What is Trauma: Causes, Impact, and Trauma-Informed Treatment

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Discover the causes, impact, and treatment of trauma. Understand the emotional responses and long-term effects of trauma and deeply distressing events.

What is Trauma: How Common Is Trauma

Many types of traumatic and stressful events can cause a traumatic reaction, from natural disasters to domestic violence, combat exposure, being a victim of a crime, or witnessing a loved one get hurt, struggling with infertility or adoption challenges, chronic medical issues, infidelity or a tumultuous divorce. Life transitions, immigration, chronic exposure to distress, and grief over the loss of a loved one can impair our ability to cope and even lead to complex trauma. Survivors of trauma respond to it differently and can experience a wide range of psychological reactions, including depression, anxiety, Post-Traumatic Stress, relationship problems, occupational challenges, or excessive substance use. However, the consequences of experiencing trauma aren’t only psychological, but also physical. Traumatic experiences are associated with a higher lifetime prevalence of chronic physical health conditions. This holds particularly true for untreated childhood trauma and is a reason why trauma-informed care is essential. Traumatic events affect not only you individually, but also your family members, friends, and colleagues. Your loved ones can suffer with you, struggle to understand what you are going through, find it hard to comprehend your distress, or try to help you and not know how. Traumatic events are dangerous, shocking, and scary experiences that can affect us emotionally, cognitively, and physically. Traumatic and adverse events can overwhelm us, but their effects are treatable. Through competent and compassionate care, we will help you and your family rebuild your resilience and overcome adversity. If you have survived an adverse or traumatic event and are consequently experiencing difficulties in readjusting, you are not alone. The Substance Abuse and Mental Health Administration (SAMSHA) points out that threatening or hurtful life events can have lasting adverse effects on all aspects of functioning, including mental, physical, social, emotional, or spiritual well-being. The prevalence of traumatic experiences is difficult to correctly assess, but estimates suggest that:

  1. Approximately 19% of men and 15% of women in the US reported a lifetime experience of a natural disaster
  2. Between 15% and 25% of women will report a lifetime history of sexual abuse
  3. As many as 1 in every 6 men have had abusive sexual experiences before the age of 18
  4. The prevalence of domestic violence among women is between 9% and 44%, depending on sources. The true number is likely closer to the higher margin, due to pervasive underreporting
  5. About 18.5% of returning veterans report symptoms consistent with post-traumatic stress disorder (PTSD) or depression
  6. Approximately 60% of adults report traumatic or other difficult family circumstances during childhood
  7. As much as 70% of children in elementary and middle schools are affected by bullying

Some of these statistics are likely an underrepresentation of the true numbers. This is because, in its nature, trauma is often associated with feelings of shame, guilt, and self-blame, thus making it less likely to be reported.

Signs & Symptoms

Adults

We all react differently to stressful events and it is impossible to predict how someone will respond to trauma. That being said, there are commonalities in how adverse events can impact our functioning. If you are experiencing any of the below symptoms, consider seeking help. Please note that you may not feel all of the symptoms below, but even a few are indicative of a possible stressful reaction.

Emotional and psychological symptoms in adults:

  • Shock, denial, or disbelief
  • Confusion, forgetfulness, not remembering how you got places
  • Anger, irritability, mood swings
  • Anxiety and fear
  • Panic/anxiety attacks
  • Guilt, shame, self-blame
  • Withdrawing from others
  • Feeling sad or hopeless
  • Difficulties feeling positive emotions
  • Feeling disconnected or numb
  • Feeling hyperalert or more vigilant than those around you

Physical symptoms in adults:

  • Insomnia or nightmares
  • Feeling jittery or restless
  • Fatigue
  • Being startled easily
  • Racing heartbeat
  • Edginess and agitation
  • Aches and pains
  • Muscle tension
  • Sweating, hot and cold flashes
  • Difficulties being in crowded places

Children

Children are often incredibly resilient in the face of adversity. However, when stressors are overwhelming, they may exhibit a wide range of emotional, behavioral, and academic difficulties. Symptoms of trauma may also vary based on the child’s age and developmental stage. Children are often unable to verbally express what is bothering them and therefore are more likely to communicate through their behaviors; what we may see as tantrums, acting out, or bids for attention are frequently their way of telling us that they need help.

