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What is Psychotrauma?
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This page addresses some commonly asked questions about psychotrauma:
What is a traumatic event?
What are some common psychological effects of traumatic events?
Are there physiological effects too?
How long do these phenomena last?
Recognizing Post-Traumatic Sress Disorder
I. What is a traumatic event?
In order to understand the nature of trauma, we can go back to the original meaning of the word trauma. It is derived from Greek and means: wound or rupture of tissue. This is what people feel when they go through a traumatic event: something breaks inside and they need to heal. Healing, similar to the healing of physical wounds, is a natural process.
There are two main elements that make an event traumatic. The first is the threat of death or severe injury to oneself or to others. The second element is that the event causes one to feel extremely afraid, helpless, or horrified. People can feel traumatized by events they’ve actually experienced, or by events they’ve witnessed or even just heard about.
Examples of traumatic events include motor vehicle and other accidents, combat, natural disasters, the sudden loss of a loved one, terror attacks, assault, rape, abuse, and neglect. Some of these might be ongoing traumas, such as sexual or physical abuse, neglect, or combat. Though they often are not thought of as traumatic, other events such as intrusive medical procedures and emigration to another country might have similar consequences.
Roughly 70% of people will experience at least one traumatic event in their lives. Because people have different ways of responding, not necessarily everyone will feel traumatized by the same event.
II. What psychological effects might one experience following a traumatic event?
People often feel as if they have changed after experiencing a traumatic event.
Many express the feeling that their most basic beliefs and assumptions about personal safety and trust have been shattered, leaving them feeling vulnerable, anxious, and less secure.
Some feel shocked, confused, or disoriented; others feel sad, fearful, or helpless.
Whatever their initial response, everybody who goes through an event by which he or she feels traumatized will gradually go through a process of coping with their responses and feelings. This process takes time, but how much time varies from person to person. Some people feel back to themselves after a few weeks, for others it might take several months.
The coping process often involves alternating experiences of denial of what has occurred and intrusive recollections of the event. The alternating nature of denial and intrusion can be understood as the psyche’s way of working through the traumatic experience, without becoming overwhelmed by intense and unmanageable emotions.
If the loss of a loved one occurred as a result of the traumatic event, it is natural and healthy to go through a process of grieving and mourning. This process usually involves five stages: shock, denial, anger, grief, and acceptance.
Similar to the mourning process, the ultimate goal of the coping process following a traumatic event is to come to some sort of resolution. This resolution involves finding meaning in what one experienced and integrating the memories of the experience and its meaning into one’s personal narrative or life story.
People’s reactions to traumatic experiences are highly individualized. Nonetheless, there are some common reactions typically experienced by trauma survivors, in various combinations and to varying degrees of intensity.
Some common psychological responses to trauma include…
Re-experiencing the event. That is, feeling as if the traumatic event is happening all over again – the sights, the sounds, the smells. This might occur in the form of sudden vivid flashbacks or nightmares.
Avoidance of people, places, conversation topics, and other stimuli that are likely to remind one of the traumatic experience. Other forms of avoidance include disconnection from others, decreased interest in activities, emotional numbing, and a sense of pessimism about the future. Along similar lines, many people experience dissociative sensations, such as feeling as if "this isn't happening to me, or it didn't really happen to me".
Again, it is important to emphasize that these are normal reactions to abnormal events.
III. Are there physiological effects too?
Yes. Following a traumatic event, many people feel as if their body is in an almost constant state of increased arousal. This state of “hyperarousal” is often experienced in the form of sleep difficulties, not being able to concentrate or remember things, feeling more on guard and/or irritable, and being more easily startled by sudden noises or movements.
IV. How long do these phenomena last?
Most people who have gone through a traumatic event, experience some form of temporary emotional imbalance, which is often expressed in the phenomena described above. Again, these are normal reactions to abnormal events.
Human beings tend to be quite resilient, and in most cases, these phenomena subside over time. Healing is a process, and usually within a month or so most people find their suffering decreases greatly and continues to decrease gradually over the course of several months to a year. Some people find that talking to trusted others about what happened and how they feel helps them with the process of healing from their trauma. Involvement in empowering activities that encourage reconnection with people can help trauma survivors to find meaning in their lives.
However, a minority of around 10 – 20 % of people who have gone through a trauma develop what is known as post-traumatic stress disorder (PTSD). People who suffer from PTSD experience the types of phenomena described above: re-experiencing, avoidance, and increased arousal. Most trauma survivors experience these phenomena in the first week or two after the traumatic event, however usually the frequency and intensity of these phenomena decrease over the course of the first month.
During the first month after the traumatic event, if you find that these phenomena do not decrease over time and they cause considerable distress and impair your daily functioning, it may indicate the presence of acute stress disorder.
Acute stress disorder involves re-experiencing of the traumatic event, avoidance, and increased arousal, along with the experience of dissociation. Dissociation involves feeling as if “this isn’t happening to me,” having an out of body experience, a sense of numbness, spacing out, or only remembering limited fragments of the traumatic experience afterward.
If you find yourself experiencing these phenomena for longer than one month and you find that they significantly impair your functioning at work, school, or in interpersonal relationships, it is advisable to seek help. Severe depression and overuse of alcohol and/or drugs following a traumatic incident are additional signs that one should consider seeking professional help.
Recognizing PTSD
Below is a checklist of PTSD-related phenomena that will help you decide whether you ought to seek professional help: (Based upon the DSM-IV diagnostic criteria for post-traumatic stress disorder)
Re-experiencing:- Repetitive and distressing images or thoughts about the event
- Distressing dreams or nightmares of or related to the event
- Flashbacks: feeling as if the event is recurring right now
- Feeling intense psychological distress when exposed to things that are similar to the actual event or symbolize it
- Experiencing physiological arousal when exposed to things that are similar to the actual event of symbolize it
Avoidance:- Avoiding thoughts, feelings, or conversations related to the traumatic event
- Avoiding places, people, or activities that cause you to recall the event
- Not being able to remember an important aspect of the traumatic event
- Markedly decreased interest in significant activities
- Feeling detached or estranged from other people
- A narrowing of your range of emotions, such as not being able to experience loving feelings
- Feeling unable to look ahead to the future, such as not expecting to marry, have children, have a career, or not expecting to have a normal life span
Increased arousal:- Sleep difficulties
- Irritability or angry outbursts
- Concentration difficulties
- An overall heightened state of awareness
- Feeling more reactive to loud or sudden noises or movements
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2001