Trauma

What is Trauma?

Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, sometimes for a variety of reasons, people have difficulty moving forward and find trauma is stealing their joy. A well trained therapist can help trauma survivors move from surviving to living once again. Trauma therapy can provide individuals the tools they need to process their experiences effectively and support healing. 

In therapy we use the phrase Big 'T' or Little ‘t’ as shorthand to communicate differences between traumatic events.

When most people think about trauma, they tend to think about those who have been exposed to war, combat, natural disasters, terrorism, and catastrophic accidents. These are some of the most profound experiences one can endure. However, trauma can manifest from less overt experiences, highlighting the importance of individual therapy to explore personal narratives and emotions linked to both Big ‘T’ and little ‘t’ traumas. From a trauma therapist’s point of view, anytime a personal need is not met, there is an opportunity for a micro trauma. In theory, we have all experienced personal traumas; what determines treatment is the degree to which they are getting in your way.

Small ‘t’ Trauma

Small ‘t’ traumas are events that exceed our capacity to cope and cause a disruption in emotional functioning. These distressing events are not inherently life or bodily-integrity threatening, but are better described as ego-threatening due to the individual left feeling notable helplessness. Seeking trauma therapy can help individuals address these small ‘t’ traumas, allowing them to rebuild their sense of empowerment and regulation. Some examples of small ‘t’ traumas include:

  • Conflict with significant others or children

  • Infidelity

  • Divorce

  • Conflict with supervisor/boss or colleagues

  • Abrupt or extended relocation/move

  • Planning a wedding

  • Starting a new job

  • Having or adopting a child

  • Legal trouble

  • Financial worries or difficulty

  • Expensive and unplanned home repairs

Large ‘T’ Trauma

A large-T trauma is distinguished as an extraordinary and significant event that leaves the individual feeling powerless and possessing little control in their environment. Trauma therapy is essential in processing these events, allowing individuals to reclaim their sense of agency and rebuild their lives. Such events could take form as a natural disaster, terrorist attack, sexual assault, or war zone. Helplessness is also a key factor of large ‘T’ traumas, and the extent of experienced helplessness is far beyond that of a small ‘t’ trauma.

Avoidance takes a much different form with large ‘T’ traumas. The individual tends to more overtly and decisively engage in actions that are classified as avoidance. They may deliberately avoid phone calls from investigators, bury their military uniform and memorabilia in the attic, or avoid crowded places. Their attempts to minimize distress and reduce reminders of the traumatic event are time and energy-consuming, as opposed to the more passive avoidance that occurs with small ‘t’ traumas. One large ‘T’ trauma is often enough to cause severe distress and interfere with an individual’s daily functioning, and this effect is intensified the longer avoidance behaviors endure and treatment is circumvented.

Symptoms of Trauma

We all react in different ways to trauma, experiencing a wide range of physical and emotional reactions. There is no “right” or “wrong” way to think, feel, or respond, so don’t judge your own reactions or those of other people. Your responses are NORMAL reactions to ABNORMAL events.

Emotional & Psychological Symptoms:

  • Shock, denial, or disbelief

  • Confusion, difficulty concentrating

  • Anger, irritability, mood swings

  • Anxiety and fear

  • Guilt, shame, self-blame

  • Withdrawing from others

  • Feeling sad or hopeless

  • Feeling disconnected or numb

  • Physical Symptoms:

  • Insomnia or nightmares

  • Fatigue

  • Being startled easily

  • Difficulty concentrating

  • Racing heartbeat

  • Edginess and agitation

  • Aches and pains

  • Muscle tension

  • The Future is Hopeful

If you have endured multiple small ‘t’ traumas or even one large ‘T’ trauma, there is good news. Trauma-focused therapy typically includes evidence-based treatments such as prolonged-exposure and cognitive-processing therapy, as well as EMDR. Engaging in individual therapy provides a safe space to explore these feelings and learn new coping skills that contribute to lasting recovery. These are effective (and research-based) treatments that can reduce, if not eliminate, trauma symptoms and PTSD.

American Psychological Association Recommended Treatment Approaches for Trauma:

  • Cognitive Behavioral Therapy

  • Cognitive Processing Therapy

  • EMDR

  • Cognitive Therapy

  • Prolonged Exposure

  • Conditionally Recommended:

  • Brief Eclectic Psychotherapy

  • Narrative Exposure Therapy

  • Medications

There is no quick fix or ‘cure; but these therapies are facilitated with the goal of decreasing trauma symptoms, and therefore distress, while simultaneously increasing the client's quality of life. Each treatment is quite different, and includes strategies from recalling and fading the memory of the trauma to addressing and reprocessing memories, thoughts, and beliefs.

When Should I Seek Help 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, it's time to seek professional help from a trauma expert.

Seek Help If You Are:

  • Having trouble functioning at home or work

  • suffering from fear, anxiety, or depression

  • unable to form close, satisfying relationships

  • experiencing terrifying memories, nightmares, or flashbacks

  • avoiding more and more things that remind you of the trauma

  • feel emotionally numb and disconnected from others

Working through trauma can be scary, painful, and potentially re-traumatizing, but ultimately rewarding and freeing. This work is best done with the help of an experienced trauma specialist. If you think you may benefit from trauma focused treatment please contact us today to schedule a consultation with one of our trauma specialists. Together you can to determine the right course of treatment for you.

Source www.apa.org, www.psychologytoday.com