Trauma Basics
What is trauma?
Experiencing, witnessing, or being confronted with physical, verbal, and/or emotional abuse or another event that involves actual or threatened death or serious injury to self or others. Response to trauma includes extreme fear, helplessness, or horror.
Normal Immediate Responses to Trauma
Alarm state, then fight, flight, or freeze. This means increased sympathetic nervous system activity, hypervigilance, and a tuning out of all non-essential information – anything that does not contribute to immediate survival.
Normal Post-Trauma Responses (after the threat is removed)
- Intrusive thoughts, dreams of the event, or other re-experiencing
- Emotional re-experiencing (eg., feeling terror, panicky)
- Avoidance of reminders of trauma or similar situations
These are all normal in the short-run. They are only problematic if they continue.
Prolonged Trauma Reactions
- Hypothalamic-pituitary-adrenal (HPA) axis in brain: Chronic activiation “wears out” parts of brain involved in memory, cognition, and arousal
- Catecholamine systems altered, resulting in hyperactivity, anxiety, impulsivity, sleep problems, irregular heart beat, hypertension
- Often misdiagnosed as AD/HD
PTSD
Not everyone who experiences trauma develops PTSD. To be considered Post-Traumatic Stress Disorder, the following must exist:
- Presence of traumatic event
- Symptoms of re-experiencing the event, avoidance of trauma-related situations, and hyperarousal
- Symptoms that last for more than one month
- Symptoms cause significant distress or impairment in social or occupational functioning
Why doesn’t trauma regularly result in PTSD? Because it is not the event itself that predicts difficulties. Rather, it is the combination of:
- the event
- the person’s pre-existing vulnerability and coping skills
- the post-trauma social support environment
Children are more susceptible to prolonged trauma reactions than adults.
