconnect with old friends. If you’ve retreated from relationships that were once important to you, make the effort to reconnect.
Join a support group for trauma survivors. Connecting with others who are facing the same problems can help reduce your sense of isolation, and hearing how others cope can help inspire you in your own recovery.
Volunteer. As well as helping others, volunteering can be a great way to challenge the sense of helplessness that often accompanies trauma. Remind yourself of your strengths and reclaim your sense of power by helping others.
Make new friends. If you live alone or far from family and friends, it’s important to reach out and make new friends. Take a class or join a club to meet people with similar interests, connect to an alumni association, or reach out to neighbors or work colleagues.
If connecting to others is difficult… Many people who have experienced trauma feel disconnected, withdrawn and find it difficult to connect with other people. If that describes you, there are some actions you can take before you next meet with a friend: Exercise or move. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.
Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Sit up straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.
Tip 3: Self-regulate your nervous system
No matter how agitated, anxious, or out of control you feel, it’s important to know that you can change your arousal system and calm yourself. Not only will it help relieve the anxiety associated with trauma, but it will also engender a greater sense of control.
Mindful breathing. If you are feeling disoriented, confused, or upset, practicing mindful breathing is a quick way to calm yourself. Simply take 60 breaths, focusing your attention on each ‘out’ breath.
Sensory input. Does a specific sight, smell or taste quickly make you feel calm? Or maybe petting an animal or listening to music works to quickly soothe you? Everyone responds to sensory input a little differently, so experiment with different quick stress relief techniques to find what works best for you.
Staying grounded. To feel in the present and more grounded, sit on a chair. Feel your feet on the ground and your back against the chair. Look around you and pick six objects that have red or blue in them. Notice how your breathing gets deeper and calmer.
Allow yourself to feel what you feel when you feel it. Acknowledge your feelings about the trauma as they arise and accept them. HelpGuide’s Emotional Intelligence Toolkit can help.
Tip 4: Take care of your health
It’s true: having a healthy body can increase your ability to cope with the stress of trauma.
Get plenty of sleep. After a traumatic experience, worry or fear may disturb your sleep patterns. But a lack of quality sleep can exacerbate your trauma symptoms and make it harder to maintain your emotional balance. Go to sleep and get up at the same time each day and aim for 7 to 9 hours of sleep each night.
Avoid alcohol and drugs. Their use can worsen your trauma symptoms and increase feelings of depression, anxiety, and isolation.
Eat a well-balanced diet. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. Avoid sugary and fried foods and eat plenty of omega-3 fats—such as salmon, walnuts, soybeans, and flaxseeds—to give your mood a boost.
Reduce stress. Try relaxation techniques such as meditation, yoga, or deep breathing exercises. Schedule time for activities that bring you joy such as your favorite hobbies.
When to seek professional therapy for trauma
Recovering from trauma takes time, and everyone heals at their own pace. But if months have passed and your symptoms aren’t letting up, you may need professional help from a trauma expert.
Seek help for trauma if you’re:
Having trouble functioning at home or work
Suffering from severe fear, anxiety, or depression
Unable to form close, satisfying relationships
Experiencing terrifying memories, nightmares, or flashbacks
Avoiding more and more anything that reminds you of the trauma
Emotionally numb and disconnected from others
Using alcohol or drugs to feel better
Working through trauma can be scary, painful, and potentially re-traumatizing, so this healing work is best undertaken with the help of an experienced trauma specialist. Finding the right therapist may take some time. It’s very important that the therapist you choose has experience treating trauma. But the quality of the relationship with your therapist is equally important. Choose a trauma specialist you feel comfortable with. If you don’t feel safe, respected, or understood, find another therapist.
Ask yourself:
Did you feel comfortable discussing your problems with the therapist?
Did you feel like the therapist understood what you were talking about?
Were your concerns taken seriously or were they minimized or dismissed?
Were you treated with compassion and respect?
Do you believe that you could grow to trust the therapist?
Treatment for trauma
In order to heal from psychological and emotional trauma, you’ll need to resolve the unpleasant feelings and memories you’ve long avoided, discharge pent-up “fight-or-flight” energy, learn to regulate strong emotions, and rebuild your ability to trust other people. A trauma specialist may use a variety of different therapy approaches in your treatment.
Somatic experience focuses on bodily sensations, rather than thoughts and memories about the traumatic event. By concentrating on what’s happening in your body, you can release pent-up trauma-related energy through shaking, crying, and other forms of physical release.
Cognitive-behavioral therapy helps you process and evaluate your thoughts and feelings about the trauma.
EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation that can “unfreeze” traumatic memories.
Helping a loved one deal with trauma
When a loved one has suffered trauma, your support can play a crucial role in their recovery.
Be patient and understanding. Healing from trauma takes time. Be patient with the pace of recovery and remember that everyone’s response to trauma is different. Don’t judge your loved one’s reaction against your own response or anyone else’s.
Offer practical support to help your loved one get back into a normal routine. That may mean helping with collecting groceries or doing housework, for example, or simply being available to talk or listen.
Don’t pressure your loved one into talking but be available if they want to talk. Some trauma survivors find it difficult to talk about what happened. Don’t force your loved one to open up but let them know you are there to listen if they want to talk, or available to just hang out if they don’t.
Help your loved one to socialize and relax. Encourage them to participate in physical exercise, seek out friends, and pursue hobbies and other activities that bring them pleasure. Take a fitness class together or set a regular lunch date with friends.
Don’t take the trauma symptoms personally. Your loved one may become angry, irritable, withdrawn, or emotionally distant. Remember that this is a result of the trauma and may not have anything to do with you or your relationship.
To help a child recover from trauma, it’s important to communicate openly. Let them know that it’s normal to feel scared or upset. Your child may also look to you for cues on how they should respond to trauma, so let them see you dealing with your symptoms in a positive way.
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