In this blog, Hannah Trimble from Shawmind explores trauma.
The term ‘trauma’ is frequently used in the current mental health climate; with up to eight in ten people in the general population having experienced at least one traumatic incident in their lifetime. The definition of trauma, the causes and its subsequent impact on the individual is still misunderstood. Simply put, a trauma is any event and the subsequent emotional response to an event(s), which cause an individual to experience differing levels of distress. This distress can either, if processed correctly, have a minimal effect on the psyche, a mild-to-moderate effect one’s functioning or can be disabling for some individuals. This article focusses on emotional (psychological) and not physical trauma and provides an outline of trauma in comparison to PTSD.
Emotional trauma can be categorised as the following: acute, chronic or complex. Acute emotional trauma is the mental response that happens during or immediately following the incident. Chronic trauma is a prolonged response from a past traumatic event or incident. Complex trauma is a response to multiple traumatic events, which creates psychological distress and has a profound effect on one’s ability to function. Of course, an individual can become ‘re-traumatised’ if they experience the same or similar distressing event more than once.
Traumatic experiences during childhood, whether acute, chronic or complex, are referred to as ACEs (Adverse Childhood Experiences), for which, over four in ten people have experienced an ACE during their childhood. Some individuals are more neurologically susceptible to having psychological distress from a trauma, such as children or adults who have experienced an ACE. Moreover, the brain may ‘archive’ unpleasant memories or experiences which occurred in the past and process these much later in somebody’s life. This means that an individual may not immediately recognise an experience as traumatic, but years later, may become distressed and struggle to process the event.
Trauma is often the result of, but not limited to, experiences such as life-threatening or neath-death incidents, real or perceived danger, ongoing distressing events, abuse, neglect, sexual violence, natural disasters, and exposure to phobias. Trauma is also very personal, meaning that for some people who experience these events, it will not have a lasting impact on the psyche, behaviour, or daily functioning. For others, these events can have a strong effect on one’s ability to function in everyday life, impacting areas including work, education and interpersonal relationships. Likewise, a seemly innocuous experience, such as going on an unpleasant holiday may be traumatic for some individuals.
This emphasises the importance of being understanding and having a good social network to support an individual living with a traumatic memory. It is crucial to remain non-judgmental when listening to a family member or friend disclose a traumatic event, as these experiences and the effect they have on daily functioning are personal between individuals.
Post-Traumatic Stress Disorder (PTSD)
Although the terms ‘trauma’ and ‘PTSD’ are sometimes used interchangeably, distinction must be made between these two conceptions. PTSD is a debilitating psychiatric condition associated with underlying vulnerabilities; these being cognitive and functional impairment. The onset of PTSD then subsequently occurs from exposure to traumatic experiences. PTSD is an abnormal response to a traumatic or distressing event, with symptoms and aftershock which do not improve over time. The main psychological symptoms of PTSD are persistently and repeatedly re-experiencing the traumatic event, having intrusive thoughts and flashbacks, heightened anxiety, feeling intense negative emotions such as sadness or guilt and avoiding reminders or stimuli associated with the traumatic experience to avoid becoming distressed or re-traumatised.
Neurological Origin of PTSD & How it Differs from Trauma
For those with PTSD, neuroanatomy is altered, with the hippocampus (the part of the brain responsible for memory and learning) being reduced in size, whereas the amygdala (the emotional processing and fear part of the brain) is overactive. Those with PTSD also have a smaller medial prefrontal cortex, which in the context of traumatic events, serves the important function of having control over emotional reactivity of the brain’s fear response (amygdala). In other words, PTSD brains overreact to traumatic situations and memories by producing an excess emotional-fear response and results in greater distress among these individuals.
Those with good mental processing who experience a traumatic event are less likely to have PTSD than individuals with cognitive impairment in the emotional processing of events. This may explain why only around one in ten individuals have PTSD, whereas it is estimated that a large majority of the general population will experience at least one trauma in their lifetime. This underlines the distinction between the two; with PTSD having a more biological origin, whereas traumatic events are environmental and extensive in dimension. Anybody can potentially have PTSD, although it is more common in females, with this being four times more common in girls than boys in children. Given that a child’s brain is not yet fully developed, it makes sense why children who suffer trauma may only process the event many years later. This places a greater emphasis on optimising wellbeing for children, especially early on in development, as to reduce the likelihood of the trauma impacting a child’s mental health and functioning.
To summarise, some individuals are more vulnerable for being affected by traumatic events and when living with trauma or PTSD, your first line of support will usually be family and friends. It's important to remember that time is needed to recover from any traumatic event but if the physical and emotional symptoms are still there after around six weeks or longer, you should seek professional support to help manage these. Fortunately, there are numerous successful treatments available for those living with trauma and PTSD – these include: eye movement desensitization and reprocessing (EMDR), cognitive behavioural therapy (CBT) and talking therapies. For children living with or who have recently experienced a distressing event, it is important for them to have a significant attachment figure, such as a role model, in their life. This could be a parent, carer, relative or a teacher or anybody to whom the child feels a good and strong sense of attachment. These attachment figures will help a child to feel safe, loved and secure, which will positively impact their mental health as they develop.
For more information on trauma, please consider taking our trauma-informed course, which can be found here:
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