Emotional & Psychological Trauma

Causes, Symptoms, Effects, and Treatment
Trauma. The word brings to mind the effects of such major events as war, rape, kidnapping, abuse, torture, or other similar assault. The emotional aftermath of such events, recognized by the medical and psychological communities, and increasingly by the general public, is known as Post-Traumatic Stress Disorder (PTSD). Now there is a new field of investigation that is less familiar, even to professionals: emotional or psychological trauma.

What is emotional or psychological trauma?
The ability to recognize emotional trauma has changed radically over the course of history. Until rather recently psychological trauma was noted only in men after catastrophic wars. The women's movement in the sixties broadened the definition of emotional trauma to include physically and sexually abused women and children. Now because of the discoveries made in the nineties known as the decade of the brain, psychological trauma has further broadened its definition.

Recent research has revealed that emotional trauma can result from such common occurrences as an auto accident, the breakup of a significant relationship, a humiliating or deeply disappointing experience, the discovery of a life-threatening illness or disabling condition, or other similar situations. Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.

Regardless of its source, an emotional trauma contains three common elements:

it was unexpected;
the person was unprepared; and
there was nothing the person could do to prevent it from happening.

It is not the event that determines whether something is traumatic to someone, but the individual's experience of the event. And it is not predictable how a given person will react to a particular event. For someone who is used to being in control of emotions and events, it may be surprising – even embarrassing – to discover that something like an accident or job loss can be so debilitating.

What causes emotional or psychological trauma?
Our brains are structured into three main parts, long observed in autopsies:

• the cortex (the outer surface, where higher thinking skills arise; includes the frontal cortex, the most recently evolved portion of the brain)
• the limbic system (the center of the brain, where emotions evolve)
• the brain stem (the reptilian brain that controls basic survival functions)

Because of the development of brain scan technology, scientists can now observe the brain in action, without waiting for an autopsy. These scans reveal that trauma actually changes the structure and function of the brain, at the point where the frontal cortex, the emotional brain and the survival brain converge. A significant finding is that brain scans of people with relationship or developmental problems, learning problems, and social problems related to emotional intelligence reveal similar structural and functional irregularities to those resulting from PTSD.

What is the difference between stress and emotional or psychological trauma?
One way to tell the difference between stress and emotional trauma is by looking at the outcome – how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing the following:

how quickly upset is triggered
how frequently upset is triggered
how intensely threatening the source of upset is
how long upset lasts
how long it takes to calm down

If we can communicate our distress to people who care about us and can respond adequately, and if we return to a state of equilibrium following a stressful event, we are in the realm of stress. If we become frozen in a state of active emotional intensity, we are experiencing an emotional trauma – even though sometimes we may not be consciously aware of the level of distress we are experiencing.

Why can an event cause an emotionally traumatic response in one person and not in another?
There is no clear answer to this question, but it is likely that one or more of these factors are involved:

• the severity of the event;
• the individual's personal history (which may not even be recalled);
• the larger meaning the event represents for the individual (which may not be immediately evident);
• coping skills, values and beliefs held by the individual (some of which may have never been identified); and
• the reactions and support from family, friends, and/or professionals.

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop symptoms of "vicarious" or "secondary" traumatization. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

What are the symptoms of emotional trauma?
There are common effects or conditions that may occur following a traumatic event. Sometimes these responses can be delayed, for months or even years after the event. Often, people do not even initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from a more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

Physical
Eating disturbances (more or less than usual)
Sleep disturbances (more or less than usual)
Sexual dysfunction
Low energy
Chronic, unexplained pain

Emotional
Depression, spontaneous crying, despair and hopelessness
Anxiety
Panic attacks
Fearfulness
Compulsive and obsessive behaviors
Exaggerating (especially when others chronically disbelieve them)
Feeling out of control
Irritability, angry and resentment
Emotional numbness
Withdrawal from normal routine and relationships


Cognitive
Memory lapses, especially about the trauma
Difficulty making decisions
Decreased ability to concentrate
Feeling distracted
The following additional symptoms of emotional trauma are commonly associated with a severe precipitating event, such as a natural disaster, exposure to war, rape, assault, violent crime, major car or airplane crashes, or child abuse. Extreme symptoms can also occur as a delayed reaction to the traumatic event.

Re-experiencing the Trauma
intrusive thoughts
flashbacks or nightmares
sudden floods of emotions or images related to the traumatic event

Emotional Numbing and Avoidance
amnesia
avoidance of situations that resemble the initial event
detachment
depression
guilt feelings
grief reactions
an altered sense of time

Increased Arousal
hyper-vigilance, jumpiness, an extreme sense of being "on guard"
overreactions, including sudden unprovoked anger
general anxiety
insomnia
obsessions with death

What are the possible effects of emotional trauma?
Even when unrecognized, emotional trauma can create lasting difficulties in an individual's life. One way to determine whether an emotional or psychological trauma has occurred, perhaps even early in life before language or conscious awareness were in place, is to look at the kinds of recurring problems one might be experiencing. These can serve as clues to an earlier situation that caused a dysregulation in the structure or function of the brain.

Common personal and behavioral effects of emotional trauma:

substance abuse
compulsive behavior patterns
self-destructive and impulsive behavior
lashing out
uncontrollable reactive thoughts
inability to make healthy professional or lifestyle choices
dissociative symptoms ("splitting off" parts of the self)
feelings of ineffectiveness, shame, despair, hopelessness
feeling permanently damaged
a loss of previously sustained beliefs

Common effects of emotional trauma on interpersonal relationships:

inability to maintain close relationships or choose appropriate friends and mates
sexual problems
hostility
arguments with family members, employers or co-workers
social withdrawal
feeling constantly threatened

What if symptoms don't go away, or appear at a later time?
Over time, even without professional treatment, symptoms of an emotional trauma generally subside, and normal daily functioning gradually returns. However, even after time has passed, sometimes the symptoms don't go away. Or they may appear to be gone, but surface again in another stressful situation. When a person's daily life functioning or life choices continue to be affected, a post-traumatic stress disorder may be the problem, requiring professional assistance.

How is emotional trauma treated?
Traditional approaches to treating emotional trauma include:

talk therapies (working out the feelings associated with the trauma);
Cognitive-Behavioral Therapy (CBT) involves changing one's thoughts and actions, and includes systematic desensitization to reduce reactivity to a traumatic stressor
relaxation/stress reduction techniques, such as biofeedback or breathwork; and
hypnosis to deal with reactions often below the level of conscious awareness.

There are also several recent developments in the treatment to emotional trauma. Depending on the nature of the trauma and the age or state of development at which it occurred, these somatic (body) psychotherapies might even be more effective than traditional therapies. Some of the new therapies include:

EMDR (Eye Movement Desensitization and Reprogramming)
Somatic Experiencing
Hakomi
Integrative Body Psychotherapy

EMDR THERAPIST NETWORK