General signs to look out for in children:

  • Changes in sleep or appetite
  • Persistent nightmares or difficulties falling and/or staying asleep
  • Anger or rage
  • Difficulty being soothed
  • Unreasonable fear
  • Regressing to a previous developmental stage (e.g. wetting bed after that had stopped)
  • Unusually strong startle response
  • Sudden difficulties at school, grades decreasing
  • Lethargy
  • Withdrawal from previously trusted adults
  • Clinginess or intense anxiety when separated from parent
  • Frequent stomach aches and/or headaches
  • Unusual shyness or acting out in social situations

How Does Trauma Affect Us

If left untreated, reactions to traumatic events can impact our lives significantly, in many areas, including professional realization, personal fulfillment, interpersonal relationships, and even physical health. Trauma, whether it is a one-time event or repetitive and long-lasting adverse events, affects everyone differently. Some may exhibit symptoms consistent with Post-Traumatic Stress, while others will demonstrate resilience or subclinical symptoms, which may resolve themselves over time. When they do not, however, the impact of trauma can be subtle, insidious, or downright destructive. You may feel detached from everyone and disconnected from your friends, children, or significant other. Your positive emotional reactions may feel dull or numbed down, while feelings of shame, vulnerability, or weakness may dominate, leaving you feeling frequently irritable, on edge and, at the same time, exhausted. There is a reason for this change; although it may come slowly and subtly, it will become more pervasive over time. Traumatic events cause changes in our physiology, like elevation in cortisol levels, which can leave us in a constant state of hyperactivation or vigilance, causing a prolonged stress response. Therefore, besides persistent fatigue, they threaten more long-term physical illnesses, such as heart, liver, autoimmune, and chronic obstructive pulmonary disease. Trauma affects our thinking too, whether we realize it or not. You may have difficulty making decisions, feeling cynical, unmotivated, or feeling like the world is dangerous or that others cannot be trusted. You may not want to remember the painful events, talk, or even think about them, and numb yourself through engaging in risky behaviors—such as reckless driving, drinking, drugs, overworking, binge eating, or gambling. You may even try to avoid people and places that are painful reminders of what you have gone through. However, that may leave you feeling as if you are missing out, while the world around you is moving forward. It may cause you to isolate yourself from your loved ones, or feel like you are observing them from the outside, not ever quite present in your own life. Acknowledging that traumatic experiences have affected us is an important first step towards regaining control of our life and our emotions. When you free yourself from the burden of trauma symptoms you will start to feel a connection with your loved ones once again, enjoy your children, and feel happiness, joy, and excitement. You can regain a sense of purpose and experience renewed hope and motivation. Seeking professional help is not an admission of weakness, it means taking your life in your own hands, for your own sake and for the benefit of your family and loved ones.

Family Impact of Trauma

If you are experiencing challenges, such as depression, anxiety, PTS, or substance use, you are likely not suffering in a vacuum. According to the National Child Traumatic Stress Network, families in which a member is experiencing post-traumatic difficulties tend to go through increased levels of stress, crisis, and family discord. Spouses and partners of someone living with PTS can suffer from increased anxiety, depression, and even physical symptoms, further straining the relationship and resulting in possible decrease in positive feelings and intimacy, increased isolation, and compromised ability to be emotionally available and supportive to other family members, such as children. Families who come together in overcoming trauma, on the other hand, can grow stronger through the challenging experiences, strengthen their bonds, and help hasten the recovery of all individuals involved. Let us help you come together and become more resilient.

Intergenerational & Historical Trauma

The term intergenerational trauma, also known as trans- or multigenerational trauma, occurs when a traumatic event takes place to either an individual, family, or collective community and gets passed down to subsequent generations. Traumatic events are often perpetrated by outside sources rather than within the family itself. Examples of this include generations that have been exposed to discrimination, oppression, violence, sexual abuse, accidental deaths, and suicide. The term was first acknowledged in 1988, when a study of Holocaust survivors found that they were overrepresented in psychiatric referrals by 300%. Its impact has since been demonstrated across various cultures and communities, including descendants of refugees, Native Americans who were forced to attend residential schools, and African Americans who experienced generations of slavery, segregation, and institutionalized racism. Intergenerational trauma implies that parents can pass down unresolved tension and feelings from their own families of origin onto their children. Historical trauma is an example of intergenerational trauma and refers to the legacy of traumatic events that are experienced by a collective group of people. Often, these communities have faced oppression and the social and psychological effects can be observed among succeeding generations. The three main components that encompass historical trauma are: widespread effects to Indigenous communities, historic traumatic events that result in collective suffering within a community, and a purposeful, malicious intent of outsiders who inflicted these traumatic events.

Moral Injury

Moral injury can be understood as a deep wound to our moral code, and can result from a number of potentially morally injurious events. Initially, the definition more narrowly included committing, failing to prevent, or witnessing harm that goes against our moral code. However, as our understanding of moral injury has grown, researchers now identify traumatic loss, as in the suicide of a loved one, for instance, as a potentially morally injurious event. The concept of moral injury is also closely related to what is known as systemic betrayal—when the people or institutions on which we depend fail to ensure our safety or violate us in a meaningful way. While moral injury is a phenomenon that is distinct from port-traumatic stress/PTSD, the experiences of both are closely related and moral injury poses an additional challenge to healing. Moreover, evidence-based treatments for PTSD have proven to come short when it comes to treating moral injury.

