Trauma is an overwhelming emotional reaction to a disturbing or life-threatening occurrence or set of events that impacts physical, mental, emotional, and social well-being.
Overview of Trauma
- Types of trauma
- Acute trauma
- Common emotional symptoms for acute trauma
- Chronic trauma
- Common emotional symptoms for chronic trauma
- Complex trauma
- Common emotional symptoms for complex trauma
- Secondary or vicarious trauma
- Common emotional symptoms for vicarious trauma
- Consequences of vicarious trauma
- Adverse Childhood Experiences (ACE
What are the different types of trauma?
- Acute trauma
- Chronic trauma
- Complex trauma
- Secondary or vicarious trauma
- Adverse Childhood Experiences (ACE)
What is acute trauma?
- Immediate short duration emotional reaction to a single, isolated life event
- Emotional reactions may include shock, denial, fear and anger
What are common emotional symptoms for acute trauma?
- Initial emotional responses include shock, denial, dissociation, agitation, anxiety, confusion, numbness, and physiological arousal
- Increased arousal (insomnia, difficulty concentrating, irritability, anger, angry outbursts, constant anxiety, and being constantly on guard for threats (hypervigilance))
- Unpredictable emotions & emotional outbursts (intense fear, anger, shame, sadness, etc.)
- Flashbacks (re-experiencing the trauma through distressing memories)
- Strained relationship (breakdown in communication, difficult, toxic & unhealthy relationships)
- Emotional responses may dissipate with time or it may linger for an extended period of time
Acute trauma
Causes
- Traumatic grief, victim of a crime, kidnapping, accident, school violence, loss of a loved one, witnessing abuse of a parent or household member, physical abuse, sexual abuse, community violence, chronic illness, medical injury, or procedures, neglect, starvation, or deprivation, homelessness, natural disasters (earthquake, tornadoes, tsunamis, wildfire, hurricane, flood), mass shooting, war or combat, car crash, major injury, etc.
Consequences
- Associated with short-term post-traumatic stress disorder (PTSD)
- Adverse psychological effects: anxiety, depression, dissociative disorders, substance abuse
- Insomnia, nightmares (re-experiencing the trauma through distressing memories), headache, nausea, changes in appetite
- May lead to gastrointestinal, cardiovascular, immune, neurohormonal, musculoskeletal complications
- Increased sympathetic drive, activation of “fight or flight” response & increased stress hormone levels
What is chronic trauma?
Persistent prolonged disturbing events that may include emotional (bullying), physical (domestic violence), or sexual abuse
What are common emotional symptoms for chronic trauma?
- Unpredictable emotions (shame, hopelessness, helplessness, anger, persistent sadness, despair, and guilt – as if they are responsible for the event)
- Felling detachment from physical body, mental & emotional processes
- Felling different from others
- Isolation
- Flashbacks (re-experiencing the trauma through distressing memories)
- Change in personal self-concept
- Distrust
- Dissociation (significant relationship problems, rapid mood swings, trouble concentrating and remembering, panic attacks, thoughts of suicide or self-harm, mental health problems, depression, anxiety, etc.)
- Preoccupied with revenge or feeling vulnerable (fearing the perpetrator)
- Substance abuse
Chronic trauma
Causes
- Traumatic grief, victim of a crime, kidnapping, accident, school violence, loss of a loved one, witnessing abuse of a parent or household member, physical abuse, sexual abuse, community violence, chronic illness, medical injury, or procedures, neglect, starvation, or deprivation, homelessness, natural disasters (earthquake, tornadoes, tsunamis, wildfire, hurricane, flood), mass shooting, war or combat, car crash, major injury, etc.
Consequences
- Adverse health effects
- Increased risk for
- irritable bowel syndrome (IBS)
- Chronic fatigue syndrome
- Chronic pain conditions
- Fibromyalgia
- PTSD linked to
- Type 2 diabetes
- Heart disease
- Rheumatoid arthritis
What is complex trauma?
Persistent disturbing events often involves “being or feeling” the inability to escape (feeling trapped) which may occur during childhood or adulthood. Disturbs many aspects of childhood development including physical, mental, and emotional development. Children face difficulty forming secure attachments and the impacts of trauma lingers through adulthood.
What are common emotional symptoms for complex trauma?
- Isolated, anxious, helpless, hopeless, distrustful, unsafe, guilty, and ashamed
- Feeling different from others
- Avoidance (people, places, or situations that may cause flashback of the traumatic event)
- Flashbacks (re-experiencing the trauma through distressing memories)
- Distortion of self-identity (‘I do not know myself anymore’)
- Unpredictable emotional outbursts (explosive anger, persistent sadness)
- Challenges in interpersonal relationships (cutting ties with family and friends)
- Episodes of losing attention and concentration (dissociation)
- Hyperarousal (“on alert”)
- Low self-esteem (negative self-perception)
- Feeling detached from one’s body or mental processes
- Distorted perception of abuser (seeking revenge or over-empowering the abuser)
Common Chronic Symptoms
Causes
- Physical, emotional, or sexual abuse
- Chronic neglect (abandonment)
- Medical trauma
- Being held captive and tortured
- Genocide
- Human trafficking
- Living in a war zone
- Repeatedly witnessing violence or abuse
Consequences
- Physical and mental health complication
- Insomnia and nightmares
- Substance use problem as a coping strategy (trauma may lead to addiction)
- PTSD
- Self-harm
- Suicidal thoughts
- Over or under-eating
- Over-working
What is secondary or vicarious trauma?
