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Trauma and PTSD

What is trauma?

Trauma refers to an emotional, psychological, or physical response to a distressing or disturbing event, or series of events.

Traumatic events are defined as ones that involve actual or threatened death, serious injury, or sexual violence such as being involved in a car accident, natural disaster, or childhood abuse. Psychological effects can occur when the trauma is directly experienced, or the person has witnessed it or heard about it happening to someone close to the person. The trauma might be a “single incident” trauma, such as an accident, or a “complex trauma” such as recurrent abuse. Stresses that are not life-threatening, such as bullying and the loss of a loved one, can also lead to psychological effects including adjustment and grief reactions.

How can trauma affect you?

People react to traumatic events differently. Some people experienced limited or short-lived distress but no long-lasting concerns. But for others, exposure to traumatic experiences can lead to intense and prolonged distress that can impair their functioning. Here are some of the more common conditions that can occur following exposure to trauma and stressors:

PTSD

PTSD occurs in response to exposure to a life threatening or violent event. It is characterised by a set of symptoms that typically persist for an extended period after the traumatic event. These symptoms can be grouped into several categories:

  1. Intrusive Symptoms: These symptoms involve re-experiencing the traumatic event. They can include flashbacks, nightmares, distressing memories, or even physical sensations associated with the trauma.
  2. Avoidance Symptoms: Individuals often go to great lengths to avoid reminders of the traumatic event. This can include avoiding places, people, or activities that trigger distressing memories. They may also avoid discussing the trauma altogether.
  3. Negative Changes in Mood and Cognition: This category includes symptoms such as persistent negative emotions (e.g., fear, guilt, anger), distorted thoughts about oneself or others, feelings of detachment or estrangement from loved ones, and a reduced interest in previously enjoyed activities.
  4. Arousal and Reactivity Symptoms: These symptoms can manifest as hypervigilance, irritability, difficulty concentrating, exaggerated startle response, and problems with sleep.

In order to be diagnosed with PTSD, these symptoms must persist for at least a month after the event, and cause significant distress or impairment in a person’s daily life. It’s important to note that not everyone who experiences a traumatic event will develop PTSD, and the severity of the disorder can vary widely among individuals.

Acute Stress Disorder

Acute Stress Disorder involves similar symptoms as PTSD, but the duration is less. To be diagnosed with Acute Stress Disorder, a person must experience these symptoms for a duration of at least three days and up to a maximum of four weeks after the traumatic event. If the symptoms persist beyond this timeframe or worsen, the diagnosis may change to PTSD.

Adjustment Disorders

An adjustment disorder is a condition that occurs following exposure to a non-life threatening stressor. Events could include a major life change, a loss, relationship problems, work-related issues, or financial difficulties. Symptoms can vary and include worry, sadness, and changes in sleep and behaviours.

Prolonged Grief Disorder

This occurs when someone experiences prolonged and intense grief symptoms 6 months (for children) or 12 months (for adults) after the death of a person close to the individual.

Disorders Associated with Childhood Abuse

Those who have experienced abuse during childhood can experience psychological concerns such as PTSD, depression, anxiety, reactive attachment disorder in children, and also “complex trauma” and personality disorders in adults.

Some tips for dealing with a traumatic incident

  1. Ensure your safety and the safety of others.
  2. Seek support from others
    1. Reach out to family and friends
    2. Seek support from trauma informed medical and allied health professionals
  3. Look after your physical self:
    1. Eat well
    2. Get adequate sleep
    3. Move your body
    4. Develop a good daily routine
  4. Use grounding and relaxation techniques such as:
    1. Slowed breathing
    2. Muscular relaxation
    3. Mindfulness techniques
    4. Grounding – Naming 5 things you can hear, see, taste, touch, smell
  5. It might be helpful to talk about the incident with someone you trust or a mental health professional.
  6. If it is safe to do so, try not to avoid reminders of the event.
    Try to return to your usual activities as soon as you are ready – you might do this in a gradual way and with support.
  7. Watch for unhelpful changes in your thinking about yourself, others and the world around you – if you have developed unhelpful thoughts, talk to friends about it or seek support from a psychologist.
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What professional help is available?

Psychological therapy is a crucial component of treating trauma-related conditions such as Post-Traumatic Stress Disorder (PTSD), Acute Stress Disorder, and Adjustment Disorder, among others. Several evidence-based therapeutic approaches have been developed to help individuals who have experienced trauma to process their experiences, reduce symptoms, and improve their overall mental health and well-being. Some of the most helpful psychological therapies for trauma include:

  1. Cognitive-Behavioural Therapy (CBT): CBT is one of the most widely used and researched forms of therapy for trauma. It aims to help individuals understand and challenge unhelpful thoughts and beliefs related to the trauma, as well as modify dysfunctional behaviours and reactions. CBT for trauma often includes exposure therapy, which helps individuals confront and process traumatic memories in a safe and controlled manner.
  2. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a structured therapy that uses bilateral stimulation (such as eye movements) to help individuals reprocess traumatic memories and reduce their emotional charge. It is particularly effective for people with PTSD and other trauma-related conditions.
  3. Prolonged Exposure Therapy: This therapy involves systematically and repeatedly confronting the traumatic memories and situations that have been avoided due to fear. By doing this, individuals can process the trauma and reduce their avoidance behaviours.
  4. Dialectical Behaviour Therapy (DBT): DBT is often used for individuals who have experienced complex trauma, which includes ongoing, interpersonal trauma. It focuses on emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.
  5. Schema Therapy: It is an integrative form of therapy that incorporates elements from cognitive-behavioural therapy (CBT), psychoanalytic concepts, attachment theory, and gestalt therapy to help individuals identify and address long-standing, deeply ingrained patterns of thinking, feeling, and behaviour known as “schemas.”