Trauma Overview

Before you dive into the trauma section, make sure you have read every page of the anxiety coping. This means body skills, emotion skills and thinking skills. Do the worksheets too. The reason for this is so that you will have good control over your body’s reactions as you go through this section. Lean heavily on the body responses so that if you have flashbacks you can utilize some of the same skills to calm your body’s reactions.

If you are looking into this you probably have a good idea if you have been exposed to trauma or not. You are the best judge of that. Although it has been classified and defined, traumatic reactions vary from person to person. The very few examples listed below do not include the thousands of events that can lead to trauma.

Understand as you go through this that there are a few overarching categories. The first is what most think of when you consider trauma; a life threatening event that one has personally experienced.

This may also include having your life seriously threatened, serious injury, sexual assault, sexual violence or exposure to or witnessing these things whilst being powerless to stop these events. Also included in the DSM definition of trauma is directly experiencing the traumatic event, witnessing the traumatic event in person, learning about the traumatic event of a close family member or friend, and experiencing firsthand the repeated or extreme exposure to details of the traumatic event (APA, 2013)

Events can occur publicly or privately. Public trauma is easily accepted as truth and others have similar experiences, making the possibility of finding other like survivors. These events are war, terrorist attacks, hostage situations, natural disasters and large scale accidents.

The private traumas occur behind closed doors and frequently cannot be proven and are shrouded in secrecy and hold invisible or unseen wounds. It can often be an offender's word against a survivor's word, if any words are ever said. These include rape, domestic violence, childhood abuse, neglect, torture within the home, dysfunctional family violence, and attachment traumas.

Private traumas can also include those who have experienced powerlessness that others were not aware of in traumatic situations. There are times when due to events or structural hierarchy a person is not able to act as they see best and the outcome leads to devastation. This could be a mother not allowed to make a medical decision leading to negative outcomes or a soldier not able to act with choice and have a negative outcome.

Attachment trauma is a unique type of trauma that stems from not having proper attachment from those that are supposed to care for you. Oftentimes it is life threatening, but many times it is not. This comes from neglect, parental depression or mental health issues that led to inconsistent care, drug or alcohol addiction or other circumstances that kept the primary caregivers from bonding or attaching to you.

Rather than exploring things that lead to trauma, we will assume that you are reading this because you have already assessed yourself or someone you care about and determined that you need some information for coping with trauma and understanding a bit more what it is doing to your body, mind and relationships.

ADAPTING DURING AND AFTER TRAUMA

Factors that impact adapting during trauma

Powerlessness, helplessness or a lack of efficacy is often, but not always, a big part of traumatic events. When these events occur they are outside of our control for that moment and we are without personal power to effect change on the situation. The less control, choice, or options a person has during trauma the more likely the event is to be a traumatic experience.

Take for example, a person is caught in a tsunami so suddenly they cannot get to any form of safety but are able to grab a hold of and climb a nearby tree, then grab on to a tower and make it to a rooftop. Although they were injured and their life certainly threatened as the pull of the water nearly took them away several times during the climb, they were taking action the entire time. They had self-efficacy to some degree during the event. Now imagine the event with no control, no choice, no decisions to be made and the sense of helplessness and powerlessness that ensues.

Surviving a trauma, regardless of if it is known by others or not, involves adapting our coping skills in order to survive. When we use adaptive skills to survive, they provide short-term relief and coping, but in the long-run we must modify these skills to suit our changing environment.

SAFETY SCANNING

Hypervigilance is probably a more clinical term, but let's take a look at safety scanning. You have a trauma. Your brain would like you to remember this so you do not have to go through it again and falsely believes that it can help prevent it from occurring by being super aware of anything that is close to what occurred during the trauma. Makes sense right? So, we are going to go down a hypothetical trauma that hopefully will not be too triggering.

Let’s say I am driving over a railroad track, I look right, look left cross and BAM the back end of my car gets hit by a train. Glass breaks, metal makes noise, gas leaks, tires scrape, my car goes into the ditch and mud and grass fly everywhere. I am fine, a few scratches, but man, for a moment I was sure I was dead. Of course, I suck it up and pretend everything is fine. Six months later road rage surfaces. A few months after that I get anxious at my partner when they mow the lawn and have a panic attack, but am not sure why. I have to start leaving the house when it’s the day to mow the lawn. I can’t go eat out a restaurants any longer because the sound of the forks on the plates and clinking glasses makes me so angry I end up yelling at someone. I am so frustrated all the time.

What is going on behind the scenes is that my brain is searching for things to keep me safe. Although I remember a train hitting my car and it makes sense when I get anxious driving I do not consider how my brain views this. My limbic region is scanning the environment to look for anything that reminds me of the trauma. My brain sees danger in glass, grass, metal, gas smell, mud smell, metal sound, glass sound, mud feel and smell, powder from airbag, chalking feeling or dry hands, copper taste from bloody lip, smell of penny jar by the door, smell of garage. The longer I do not address the trauma the bigger the list gets. The earlier I address my trauma the smaller the list stays. This is because when we avoid the trauma, the brain is not being validated that we remember and have categorized the trauma. So hopefully you got that hidden message.

When you avoid addressing your trauma, your symptoms will worsen. Flashbacks are like a trauma knocking at the door. They will not go away because you do not answer. They will just start pounding at the windows. If that is not heard, they will sneak into your house by night. Avoiding addressing trauma will lead to a cascade of physical, psychological and social issues.

Back to scanning for safety, our brain scans the environment looking for things that remind us of our trauma. Now take a moment and look at your trauma. If it was combat trauma, look at your reactions to other humans, similar environments, noises etc. If it was childhood trauma, look at your reactions to people you attach to or bond with, your reactions to betrayal of trust. If it is medical trauma, look at how you perceive and respond to your body or medical professionals now. Do you have severe scanxiety? Just examine your personal traumatic experience and see how you are scanning.

Now let’s look at actual scanning. How often do you look for escape routes in stores? How often do you sit with your back against a wall? How often do you make sure that you are not alone with someone you perceive to be dangerous? Will you go out at night or do you have to be safely locked in home? Can you sleep or are you checking the surroundings? Do you run an errand and put so much energy into checking the environment for safety that you forget what you went to do? Do you have routines that keep your house in order to such a degree they interfere with your ability to go to bed on time or go to work on time? Think of your own scanning and notice how you scan for safety and where you are most often seeking safety.

In the anxiety section, we discussed how you are not getting dumber it is just that your anxiety is interfering with your memory. This is the case with traumatic scanning or hypervigilance. It is not that your memory is going or you are forgetting things, it is rather that safety is more important than these things and gets your memory space. After trauma we really understand safety more because we are more aware that things aren’t safe. Because of this new found reality we prioritize safety measures whereas others without trauma do not. So when we go to a store with a mental shopping list, it gets pushed down as we begin to look for escape routes and unsafe people.