Trauma is a distressing experience that can have long-lasting psychological and physical effects on a person’s life. Trauma can be divided into two subgroups: big “T” trauma and small “t” trauma.
Big “T” Trauma:
Big “T” traumas refer to those that cause life-threatening harm or significant harm to an individual or group of people.
Examples of big “T” traumas include:
- Natural disasters such as hurricanes, floods, and earthquakes
- War, terrorism, and political violence
- Physical, sexual, or emotional abuse
- Serious accidents such as car crashes or plane crashes
- Life-threatening illnesses or injuries
- Witnessing violence or death or other’s trauma
Small “t” Trauma:
Small “t” traumas refer to less severe but still have an adverse effect on someone’s life.
Examples of small “t” traumas include:
- Complicated divorce or separation
- Verbal abuse, bullying or harassment
- Losing a job or financial instability
- Chronic illness or injury
- Neglect or abandonment
- Natural disasters that do not result in serious harm
- Non-life-threatening injury
- Working for a difficult boss
Trauma can lead to the development of various mental illnesses such as Acute Stress Disorder (ASD), Post Traumatic Stress Disorder (PTSD), and Complex PTSD (C-PTSD). It can also contribute to the development of personality disorders such as Borderline Personality Disorder (BPD) and Dependent Personality Disorder. Additionally, trauma can lead to the abuse of drugs and alcohol and can cause severe anxiety and depression.
Acute Stress Disorder (ASD)
Acute Stress Disorder (ASD) is a mental health condition that can arise after experiencing or witnessing a traumatic event. Its symptoms typically last between three days to one month after the traumatic event. The DSM-5 outlines the diagnostic criteria for ASD, including dissociative symptoms, intrusive symptoms, avoidance, negative mood, and arousal symptoms. Some of the main symptoms of ASD include:
- Flashbacks or nightmares.
- Feeling detached from oneself or surroundings.
- Avoiding reminders of the event.
- Feeling numb or emotionally detached.
- Hypervigilance or feeling easily startled.
ASD is often a precursor to PTSD, but not everyone who experiences ASD will go on to develop PTSD. It is important to note the difference between ASD and PTSD to understand the severity of symptoms and treatment options.
Post Traumatic Stress Disorder (PTSD)
PTSD is a mental health condition that can arise after experiencing or witnessing a traumatic event. The DSM-5 outlines specific criteria for diagnosing PTSD, which includes exposure to a traumatic event, re-experiencing the event, avoidance behaviour, negative changes in cognition and mood, and alterations in arousal and reactivity.
About 5-10% of Australians suffer from PTSD at some point in their lives.
How do I know if I have PTSD?
If you have experienced a traumatic event and are experiencing symptoms that interfere with your daily life, it is important to seek professional help. A mental health professional, such as a psychologist or psychiatrist, can assess your symptoms and determine if you have PTSD.
The symptoms of PTSD can be categorized into four core features, and the severity of these symptoms can vary from person to person. These features include:
- Intrusion: This category includes intrusive thoughts and memories of the traumatic event, such as repeated or involuntary memories, distressing dreams, or flashbacks which may cause someone to feel like they are reliving the traumatic experience.
- Avoidance: People suffering from PTSD may attempt to avoid reminders of the traumatic event, such as people, places, activities, objects or situations which trigger distressing memories. They may also attempt to avoid thinking or talking about what happened.
- Alterations in cognition and mood: These include negative thoughts and feelings about oneself or others, such as guilt, shame or anger; as well as having a distorted sense of blame for the event. People suffering from PTSD may also experience loss of interest in activities they once enjoyed, feel detached from others, or struggle with experiencing positive emotions.
- Alterations in arousal and reactivity: This category includes symptoms such as irritability, anger outbursts, reckless behaviour, hypervigilance, being easily startled, or having difficulty concentrating or sleeping.
What is Complex PTSD (C-PTSD)
C-PTSD is a mental health condition that develops after an exposure to multiple and/or prolonged repetitive traumatic events, particularly during childhood or adolescence such as childhood abuse/neglect to human trafficking or war. The DSM-5 recognizes C-PTSD as a subtype of PTSD; however, it differs from general PTSD in certain aspects.
Complex C-PTSD Symptoms
- Emotion Regulation Difficulties: People suffering from C-PTSD often experience intense and overwhelming emotions, difficulty managing emotions, and intense emotional reactions to triggers.
