Trauma

What is Trauma?

Often, trauma is used to refer both to negative events that produce distress and to the distress itself. Actually the word ‘trauma’ refers only to the event, not the reaction, and should be reserved for major events that are psychologically over-whelming for an individual.  However psychological trauma is a recognised emotional response and has been defined in the DSM IV as ‘…direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate’

What events would be classified as trauma?

Combat, sexual and physical assault, robbery, being kidnapped, being taken hostage, terrorist attacks, torture, disasters, severe automobile accidents, and life-threatening illnesses, as well as witnessing death or serious injury by violent assault, accidents, war, or disaster, childhood sexual abuse.

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What are reactions to trauma?

Typically immediately after the event:

    • shock
    • denial
    • disorientation

It can be very helpful to have a debrief process in the 48-72 hours following such a trauma, particularly when a number of people have been involved.  This Critical Incident stress Debrief (CISD) involves bringing the group together for a structured process, with the goal of making meaning and gaining a rounded perspective on the event.  It is thought that this may prevent a later reaction such as PTSD I am a skilled CISD facilitator.

Longer term reactions may include

  • unpredictable emotions
  • flashbacks
  • strained relationships
  • physical symptoms like headaches or nausea.
These are all normal feelings

If reactions persist beyond 6 months, Post Traumatic Stress Disorder (PTSD) may be diagnosed: Sometimes PTSD may occur after many years, apparently ‘out of the blue’.  Appropriate treatment for PTSD is either a course of skilled Cognitive Behavioral Therapy (CBT) or EMDR (Eye Movement Desensitisation Reprocessing). I am an EMDR therapist and find that individuals process their trauma rapidly and are able to move on and leave the trauma in the past. Counselling can help these individuals find constructive ways of managing their emotions. You may have experienced an event or range of events where you have feared for your life or maybe of someone close to you. Traumas such as these include many types of accidents, rape, childhood abuse, domestic violence, kidnap and mugging; or it may be that you have worked in or travelled to various war zones.  Sometimes people appear to cope reasonably well at the time of the incident but find that later, possibly after many years, disturbing memories or reactions seem to hit us ‘out of the blue’. Sometimes there is an obvious trigger but this isn’t always the case.  The experience of trauma is unique to each individual and therefore different therapies may be appropriate. When I work with people who have experienced traumatic events who may have symptoms of PTSD, I may use a combination of approaches which may include, EMDR [Eye Movement Desensitisation and Reprocessing], HSF [Human Social Functioning] and CBT [Cognitive Behavioural Therapy].