Dr. Sarah Davies
Now, perhaps more than ever, our understanding of the underpinnings and aftermath of trauma(s) is becoming fundamental in today’s society. Trauma is becoming more widely discussed in our communities and we may be exposed to an overwhelming amount of information. Here is an overview of what trauma is, how it can impact our wellbeing and possible courses of treatment, including self-help strategies.
What is trauma?
Trauma can be described as any emotional response to an event that was extremely distressing and life-threatening. Trauma can be referred to as person-specific or individualistic, as one person may have a certain emotional response to a traumatic event, whereas somebody else may not – and that is okay. There is no ‘right’ or ‘wrong’ way to respond to a traumatic event.
Trauma can occur anytime throughout a person’s life; it can be subtle and it doesn’t always have to be something that is ‘obvious’. There are many different types of trauma(s), such as ‘single-event trauma’ and ‘complex trauma’. Single-event trauma may be ‘one-off’ incidents that are not prolonged over time, whereas complex trauma may include events that are prolonged and repeated – sometimes complex trauma may be interpersonal in nature whereby the survivor may have been subjected to trauma by somebody they know (e.g. immediate family member, partner, extended family, a person in authority).
Examples of single-event trauma:
Accidents, e.g. road traffic accidents.
Sexual or physical assault in adulthood.
Loss or bereavement.
Being involved in war.
Witnessing terrible things happen to someone else.
Examples of complex trauma:
Childhood abuse, such as physical, sexual and emotional.
Domestic and family violence.
Partner abuse and/or violence.
Refugee and asylum seeker trauma.
Secondary trauma - a person can hear about a traumatic event and have an emotional response.
Historical and collective trauma, such as racism, slavery and war.
Events such as moving to a new house, changing jobs or sudden changes in circumstances are often described as ‘little t’ trauma events.
The aftermath of trauma
After trauma, we may experience difficulties in our emotional, behavioural and cognitive wellbeing, which may include:
Re-experiencing the traumatic event, for example intrusive thoughts, images, flashbacks and nightmares.
Increased perception of threat, such as we may be easily startled, feel on edge and be hypervigilant.
Avoidance behaviours - we may avoid people/places/reminders of the trauma.
In addition to this, if we have experienced complex trauma we may have difficulties in:
Regulating our emotions, such as anger, irritability and dissociation. We may manage our emotions with self-harm and suicide thoughts and acts.
How we see ourselves. We may have severe negative perceptions about ourselves, be highly self-critical and experience shame and guilt.
Maintaining adaptive interpersonal relationships. We may feel distrustful of others and therefore we may fear relationships.
Sometimes, we may not experience any immediate difficulties after a traumatic event, until it is ‘safe’ for us. Instead, we may be functioning in one or more survival modes: freeze, fight, flight and fawn.
Within an environment which is unsafe, stressful and traumatic, our nervous system (sympathetic and dorsal response systems) is under constant threat to keep us alive. These survival modes are efficient in doing this. However, chronic activation of these modes can be detrimental to our nervous system and our wellbeing in the long run. You may also wish to refer to the ‘Window of Tolerance’ to learn steps to achieve optimal functioning.
Similarly, there may be times that we may be triggered or re-traumatised which may elicit one or more survival modes to become activated again. If at any point we feel ‘unsafe’ our survival modes will be activated and we may not be able to fully make sense and process the trauma until we feel safe again. If we are able to facilitate ‘safeness’ in ourselves and our environment, we may begin to shift from surviving to thriving.
So, how can we begin to start developing safeness within ourselves?
Developing our own self-care practices and meeting our own needs. Looking after ourselves (e.g. exercise, sleeping well, eating healthy balanced meals) means that we are giving ourselves the care that we deserve and need (which may have been neglected due to trauma).
Being compassionate to ourselves. This can be beneficial for our intense self-criticism. Ask yourself, “Is there a kind alternative thought to this one?”, “What would I say to a close friend/relative?”, “What would I like to say/do to soothe my inner child?” Also, you could also note positive qualities about yourself (you can also ask a person you trust).
Setting and sticking to healthy boundaries. Setting boundaries can be an important aspect to showing yourself kindness by honouring your own needs. Start by thinking of some of the things that you value in your interpersonal relationships.
Using skills to manage our distress and to regulate our emotions. For example, if we experience flashbacks, we may use grounding techniques to soothe us. Also, using DBT (Dialectical Behaviour Therapy) skills, such as the STOPP skills and Wise Mind skills can assist to regulate our emotions and behaviours.
Once we are equipped with the skills and strategies to help regulate our emotions and manage distress, we may wish to process specific traumatic experiences with structured therapeutic interventions, such as;
EMDR (eye movement desensitisation reprocessing)
Tension and Trauma Releasing Exercises
Individual experiences of trauma can be complex and person specific. Even after a traumatic event we may be triggered or continue to perceive events as threatening, and this may lead us to respond in freeze, fight, flight or fawn modes. We can begin to heal from the aftermath of trauma by creating a sense safeness within ourselves, which can be achieved by setting boundaries, prioritising our own needs, developing self-care practices and practicing self-compassion.
With the right support and tools you can shift from surviving to thriving.