What is Trauma and How is it Treated?

Trauma is an emotional response to a distressing event. Distressful events and/or violence continues to manifest in new ways culturally and with each new generation. DSM-5 defines trauma as an exposure to an actual or threatened death, serious injury, or sexual violence. Generally, when a person experiences an event or series of events such as abuse, a bad accident, rape, or other sexual violence, combat or a natural disaster, they may have an emotional response called trauma.

Having an emotional response to these events is normal but the type and duration of the response can create symptoms that are problematic or even dangerous. In fact, DSM-5 identifies four trauma related disorders that seriously impact human lives. These are: PTSD or Post Traumatic Stress Disorder, RAD or Reactive Attachment Disorder, DSED or Disinhibited Social Engagement Disorder and Acute Stress Disorder. All of these conditions impact lives in a serious manner and require treatment for the person to function successfully in their daily lives. 

Trauma can be either emotional or physical or both.

Physical trauma is related to bodily injury while emotional trauma has to do with a person’s psychological response to an event. An acute emotional response happens during and immediately after a distressing event. Chronic emotional response to trauma is a long-term response that is prolonged over the span of months or years. Chronic trauma response can lead to conditions such as those listed above from the DSM-5 and can include suicidal thoughts, suicidal attempts, and/or successful suicide. (988 – suicide and crisis lifeline) Trauma that causes chronic symptoms is a serious concern and most likely will require the help and support of a mental health professional for coping and recovery.

Some examples of emotional trauma and how it can manifest are:   

• Fear

• Helplessness

• Dissociation

• Changes in attention, concentration, and memory retrieval

• Changes in behavior

• Changes in attitude

• Changes in worldview

• Difficulty functioning in daily life

• Denial

• Anger

• Avoidance

• Depression

• Anxiety

• Mood swings

• Guilt/shame

• Social withdrawal     

While this list is not exhaustive, it gives a clear picture of the numerous ways trauma can impact a person emotionally. It is interesting to note that emotional trauma can also manifest as physical symptoms.

Some examples of physical symptoms are:

• Increased heart rate   

• Body aches or pains

• Tense muscles

• Feeling on edge

• Exaggerated startle response

• Nightmares

• Insomnia

• Overwhelming fatigue

• Appetite changes

• Sexual dysfunction such as difficulty becoming aroused or reaching orgasm

• Hyper vigilance

How Trauma is Treated

The primary treatment for trauma is psychotherapy or talk therapy. In some cases, medication may be indicated in addition to psychotherapy. Some cases of trauma may require a combination of therapies depending on the type of trauma, the severity, and what the individual responds to. Some people may need both individual sessions and support group work with groups that are designed for trauma treatment. In recent years, alternative therapies such as animal assisted therapies (i.e., equine therapy) or art therapy have been used with either adults or children and have had some success.

Specifically, some of the most frequently used psychotherapies include:

EMDR or Rapid Eye Movement Desensitization and Reprocessing is a type of psychotherapy that focuses specifically on treating trauma. Because EMDR requires special training it is recommended you ask for an EMDR trained therapist. This form of therapy helps process and release traumatic memories through eye movements.

Prolonged Exposure Therapy involves exposing you to the source of your fear until you are not afraid anymore.

Cognitive Processing Therapy (CPT) challenges your perspective about why the traumatic event occurred and the thoughts and beliefs you developed since.

Trauma Focused Cognitive Behavioral Therapy (TF-CBT) is a form of psychotherapy for children and adolescents which helps address inaccurate beliefs and unhealthy behavior patterns.

Let it be noted, if a client is resistant or apprehensive about an approach, it can do more harm than good to insist on a particular technique. A large part of therapy is your relationship with your therapist as it is essential you feel safe in that relationship. There are many different types of therapists with different skills and finding the right fit is also imperative to the process being effective and healing.

In addition to therapy, the importance of maintaining a routine, eating healthy, getting regular exercise, getting 8 hours sleep each night and avoiding drugs and alcohol is paramount to healing trauma.  

Trauma can be complicated and without intervention can develop into behavior patterns and maladaptive coping responses that seriously impact quality of life. Psychotherapy as an intervention can help a person get back into life in a healthy balanced way that promotes well-being. If you have experienced trauma and have symptoms that have persisted more than 30 days, reach out for support.