Traumatic events can encompass a wide variety of experiences. Some traumatic events, like car accidents, natural disasters, or being a victim of a bank robbery, are referred to as ‘single-incident trauma’, meaning the trauma occurred at one discreet point in time. Other traumatic events, like child abuse or spousal abuse, are often referred to as ‘complex trauma’, because they often happen on multiple occasions over time and sadly can involve attachment figures as the perpetrator of the abuse. Reactions after trauma vary widely and can include but are not limited to the following:
- Stress Disorders such as Post Traumatic Stress Disorder
- Problems with Dissociation (mental avoidance)
- Somatoform Disorders (bodily symptoms that are influenced by psychological difficulties)
- Substance Abuse
- Difficulty with regulating emotion
- Relationship problems (Briere & Scott, 2006)
When an individual is exposed to any traumatic event, their brain does certain things in that moment of trauma in order to cope with an overwhelming level of distress and/or pain. If the nature of the traumatic event renders the usual ‘fight’ or ‘flight’ strategies as non-viable options, the brain will often try to mentally avoid or dissociate from psychological distress and/or physical pain. The DSM V describes dissociation as “a disruption…in the normally integrated functions of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour” (p.291, 2013). Whilst this strategy may be useful to protect the individual in the moment of trauma, it can also have the effect of making it very hard for that individual to move on from the traumatic event after it has ended, as the brain cannot make sense of the traumatic event in its usual integrated way. Furthermore, in some situations, the distress associated with thinking about that traumatic event after the fact can trigger the brain’s dissociation response all over again. This may be especially true for people who have gone through complex trauma, because the events have happened multiple times, the brain can become accustomed to the dissociative response (Silberg, 2013).
This is why it is especially important for therapy to be conducted in a safe and modulated manner when it comes to processing traumatic events. Extensive practicing of coping strategies to healthily regulate emotion must occur before the traumatic memories can be properly dealt with, either through Eye Movement Desensitization and Reprocessing (EMDR) or Exposure Therapy. As is especially the case with complex trauma, the processing of the actual traumatic events is actually a relatively small proportion of the therapeutic work compared to learning strategies to regulate emotions, rebuilding a positive sense of self, and building a safe relationship with the therapist.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. American Psychiatric Publishing: Washington, DC; London, England.
Briere, J. & Scott, C. (2006). Principles of Trauma Therapy. A Guide to Symptoms, Evaluation, and Treatment. Sage Publications, California.
Silberg, J.L. (2013). The Child Survivor. Healing Developmental Trauma and Dissociation. Routledge: New York; London.