Persistent exposure to the trauma of others (physicians, law enforcement, first responder, etc.). Cumulative and repetitive exposure to the traumatic experiences and stories of others affects an individual’s belief system. Burnout is caused by the profession’s long-term physical and psychological impacts.
What are common emotional symptoms for vicarious trauma?
- Irritability, aggressiveness, frustration, anxiety, and fear
- Unable to manage personal boundaries
- Overstepping the boundaries of the role (profession)
- Compassionate thoughts of other’s situation
- Difficulty leaving work at the end of the day (do not leave on time)
- Loss of connection with oneself and others
- Loss of self-identity
- Increased need to control events/outcomes/others
- Loss of pleasure in daily activities
- Relationship problems (avoiding intimacy, increased interpersonal conflicts, and withdrawing from friends and family)
- Uncontrolled emotional outbursts (aggressive, explosive, or violent)
What are the consequences of vicarious trauma?
- Insomnia and nightmares
- Compassion fatigue
- Vicarious traumatization
- Secondary traumatic stress
- Aches and pains
- Decreased immune function
- Addictive behavior (under or overeating, gambling, substance abuse)
- Decreased participation in activates that were once enjoyed
What are Adverse Childhood Experiences (ACE) or Developmental Trauma?
During childhood (0-17 years), prior to the development of coping skills, being exposed to or witnessing disturbing events (abuse, neglect, and/or abandonment). Events that undermine bonding, safety, and security. Disrupts neurological, cognitive, and psychological development. Effects lingers into adulthood.
What are common emotional symptoms for adverse childhood experiences (ACE)?
- Easily frightened, extremely fearful, aggressive, impulsive, guilty, helplessness, shameful,
- Dissociation (feeling numb to physical and emotional feelings, feel cut off from physical body and surrounding)
- Unpredictable emotional outbursts
Adverse Childhood Experiences (ACE) or Developmental Trauma
Causes
- Physical, emotional, sexual abuse,
- Neglect (physical and emotional)
- Dysfunctional family
- Parental mental illness
- Witnessing parent physical abuse
- Incarcerated relative
- Household substance abuse
- Not being raised by both biological parents
Consequences
- Changes emotional, behavioral, and cognitive functioning
- Developmental disruption
- Associated with risky behaviors, chronic health conditions and substance use
- Insomnia
- Mental health conditions (depression, anxiety, post-traumatic stress disorder (PTSD))
- Sedentary lifestyle (obesity)
- Increased risk for diabetes, cancer, heart disease, and stroke
- Increased risk for suicide
What are the essential elements of trauma?
- Triggers
- Victimization
- Revictimization
What are the triggers for trauma?
Triggers
- Certain elements of daily living may bring back strong memories of the traumatic event
- Brain attaches certain details to the memory, which becomes triggers
- When exposed to these elements the brain switches to danger mode, causing the body to react as if in danger, re-traumatization (fear, anxiety, and increased heart rate)
- The traumatic event’s sights, sounds, and feeling come to life which is known as flashback
Different Types of Triggers
- Can potentially be anything that brings back memories of the traumatic event
- These triggers are associated with the different senses (seeing, feeling, smelling, touching, or tasting something)
What is victimization?
Victimization
- Victimization events are high intensity and short duration (physical, sexual, mental, or emotional abuse)
- When someone is victimized for the first time, they frequently self-blame for the abuse
- By self-blaming, the victim feels in control of the traumatic event
- The victim tends to change routines, behaviors, or relationships thinking that it will prevent the reoccurrence of abuse
Three stages of victimization
- Impact
- Initial reaction to the traumatic incident – shock, disbelief, denial, anger, rage, fear, terror, frustration, confusion, etc.
- Recoil
- Processing the traumatic incident – denial, blaming others, self-blame, obsessiveness-ramifications, returning to the event
- Reorganization
- Seeking help, recovering, emotional equilibrium – fear and behavioral reactions, returning to normal life)
What is Re-victimization?
Re-victimization
- When an individual is re-victimized, self-judgment and the feeling of shame and guilt are greater than the first incidence
- Family, friends, social media, and other individuals in their social circle treat re-victimized individuals with greater intensity of judgment than compassion
- Anyone can become victimized and re-victimized (strong, weak, moral, immoral, etc.)
- Traumatization and re-traumatization does not take place by victims, it is committed against them by a perpetrator
Repetition compulsion
- Repeating a traumatic event or compulsively exposing oneself to a traumatic event that resembles the original trauma (associated with earlier life trauma, a way of relieving painful experiences instead of holding them in memory)
- Re-victimization results from the impact of the original trauma
- A victimized individual needs healing from their past traumatic experiences and need to seek help for optimal health and wellness
DISCLAIMER
This information is intended for educational purposes only and it is not intended to take the place of consultation with your physician.
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