Trauma Part 1
Updated: Sep 17, 2020
PART 1: TRAUMA AND WHAT MIGHT BE HELPFUL TO KNOW ABOUT IT
1) Different kinds of trauma
All trauma puts a person’s system into a state of overwhelming stress. There are different types of trauma:
Trauma Type 1: Single event trauma, such as a car accident, having been raped or robbed, or an earthquake or flood, to name but a few. Type 1 Trauma is also called PTSD.
Trauma Type 2: This type of trauma is going on for a prolonged period of time, such as forms of abuse and maltreatment experienced by children through their caregivers over many years. It usually involves a fundamental betrayal of trust in primary relationships. Type 2 Trauma is also called Complex Trauma and sometimes Complex PTSD.
2) What is PTSD (Post-traumatic Stress Disorder)?
While, in my view, the terminology around this is not particularly helpful, I also recognise that an official diagnosis can afford people relief as well as access to funding or support, especially when relying on the medical system which offers treatments like EMDR (Eye Movement Desensitisation and Reprogramming) which apparently work best for Type 1 Trauma.
As I see it, all trauma is rooted in terrifying events or situations which overwhelm us when we experience them, render us helpless at the time of experiencing them and can have a big impact on our mental and physical health even decades later.
The human system is designed to recover from trauma in about 6 weeks after the event (Type 1). If symptoms like flashbacks, nightmares and increased anxiety persist beyond that, a diagnosis of PTSD might be made.
3) What happens when we have been exposed to trauma?
Trauma has an impact on our brains and bodies. Our brains store traumatic memories in a different place which can feel like a box whose lid can fly off when triggered and all the awfulness of the original trauma comes out in all its immediacy as if no time has elapsed since it happened. In fact, the memory is being experienced in the here-and-now as if the traumatic situation is still ongoing. It feels as if we are stuck in this box of heartache, terror, gut wrench and indescribable terror for ever, without access to the fact that we might have felt fine a minute ago and without a concept that we will feel better again in the future, perhaps soon. Traumatic memories have not yet been integrated into the time-line of a person’s life, nor have they been tagged as “over” by the brain.
As well as unbearable somatic sensations which might stem from pre-verbal trauma, a person can experience flashbacks in the form of recurring nightmares or unbearable emotions. As these unbearable inner states do not come with a label saying “I am from 10 years ago when you were raped and the bloke over there was the trigger because he has the same hight as the person who raped you”, we tend to look for reasons in our immediate environment and sometimes, we blame others or current situations which have nothing to do with it.
These states are usually triggered by an event, another person, a certain smell, sound or tone of voice, etc. reminiscent of the original event. We don’t always know in our conscious mind that this is going on which means that often, these flashbacks seem to occur at random which makes them even more scary and seemingly unpredictable. Experiencing a panic attack, the trauma victim feels just as helpless and out of control as when the original trauma took place.
Sometimes, we might feel we are “going mad” as the stress response or panic attack appear to occur out of the blue.
4) What happens to the brain as a result of trauma?
The structure in our brains called the amygdala is our system’s smoke alarm which assesses our environment for risk. If the amygdala detects danger, our so-called stress response gets kick started and our whole system prepares for survival in a microsecond. Our rational brain does not come into this. Powerful stress hormones like adrenalin and cortisol are being released which increase the heart rate, blood pressure as well as our rate of breathing in order to prepare the body to “fight, flight or freeze”. These same hormones disconnect our frontal lobes where our rational thinking takes place; we don’t have a choice at this moment but do whatever the body decides is necessary for our survival.
This can be important to know for people who have been raped or attacked and sometimes report they feel ashamed because they didn’t fight back. Their system decided for them that “freeze” or “flop” would be the best option for survival, nothing at all to do with willpower or strength of character.
After an episode of being triggered, people frequently report feeling “foggy” or unable to focus, sometimes for days after having been triggered, as it takes the body some time to disperse these stress hormones.
