Why do some people recover naturally from trauma, but others don’t?
Traumatic events are generally defined as events – both powerful and upsetting – that intrude into an individual’s life, affecting their psychological and/or physical well-being, and leading to trauma. Such events may be life-threatening, threatening either one’s own life or the life of a loved one. Events do not have to be life-threatening, however, to result in trauma. Non-life-threatening events, for example, a difficult breakup or the death of a loved one, could – in some cases – have a similar traumatic impact, and can make someone present symptoms of trauma.
Life threatening or not, events that have little impact on one individual may lead to significant distress in another. It is not the objective facts of the event that determine the impact on the individual; it is their subjective emotional experience.
The impact of the traumatic event on the individual will relate to factors such as their mental and physical health, their past traumatic experiences, their coping skills and level of resilience, and the level of emotional and social support they receive at the time.
Other factors may also play a role. These are:
- If the individual was unprepared for the event
- How powerless they felt to prevent the event
- The level of terror induced on them by the event
- If the event occurred repeatedly (such as in childhood abuse)
- If the event involved extreme cruelty
- In the case of developmental trauma, if the event occurred during childhood years, especially between the ages of 0 – 6.
What are the symptoms of trauma?
Trauma occurs when certain parts of the brain – the amygdala, hippocampus, and prefrontal cortex – become overactive. The amygdala and hippocampus are the regions of the brain involved in the fight-flight response. Unresolved trauma results when these parts of the brain remain overactive. This results in the individual feeling they are in fight-flight mode all or most of the time.
There are two types of trauma, acute and chronic; acute trauma resulting from a single distressing event, chronic trauma from prolonged exposure to distressing events. The type and severity of the traumatic event – plus the pre-existing factors listed above – will determine the type and severity of symptoms the individual experiences.
The symptoms induced by trauma in one traumatised individual will differ from those of another. They range from the emotional, to the psychological, to the behavioural, and to the physical. Because of this broad spectrum an entire list of symptoms would be exhaustive. However, there are categories of symptoms that can be commonly observed.
Emotional dysregulation
Emotional dysregulation is the incapacity of the individual to regulate their emotions. It is experienced as one of either two extremes, feeling too much emotion or too little: hyper or hypo-arousal.
- Hyperarousal
When the stress response – the amygdala and hippocampus – becomes overactive, the result is hyperarousal; ‘feeling too much emotion’. Think of the amygdala as the psyche’s smoke-alarm. When it – with the aid of the hippocampus – senses danger, the body prepares itself for fight-flight mode. While this may be appropriate during a life-threatening event, it becomes symptomatic when – even years after the event – the smoke alarm continues to signal danger, even where none exists. Anything in the environment could potentially trigger the alarm, causing the traumatised individual to feel either fearful and anxious or irritable and angry.
He remains in continuous fight-flight mode.
- Hypo-arousal
Hypo-arousal or numbing, on the other hand, is when the individual feels little or no emotion. Numbing – also known as the freeze response – is an evolutionary survival mechanism closely related to the fight-flight response. Think of numbing as a kind of psychological anesthetic, a form of ‘playing dead’, if you will.
Imagine, for a moment, the individual who experiences a terrifying, near-death experience. The psyche, rather than overwhelm him with terror, the psyche shuts down feeling through the mechanism of numbing. Imagine also the child exposed to repeated trauma. Being a child, not having any other resources, she unconsciously induces numbing by way of protection. In this way, she resources herself to somehow endure the traumatic experiences.
While numbing serves to protect during or in the immediate aftermath of a traumatic event, it no longer serves when the danger retreats. For example, what serves to protect in childhood no longer serves as an adult. Because numbing blocks all feelings, it blocks positive as well as negative ones. Feelings of life and vitality become replaced with a ‘deadness’. What once served has now become symptomatic.
Numbing can be induced by other means, for example, when an individual turns to substance abuse – or other form of addiction – as a means of coping. Though addiction can mask the symptoms of trauma in the short-term, it does not resolve them in the long term. The underlying trauma remains.
Re-experiencing
Re-experiencing is another common symptom of trauma. Anything in the environment that reminds the individual of the original event may cause them to ‘re-experience’ it. For example, someone who had a car crash may find themselves too scared to get back into a car. Similarly, a sound or smell – or for that matter, any other stimuli – could trigger a re-experiencing.
Occurring even decades after the original event, re-experiencing puts the individual into a similar state of hyper or hypo-arousal. In that moment, even though no danger exists, for the individual it is as if he is emotionally and psychologically reliving the original trauma.
Flashbacks or nightmares are also forms of re-experiencing. Like other triggering stimuli, when a flashback or nightmare occurs it is as if the original event is being experienced in real-time. While at a cognitive level the individual may know this not to be true, at the emotional level he cannot tell the difference. This is traumatic not only in and of itself, but, in addition, the fear of experiencing future flashbacks creates further anxiety.
Situations lead the individual to re-experiencing, he may begin to avoid those situations. This leads to the next common category of symptom, avoidance.
Avoidance
Certain situations trigger re-experiencing in the individual, he begins to avoid them. It may be that these situations are simply too triggering. It may also be that years of stress and anxiety leave the individual too emotionally overwhelmed to attend certain, say, social events.
Similarly, for the same reasons, the individual may avoid certain people. This can result in his withdrawing from friends and family, becoming cut off from the very social support that would help him overcome the trauma. In the case of developmental trauma, he may have had difficulties forming meaningful relationships in the first place.
As a result of avoidance, the individual’s social or professional life may suffer. The debilitating effect accumulates when the individual misses out on the best that life has to offer.
Other common symptoms of trauma
Physically, continuous flooding of the nervous system with stress hormones will affect normal bodily functioning. The traumatised individual may have trouble sleeping or eating. Additionally, long-term exposure to stress hormones can result in chronic physical illness later in life. Again, these symptoms have an accumulative effect.
Psychologically, the accumulated burden of years of trauma can then lead to other emotional difficulties, such as depression or low self-esteem.
Relieving the symptoms of trauma
Fortunately, years of research into trauma has proven that its effects need not be life-long. Psychotherapy has proven to be one of the most effective treatments for relieving the symptoms of trauma.
Working with a trauma-informed psychotherapist or psychologist, the traumatised individual can learn to retake control. Rather than being controlled by her symptoms, she learns to control them, in the process liberating herself from trauma and its debilitating effects, discovering the freedom to live a life of her choosing.
If you think you are suffering from trauma, we at Centric Mental Health can help you. Don’t hesitate to get in touch by contacting [email protected] or 016111719 to arrange a consultation with one of our trauma-informed therapists,
Find out about other trauma-related difficulties like PTSD, and our trauma therapy services here.
Written by: Declan Gernon, Psychotherapist, MIACP