Trauma

By David Baldwin, PhD

Traumatic Experiences:

Most traumatic incidents are sudden and unexpected. Whether single brief events or chronically repeated, they overwhelm our ability to cope and adapt.

Examples can include rape, mugging, war, car accidents, disasters, viewing a friend being injured, and physical or sexual abuse.

Children are more vulnerable than adults to traumas, because they have fewer skills and less experience with life. Adults can predict and avoid events that take kids by surprise.

But adults can also be overwhelmed by situations or events that occur suddenly and are beyond their control.

When this happens, a number of predictable reactions occur. These reactions to trauma are normal responses to abnormal events.

These common reactions to trauma, and what to do about them, are the focus of this brochure.

Traumatic Symptoms:

Symptoms of trauma may appear soon after the traumatic experience, or they may be delayed by months or years.

Traumatic events can produce intrusive thoughts that may affect both daily activities and dreaming. Once they occur, these flashbacks do not fade away quickly without treatment. They may grow worse as they are triggered repeatedly by cues similar to the original trauma.

It may help to think of these responses as the body's way of trying to avoid or protect you from future traumas. Sometimes this works. But if several of these symptoms persist for more than a month, you may need to seek help from a professional therapist.

Treatment:

Traumatic experiences inevitably create a healthy respect for the possibility of future traumas -- a sensitization to trauma.

The treatment of traumatic stress (or Post- Traumatic Stress Disorder) involves re- experiencing the traumatic events. In therapy, you should learn from these incident(s) that what you did was probably the best you could have done to survive at the time.

Once traumatic events have been fully re- experienced in this way, they should not re- emerge in dreams or in waking thoughts (flashbacks or intrusive thoughts).

The goal of therapy for traumatic incidents is to desensitize the person to these events.

Often, a collection of cues will remind one of the trauma. Anniversaries are an example. Other cues can be sights, sounds, or physical feelings and sensations: "body memories." Such cues can "trigger" vivid recollections of the trauma and may sometimes lead to its re-experience. Usually, they are not as disturbing as the traumatic event itself. Still, these triggers can also be defused in therapy.

The release that follows successful therapy leaves behind the uncontrollable fear that these events are happening to you again. The patient should emerge from treatment with a renewed sense of freedom.

Deciding to Seek Help:

It is tempting to put off therapy for trauma, because the memory of the event is so painful or so feared that it seems best to avoid it. Some people even deny that the event occurred, or that it bothered them.

Unfortunately, evidence and clinical experience show that memories of traumatic events do not just fade away like other more trivial memories.

Traumatic memories stay with you until reprocessed in dreams or in therapy. When dreams are recurrent and interrupted by sleeplessness, they can not serve the function of desensitizing the feared material.

Putting off dealing with traumatic memories just makes the work more complicated and lengthy.

Failure to deal with traumatic events can cost more in lost relationships, disrupted social life, and reduced work productivity than the time and money spent on therapy for the problem.

The prognosis for therapy of PTSD is generally favorable without the use of medications. This is especially true if treatment can begin relatively soon after a single traumatic incident. Treatment of chronic or early trauma is more complex, but perhaps even more valuable.

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July 1993