For people who have experienced trauma, the smoke alarm (amygdala) becomes hyper-active and overly sensitive, especially, if someone lives in very unpredictable surroundings which pose a perceived risk to health and safety on an ongoing, long-term basis (Type 2 Trauma), like a war zone, life in the middle of ongoing domestic conflict, being brought up by an alcohol or drug dependent parent, life with abuse of any kind (emotional, psychological, physical) or violence.
After trauma, the stress response, triggered by a hyper-sensitive amygdala which sees imagined threat where there is none, is always slightly activated, even during periods of calm, as if on stand-by for the next shell coming in or the next beating to take place. This results in a constantly elevated level of stress hormones, leading to a person feeling unwell, on edge, stressed and anxious, possibly unable to focus.
A hyperactive and often overly sensitive amygdala tends to misinterpret our surroundings as dangerous when, in reality, the situation would be quite safe. This comes into play especially when we experience so called triggers which in some way remind us of the original, dangerous situation.
The nature of these triggers can be entirely outside of our awareness. They can consist of anything from sounds to smells to touch, places and people, depending on the initial traumatising situation. If I was abused as an infant by someone in a red jumper, I will probably not recall the event but my unconscious knows that a red jumper signals danger and I might experience being triggered into my stress response when I see a red jumper in a shop window. This seemingly random panic attack might make me less inclined to go out in future.
Seasons can be triggering as well. The smell of freshly cut grass in summer can cause great anxiety in people who had a harrowing experience during summer time exams at school, college or university. Or someone might feel really low every November if previously someone close to the family died in that month.
There often is little or no awareness of triggers. Once triggered, behaviour experienced as non-rational can occur, such as panic attacks, displays of rage or sudden collapse of the system into a frozen-depressed state. This can reinforce feelings of being out of control in a hostile world, feeding anxiety and low self-esteem.
6) The Role of Counselling in Overcoming Trauma
The good news is that brains have the capacity to change and heal; you might have heard the expression “neuro plasticity”. This might take some time but we do not have to be held to ransom by a hyperactive amygdala or uncontrollable, automatic stress responses to our triggers for the rest of our lives.
We are all unique and so are the events and situations which caused our trauma in the first place. There is no “one size fits all” approach.
Trauma therapy should be undertaken by someone who is knowledgeable about this field. Part of this is knowing how to keep clients safe. Please don’t hesitate to ask your counsellor about their approach.
In trauma work, I will take a bit more of a lead, after having discussed this with you first. I will communicate some self-regulation skills which allow you to dip in and out of your trauma narrative at a safe pace in order not to become overwhelmed and re-traumatised. This might also give you a feeling of greater control over your stress response which, in time, can build self-confidence and feelings of greater self-empowerment.
Clients can work on trigger identification in counselling. This will bring some unconscious triggers into awareness which will help with feelings of being more in control.
There are various ways to strengthen the connections between the brain’s alarm system (the amygdala) and the frontal lobes, so that potentially, out-of-control reactions can be tempered by reason. Sometimes, just gaining a tiny amount of time before we are in danger of being propelled down the road of the automatic stress response enables us to put on the brakes and to decide to do something differently, leave the room, etc. Mindfulness practices can help with this. Do not hesitate to ask your counsellor if s/he is familiar with these. They can be communicated and demonstrated during counselling sessions and practiced at home or in a group.
In addition to feelings of relative safety, feelings of self-worth can be key. Counselling can help with this, as well as with fostering the practice of self-compassion, for our adult selves as well as for our wounded child parts.
All this can help integrate the trauma narrative into the timeline of your life and mark the event or situation as “over”. This means that you can recognise the traumatic memory as part of your life without feeling defined by it. We would hope to arrive at a point where it is possible to say: “Yes, what happened to me was awful and it shouldn’t have happened. However, it is over now, I am safe now and there is more to me than my trauma. I want to get on with living my life now.”
In addition to trauma work in counselling, it could be beneficial to look at body work (such as Yoga, etc.), as residual trauma is often located and held in the body.
 edited by Christine A. Courtois, Julian D. Ford, Treating Complex Traumatic Stress Disorders, p. 15, New York 2009  Bessel van der Kolk, The Body keeps the Score, 2014.