Trauma, is a general term used to describe the subsequent psychological effects of a physical and/or emotional assault. Following such an assault, some people appear to recover quite quickly with no need for treatment whereas others are less able to come to terms with what occurred. They are left with intense unresolved thoughts and feelings of torment, guilt, anger and shame that can last for years. It is these, as well as other, highly disturbing reactions, that are commonly referred to as Post-Traumatic Stress Disorder (PTSD). People with PTSD require psychological intervention to process and make sense of what has happened to them so that they can move forward with their lives in a healthy manner. PTSD is typically characterized by the following symptoms:
- Exposure(s) to actual or threatened death, serious injury or sexual assault/abuse/molestation. Exposures can be direct experiences, witnessing a trauma, learning that a loved one experienced a trauma or repeated exposures to the traumas of others such as in the case of first responders who recurringly deal with incidents of sexual assault, child abuse and serious accidents, etc.
- Highly distressing and disturbing memories, flashbacks and dreams of the traumatic event.
- An avoidance of anything that triggers distressing memories, reminders, thoughts and feelings of the trauma. Persons suffering from Post-Traumatic Stress Disorder will avoid certain people, places, conversations, activities, objects or situations associated with their trauma.
- Adverse changes in thoughts and emotions associated with the traumatic event such as difficulty recalling important aspects of the trauma, negative beliefs about oneself or the world (e.g., I’m a bad person, no one can be trusted), distressing emotional states (e.g., fear, anger, guilt, shame) or detachment and distancing from others.
- Marked changes in physiological and psychological arousal such as increased irritability/angry outbursts, impulsive/reckless behaviours, hypervigilance to one’s surroundings, an exaggerated startle response as well as difficulties with sleep and concentration.
It is in our nature to want to bring order to chaos; in other words, we have a need to make sense of the things that most disturb our lives. It is why we have to turn our heads back and stare intensely at a car wreck on the side of the road. The more horrifying it is, the more we feel compelled to fixate our attention there and try to understand it. We need to know how and why it happened. This process is necessary because it allows us to store new information into our memories so that we can protect ourselves from the reoccurrence of such a tragedy. It also provides us with the necessary competence and strength to prevent future threats from harming us in the same devastating manner as they did in the past. This is one of the reasons that we are driven to bring order to chaos; because possessing such understanding gives us the ability to venture bravely and optimistically into the future.
When people experience a trauma and it is not properly resolved, they are relentlessly tormented with the feeling that something in their past has not been set right. With sufficient passage of time, the anguish of such previous chaos grows and creates anxiety, depression, emotional turmoil, sleep difficulties, drug and alcohol abuse and a host of other physical and psychological problems. All of these things get in the way of people’s ability to move forward with their lives in a healthy manner. Clearly, order and understanding are required to remedy past chaos and tragedy.
Trauma-focused psychotherapies help to bring order and understanding to the horrors of our pasts. In utilizing such approaches, a qualified clinical psychologist helps you to return to the catastrophes and confusion of your past trauma and assists you to make sense of what happened. In revisiting the memories and mental images of these tragedies, you sort through the dreadful wreckage so that you can develop a theory of what occurred. Creating a theory of how and why such a thing happened affords you with 4 very important things:
- The disappearance of the physical and emotional anguish of the unprocessed trauma
- The ability to successfully detect and avoid future threats
- The capacity to effectively confront and neutralize future threats
- The emotional strength and resilience to protect your “inner-self” from future threats
Post-Traumatic Stress Disorder can occur at any age and symptoms usually begin within 3 months of experiencing the trauma. As was noted above, some people appear to recover quite quickly following a trauma whereas others are less able to come to terms with what occurred and thus require treatment. This is because certain people are more at risk for developing PTSD by virtue of having experienced prior traumas (especially in childhood), pre-existing anxiety problems, other mental illnesses, childhood adversities (e.g., family dysfunction, parental separation or death) as well as possessing poor coping strategies and a family history of psychiatric illness. There also exist genetic and biological variables that can increase or lower the risk of developing PTSD. Psychological interventions that are effective in treating PTSD include Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR) therapy and Bilateral Tapping (BT).
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