Moral injury is a psychological phenomenon initially recognized in the military literature. For example, in combat, a moral injury can occur after giving an order that results in the death of civilians or children, after experiencing a freeze response and being unable to react quickly in theater, or after failing to report an assault for fear of retaliation. More recently, researchers and clinicians have started recognizing moral injury in healthcare workers, especially as the field was overwhelmingly exposed to potentially morally injurious situations in the heat of the COVID-19 pandemic, in journalists who can be overexposed to details of atrocities and injustices, and in minorities, such as BIPOC and LGBTQIA+ individuals who continue to be disproportionately impacted by our culture’s systemic failures to combat inequality, racism, and xenophobia. Moral injury and systemic betrayal can cause profound spiritual suffering.

Psychologically, morally injurious events have the potential to cause significant and debilitating distress. They impact the ways in which we view ourselves, others, and the world. Living with moral injury may mean also losing sight of the circumstances in which the moral injury occurred, which are often profoundly traumatizing. A person then assumes full responsibility for the harm done, resulting in self-loathing. Moral injury can hijack our ability to create meaning, live with a sense of purpose, and connect with loved ones and our community. Hallmarks of moral injury are a sense of the self as unlovable or weak, self-injurious behaviors, suicidal ideation, depression, guilt and shame, social withdrawal, and spiritual/existential crisis.

As we learn more about moral injury, new treatments are being developed to specifically address this phenomenon. Some are developed by experienced clinicians and researchers in the field, who have worked extensively with individuals suffering from moral injury. Others are adaptations of already existing evidence-based treatments to accommodate for the more specific aspects of moral injury that are not addressed by, for example, PTSD treatments.

Post-Traumatic Growth of Trauma Survivors: From Distress to Recovery

Traumatic events can challenge our core beliefs of ourselves, others, and the world. They can shake us up to our very core. But enduring psychological struggles can sometimes lead to ultimately finding a sense of personal growth, resulting in what we call post-traumatic growth. Post-traumatic growth may involve a new understanding of why something terrible happened, finding meaning in the adverse event, and reevaluating what it means for our worldview. It is not bouncing back; it is faring off better than one was before the trauma happened. Post-traumatic growth can involve a new appreciation of life, improved relationships with others, feeling motivated to discover new possibilities in life, increased personal strength, a sense of self-efficacy, and spiritual change. Post-traumatic growth is a process that happens over time, requires effort, and can take place through treatment. According to the psychologist Richard Tedeschi, who developed the theory of post-traumatic growth, it means moving past just getting by or managing your symptoms.

Is Trauma-Informed Treatment for Me?

Even by considering entering psychotherapy, you are making a very important first step towards regaining control of your life. Adversity, trauma, and chronic stressors have a way of chipping away our feelings of agency, self-confidence, and sense of control of our own emotions, thoughts, and behaviors. They can get lodged in our bodies, making it very difficult to “just get over it.” The impact of traumatic events is not limited to what is commonly known as Post-Traumatic Stress, but can manifest as high anxiety, depression, feelings of loss of control, lethargy and amotivation, relationship and occupational problems, dysregulated eating and substance use. Trauma-informed treatment can help you regain control of your life by assisting you in recognizing and managing your triggers, regulating your nervous system, setting healthier boundaries, and establishing a sense of safety in your life. Whether you and your therapist choose to complete a course of structured manualized evidence-based PTSD treatment, or decide that a more integrative trauma-informed approach is appropriate, you can expect, over time, to not only feel relief, but also to see improvement in your sense of agency and your relationships. Trauma-informed treatment is not a “quick fix,” so your therapist will help you learn to be patient with yourself and allow your body and mind to heal at a pace that ensures sustainability of results. Have any of the following affected your life or the life of a loved one:

  • natural disaster or vehicular or other accident
  • participating in or witnessing combat
  • domestic violence / domestic abuse
  • sexual, physical, or emotional abuse
  • being a victim of a crime
  • chronic exposure to hardship
  • growing up in a harsh environment
  • cancer, life-threatening/chronic illness, or painful medical procedures
  • adoption difficulties / Attachment Reactive Disorder
  • infertility
  • human trafficking
  • witnessing a loved one get hurt or losing a loved one
  • abuse from someone in authority
  • infidelity or tumultuous divorce

Then you are at the right place. If you are asking yourself the question if trauma-informed therapy is for you, it probably is. Call us at 631-301-4888 or fill out this form. A staff member will contact you within 72 hours to assess your needs and help you make the most important first step towards healing and self-fulfillment.

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