Introduction to Trauma
One of the main issues I work with in my clinical therapy practice, in some form or another, is client trauma. Because of the complexity of the human nervous system, trauma can impact people in many different ways and on many different levels. In some cases it is truly incapacitating. Also I have found that there is a lot of misunderstanding around the subject of trauma, which creates needless suffering. In this article I hope to give a basic understanding of trauma and begin to discuss some ways to treat it.
What is trauma?
The word trauma comes from the Greek word for wound and is defined by Merriam-Webster as “a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury.” This is a good way to think about it: trauma is a psychic wound that leaves people in a disordered state. People with trauma may have painful triggered symptoms such as flashbacks and panic. The trauma may also disrupt normal psychological development, causing difficulties in social relatedness, communication or attachment. In more severe cases people may experience effects such as dissociation and multiple personality disorder. Trauma typically occurs where there is abuse, neglect or exposure to violence, but even exposure to strong emotional stress can cause a level of trauma. Post Traumatic Stress Disorder or PTSD is a commonly used term, but it is technically a clinical label used to describe a set of specific trauma symptoms and reactions.
A memory issue
To understand how trauma impacts people we first need to understand that trauma is primarily a memory issue, and more precisely, an issue of how memories are stored. Whereas normal memories are acquired during the day and integrated into a person’s memory network while they sleep, traumatic event memories are stored differently. They are stored in such a way that they become triggerable “alarm memories.” When something reminds the individual of the traumatic event, the memory and painful feelings associated with it are played back. This different type of memory process occurs when a person experiences a painful stimulus, (i.e. intense fear, loss, shock) along with the sense of powerless to control it.
How trauma response evolved
Researchers suggest that this neuro-physiological response evolved thousands of years ago as a way of keeping people safe in predator-rich environments. People who could better remember frightening encounters with dangerous animals, for example, were better able to avoid them in the future and thus improved their chances of survival. Over time, the brain evolved a way of storing these trauma memories so that when triggered the person would be reminded of the frightening event by means of flashbacks, nightmares, and other disturbing symptoms. It also stored the memories so that they would persist at intense levels. Although this was a wonderful system for keeping people safe in prehistoric times, in our current social environment these trauma symptoms cause tremendous suffering. And in addition to these direct memory symptoms, people also tend to develop secondary symptoms such as depression, anxiety, anger, and difficulty in social situations.
Lack of understanding causes problems
There is a lurking, but pervasive idea in the social consciousness that trauma is not based on a neurophysiological reality but occurs primarily because people are psychologically weak. The message that trauma is “all in your head” and people should be able to “pull themselves up by their bootstraps” simply does not correspond to the reality of what is happening in the nervous system. Unfortunately, this misunderstanding tremendously compounds the problem of getting proper treatment for people experiencing these symptoms. It has the the effect of fostering shame and denial in a trauma sufferer, and also cutting them off from much needed emotional support from their environment.
Resolution of trauma is possible
Although this may sound like a lot of bad news, the effects of trauma can be resolved in therapy with a competent trauma-based therapist. There are a number of specific approaches, including Eye Movement Desensitization and Reorganization (EMDR) and Eugene Gendlin’s Focusing technique which facilitate the movement of “alarm memories” to non-triggerable, normal memories. I have seen amazing results with clients in my own practice, where long-standing painful memories resolve and symptoms simply disappear.
Treatment of trauma is a delicate business however. Because of all the other issues that develop around the trauma – shame, depression, anger, sense of isolation, etc. – developing a safe “no-pressure” environment in therapy and using a trauma-informed treatment plan are essential.
This article has focused mainly on giving a very brief and basic understanding of the causes and origin of trauma. Next month I’ll present in more depth a number of different approaches and solutions to resolving it.
About the Author
David Seagull, LISW is a clinical therapist and a member of the International Society for Trauma & Dissociation. He has a private practice in Fairfield, Iowa, providing effective therapy for trauma, anxiety and depression. He can be reached at (517) 410-3318 or firstname.lastname@example.org.