Understanding Trauma
In recent weeks there have been many articles regarding the concerns that frontline staff are at risk of PTSD from the COVID-19 pandemic.
Some have been speculating on what the psychological impact the pandemic will be for children. Others have been considering how the pandemic can be considered as a collective trauma for all people.
What is trauma?
Trauma is a word that conjures different images in people's minds and can be hard to understand. So what exactly is it?
Trauma describes when we are pushed beyond our ability to cope. When something happens that overwhelm’s a person’s coping mechanisms they experience trauma. Trauma often is thought of as a response to a life threatening experience, but it can also include ongoing relentless stress, bereavement, and relationship breakdown.
Children have less coping strategies than adults and have more difficulties in processing and integrating their experiences into their life story (more on this in a bit) so can have traumatic responses to things that an adult can manage fine.
Adults who have had difficult upbringings or have experienced abuse or neglect will have less coping mechanisms than someone who hasn’t. This means that on top of the trauma and/or upset they have already experienced, they are also more likely to experience trauma again.
Trauma lives in the nervous system
As I stated earlier trauma is a response to an overwhelming situation, not the situation itself. It doesn’t matter what the situation is- when an experience leaves is feeling disconnected from our bodies, feeling helpless or stunned it can be viewed through the lens of trauma. Peter Levine states “trauma is not in the event itself; rather trauma resides in the nervous system” (from Waking the tiger; healing trauma).
Our nervous system is a network of nerves, cells and fibres that transmit information to different parts of the body. Nerves pick up sensory information all the time; they send this information to the central nervous system which interprets the information. The central nervous system then sends messages to bits of the body telling it to do things in response. Much of this is done outside of our awareness, such as the body sweating to cool down when it gets too hot; we don’t have to actively think about that for it to happen.
A small part of our brains, found in the limbic system, is our amygdala. This bit of the brain acts like a smoke detector. When it senses danger (smoke) it starts a series of reactions that get the body to respond to the threat. For example our hearts start to beat faster, blood rushes to our muscles to help us combat the threat, our digestive system slows down (sometimes making us feel sick/queasy).
We enter the ‘flight or fight’ response which are driven by our lower brain. At this point our body is awash with the stress hormone cortisol, which is created to help out body to respond to life threatening situations. The amygdala isn’t very good at telling the difference between psychological threat and physical threat so it responds the same to both. If we cannot escape the threat our bodies sometimes ‘freeze’to to try and protect itself (think of a possum playing dead to outwit it’s prey).
Once the threat is gone, our bodies go through a process of recovery from the stress- this is about the body regulating itself after all the hormones like cortisol that are released from the stress dissipate.
*The neuroscience of trauma is a pretty complicated area, so I’ve tried to explain it quite simply here, I will be posting another article to explain this area more fully for those who are interested.
Overcoming Trauma
The process for overcoming trauma is called ‘integration’. This is when a person makes sense of what has happened to them. Often a traumatic event can change a person’s way of seeing themselves and the world.
When we go through a life changing event we need time to process the change and how it fits in with how we view ourselves and the world. We often find that we’ve responded differently to how we thought we might respond. Our responses may be vastly different to how we have always seen ourselves, leading us to question who we are. We may also see the world as more dangerous or scary than we have before.
Integration is a very important aspect of recovering from trauma. Many people need help from trained professionals such as counsellors to help them overcome these difficulties. Integrating our experiences into our life story is essential to recovery; without we can find the traumatic experiences intruding on every day life.
Some ways to process trauma are to simply talk about what you’re feeling and thinking with loved ones or writing about it. This can be tricky for some and speaking to an impartial outside such as a counsellor can sometimes be easier. Counsellors can also help with emotion regulation techniques to manage traumatic reactions.
When Trauma isn’t Integrated
When trauma is not integrated and still needs to be processed it can intrude of everyday life in a variety of ways including:
Flashbacks
Disturbed sleep, including nightmares
Depression, anxiety and increased irritability
Feelings of loneliness
Confusion and difficulties with memory
Intrusive thoughts of the trauma and difficulty in stopping thinking about them
Avoiding situations and places that remind you of the trauma
Using coping mechanisms like abusing alcohol, drugs and self-harm
Difficulties relating to others and emotional connection
It is important if you’re finding yourself struggling in any of the ways mentioned above to seek help from a trained professional.