What is Trauma?
Trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless, powerless and vulnerable in your life. Traumatic experiences often involve a threat to life or safety, but any situation that leaves you feeling overwhelmed and alone can be traumatic.
Bessel van der Kolk, a leading researcher in the is field, defines trauma as “an inescapably stressful event that overwhelms people’s existing coping mechanisms” (van der Kolk & Fisler, 1995, p.505)
When the mind is overwhelmed by trauma, it struggles to recognise the event or events as over, as being a past memory. For someone who is traumatised, it can be experienced as ‘ongoing’, ‘happening right now’, in the ‘present’ moment. This is due to the brain not being able to integrate the entirety of the incident, or incidents and assess the situation as having ended, being ’over’.
What makes traumatic stress different to other forms of stress is the fact that an element of threat, or harm to life or body, must be present. The reaction to a life threatening event stimulates the nervous system to an extreme response of fight, flight or freeze. It is the release of these primitive survival responses that differentiates trauma from other forms of stress.
Flight is when a person runs away or tries to escape via another means. The purpose of this is to separate a person from threat. It is an attempt to put a distance between the individual and the danger and is usually the first line of defence.
Fight is a defensive action, as the term implies.
Both of the above reactions are not planned consciously but are a response by the primitive survival part of the brain.
Freeze is the last resort response, when fight or flight do not work. The body becomes immobile (which can look like playing dead).
To define Trauma further:
Trauma, as opposed to complex trauma, can be described as a serious emotional injury or shock to the body, due to an accident or violent situation. That is, an emotional wound or shock that creates substantial, lasting damage to the psychological wellbeing of a person. For example, an event such as the loss of a loved one, violation of an individual, divorce, redundancy, or situations that causes great distress and disruption to everyday life.
Complex Trauma is an emotional state experienced by people who are, or have been, exposed to repeated and prolonged trauma. These traumatic events for an individual may have begun early in life and possibly disrupted many aspects of their childhood development and the basic sense of who they are.
Due to ongoing abuse in childhood, the unavailability of a carer, the witnessing of violence, all of these or a combination of them, impact on the development of a child, which would continue to influence their adult life. Adults who have been exposed to this type of trauma will often resist support and have a lack of trust in their world.
Working with complex trauma usually encompasses aspect of dissociation, recovering small amounts of early experience, as well as finding a way to retrieve aspects of those traumatic events in a safe and effective way.
Developmental Trauma occurs in childhood when a child is exposed to chronic or multiple aspects of abuse, such as abandonment, various primary carers in their early years, abuse, neglect, or violence. The child can remain emotionally stuck at the developmental age of when the abuse occurred. The impact upon adult life can be seen through various behaviours, such as difficulty in being able to self-regulate from strong emotional states, rages, lack of awareness of, or dissociation from, sensations, emotions and bodily states, together with difficulty in being able to describe emotions or bodily states. The individual may cope through self-harm, risk taking and/or thrill seeking behaviours. They may have a distrust of others and a persistent negative sense of who they are.
Dissociation is a way in which an individual copes with the trauma and abuse that threatened to overwhelm them in their childhood. An adult who experiences dissociation may try to keep difficult memories at bay, or struggle to recall traumatic periods, events or people in their life, especially from childhood. Often an individual may “switch” to alternative identities when under pressure, this is known as Dissociative Identity Disorder, or “DID”. This is an identity confusion or alteration that talks or lives inside the head of an individual. These identities may differ in age, older or younger than the person’s actual age, they may have unique names, different voices, genders, mannerisms but to name a few aspect of the ‘alters.’ Some identities may not be familiar with each other.
Many people with trauma, complex trauma, developmental trauma or dissociative disorders are able to learn new ways of coping and lead healthy, fruitful lives.
How is Trauma treated?
Within my practice it is fundamental that, before anything else takes place, the individual feels safe. I work with the “Phase-Oriented Treatment” approach:
- Phase 1: Establishing safety, Stabilization and Symptom reduction
- Phase 2: Working through and integrating traumatic memories
- Phase 3: Integration and rehabilitation
Phase 1: Establishing safety, stabilization and symptom reduction
The fundamental key to recovery is for the individual to feel safe. People who have experienced trauma often feel betrayed, both by what has happened to them as well as their own bodies. Within therapy it is vital for the person to get the right help. They need to feel safe and stable (in control), before working on or talking of what happened. We would work step by step together, in session to help you gain an improvement in your daily life as well as your ability to cope. We would do this by helping you to learn how to practice self-soothing and care skills, as well as techniques to help you experience safety. This phase does not always happen quickly, but for some it does. You and your experiences are unique to you and I work at a pace that is right for you, in a respectful and caring manner.
Phase 2: Working through and integrating traumatic memories
Before this stage can be implemented, it is important that the individual is stable or has become reliably stable during phase one. For a portion of survivors to discuss and process their trauma, this could be re-traumatizing and may compromise their ability to function on a daily basis. Therefore, time is taken to ensure that the person is ready to move to this phase.
In the second phase of recovery, this is where talking about what happened is more a part of the treatment. However, this is only done with your permission by asking if you would like to discuss further. It is where you can uncover, slowly, what happened. The aim is that the traumatic memories are integrated and become less disturbing. The survivor is allowed to experience and express their feelings in a safe environment. It can be helpful for the individual to experience and express the feelings they have about what they have endured. All of the survivor’s feelings are legitimate and an understandable response to their experiences. Being able to re-experience and express these feelings in a safe and trusting therapeutic relationship can help you to overcome the mistrust, isolation, and damaged relationships that experiencing the traumatic events inevitably bring.
Phase 3: Integration and rehabilitation
This is the final stage of the process. Integration has been taking place throughout the other two phases. You will have gained insight into your own resources. The memories of trauma and also the powerful feelings the trauma generated will have lessened and would not be impacting upon your day to day life. There will have been a gradual building of bridges, throughout your therapy to your present life. During our time of working together you would have become more connected to your bodily sensations and have found ways to be more able to manage them. This would enable you to handle any situation that arises in the here and now more effectively. The final stage of recovery involves the survivor to have more meaningful relationships and engagement in their daily life. The individual is no longer defined by their traumatic experiences. They have gained knowledge and insight of who they really are; an amazing human being who found a way to survive overwhelming events and who knows that no matter what life presents to them, they always have themselves. They are survivors!
My professional mission is to bring insight into the world of an individual who has been traumatised, empowering them from a place of suffering, to one of hope and recovery, transforming the mind, body and soul from terror to calmness.
If you are interested in having Trauma Therapy in Wilmslow at The Affinity Centre please contact us on 01625 529099 or use the contact form here.
Van der Kolk, B. & Fisler, R. (1995). Dissociation & the Fragmentary Nature of Traumatic Memoires: Overview& Exploratory Study. Journal of Traumatic Stress. 8(4): 505-525
Read the book: Overcoming Childhood Trauma by Helen Kennerley. A self help guide to handling trauma.