- Interpersonal Problems: People suffering from C-PTSD may find it difficult to form and sustain relationships due to distrust, fear of abandonment, and difficulty setting boundaries.
- Negative Self-concept: People suffering from C-PTSD may harbour negative beliefs about themselves, experience shame or guilt, and suffer from a sense of worthlessness.
- Difficulty with Attention and Consciousness: People suffering from C-PTSD may struggle with dissociation, depersonalization, and derealization – leading to a sense of being disconnected from themselves and/or the world.
It is important to seek professional help if you or someone you know is experiencing symptoms of trauma, PTSD, or C-PTSD. While these conditions are treatable, they can have a significant impact on a person’s quality of life if left untreated.
Treatments for Trauma, PTSD, and C-PTSD
It is important to note that not everyone who experiences trauma develops PTSD, and not everyone who develops PTSD requires psychiatric treatment. For some people, symptoms of PTSD subside or disappear over time. Others get better with the help of their support system (family, friends, or spiritual groups). But many people with PTSD need professional treatment to recover from psychological distress that can be intense and disabling.
It is important to remember that trauma may lead to severe distress. That distress is not the individual’s fault, and PTSD is treatable. The earlier a person gets treatment, the better their chance are of recovery.
Here are evidence-based treatments for trauma, PTSD, and C-PTSD:
What Psychotherapies work for Trauma
Psychotherapy is an integral component of treating PTSD and C-PTSD. Evidence-based therapies that have been found effective for this purpose include:
1. Cognitive Processing Therapy (CPT):
CPT is a type of evidence-based cognitive behavioural therapy that is specifically designed to treat PTSD and associated symptoms. This therapy works on changing negative emotions and beliefs related to the traumatic event, such as shame, guilt, and feelings of failure or danger. The therapist helps the person confront distressing memories and emotions in a safe and controlled way.
2. Prolonged Exposure Therapy (PE):
PE involves repeated and controlled exposure to the traumatic event or its triggers, such as through virtual reality programs. PE helps individuals regain control over their fear and distress while learning coping mechanisms.
3. Trauma-focused Cognitive Behavioural Therapy (TF-CBT):
TF-CBT is an evidence-based cognitive-behavioural therapy specifically designed to treat children and adolescents who have experienced trauma. TF-CBT incorporates a variety of techniques, including exposure therapy, cognitive restructuring, and family therapy.
4. Eye Movement Desensitization and Reprocessing (EMDR):
EMDR is a type of trauma-focused psychotherapy that uses eye movements similar to those experienced during REM sleep to reprocess past traumatic memories. The therapist guides the client through questions about the traumatic memory while the client watches the therapist’s fingers or a light bar moving back and forth. This therapy has been shown to be effective in reducing symptoms of PTSD.
5. Other Related Therapies:
Other therapies which have been effective for treating trauma, PTSD and C-PTSD include:
- Schema Therapy
- Internal Family Systems Therapy
- Psychodynamic Therapy
- Mindfulness-based Stress Reduction
Medications for Trauma
Antidepressants such as SSRIs and SNRIs are often prescribed to treat the core symptoms of PTSD. These medications may be used alone or in combination with psychotherapy or other treatments.
Other medications may also be used to address specific symptoms of PTSD, such as anxiety, physical agitation, nightmares, and sleep disturbances. These medications may help to lower overall levels of distress and allow individuals with PTSD to more fully engage in their treatment.
Other therapies that could be effective in treating PTSD and C-PTSD include:
- Art therapy
- Equine therapy
It is important to discuss these treatment options with a mental health professional in order to determine which treatment or combination of treatments may be most effective for an individual’s specific needs.
The Role of Psychologists in Treating Trauma, PTSD, and C-PTSD
Psychologists play a vital role in treating trauma, PTSD, and C-PTSD. They are trained to help individuals understand and process their traumatic experiences in a safe and supportive environment. Psychologists use evidence-based treatments to help individuals reduce PTSD symptoms, improve their quality of life, and develop coping strategies to manage ongoing stressors.
Psychologists also work with individuals to develop safety plans and provide resources for ongoing support. They may collaborate with other healthcare professionals, such as psychiatrists or GP, to ensure that individuals receive comprehensive and integrated care.
Author : Umesh – Cause Effect Psychologist
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