The American Psychological Association (APA) defines trauma as an emotional response to an event like an accident, rape or natural disaster. The website Helpguide.org explains that traumatic events are generally those that shatter people’s sense of security and cause feelings of helplessness and vulnerability. The site notes that trauma is often experienced when there is a threat to life or safety, but that other types of overwhelming situations can also be traumatic, and that the subjective emotional experience is more important in defining trauma than the nature of the actual event. Trauma is more likely if an event happened unexpectedly, repeatedly, in childhood or if the person who experienced the trauma felt powerless to prevent it. People may be exposed to trauma from a wide range of experiences, including surgery, car accidents and other types of injuries, relationship breakups, the sudden death of a loved one, the discovery of a disabling or life-threatening illness, or humiliating or deeply disappointing experiences.
An event that would not be experienced as trauma under one condition may be experienced as traumatic in another. People already under heavy stress are more likely to experience a new stressor as traumatic. A history of childhood trauma, which can lead to an underlying feeling of helplessness, can also contribute to the experiencing of trauma in adulthood.
Physical and Emotional Symptoms of Trauma
Traumatic experiences can cause people to undergo a wide range of emotional and physical symptoms. The APA lists some of these as shock, denial, flashbacks, unpredictable emotions, headaches and nausea. People may feel disconnected from their emotions or they may experience anxiety, hopelessness, shame, overwhelming sadness or a sense of being in constant danger. They may find it difficult to trust others and therefore withdraw from relationships. Tension may manifest in physical symptoms such as fatigue, muscle tightness and achiness, insomnia, nightmares, a racing heart and being easily startled. People are often edgy and agitated and may experience confusion and difficulty concentrating.
Sometimes people gradually recover from the effects of a trauma without professional help. Other times, however, people get stuck and symptoms do not improve on their own. Professional help may be necessary when people find that their symptoms are interfering with their daily functioning or they are dealing with them in unhealthy ways, such as through the use of alcohol or drugs.
Treatment for trauma often involves both focus on physical symptoms and on the emotions and beliefs that underlie them. Therapies include the following:
- Eye movement desensitization and reprocessing (EMDR) – During EMDR sessions, patients recall traumatic memories while rapidly moving their eyes back and forth. A 2012 article in Scientific American reports on a number of studies validating the therapy’s effectiveness. The article notes that EMDR has been endorsed by the American Psychiatric Association, the International Society for Traumatic Stress Studies, and the Departments of Defense and of Veterans Affairs.
Despite the effectiveness of EMDR, its precise mechanisms of actions are not fully understood. One theory is that EMDR interferes with memory reconsolidation. When people recall memories, they are changed subtly before being filed away again. When patients move their eyes while recalling an event, the eye movements may compete for space in their working memories. This may allow the event to be re-filed in a changed form and be less intense when next recalled.
- Somatic experiencing (SE) – During somatic experiencing, the focus is on the physical body. Patients learn to recognize trauma-related tension and sensations and release them. The theory is that trauma symptoms are based on a malfunctioning autonomic nervous system. The developer of SE modeled the therapy on the way in which animals in the wild deal with excess energy.
- Psychomotor therapy – During psychomotor therapy, patients are led to give names and voices to their memories and to re-write them in a more positive way. It may involve role-play and group interaction. A 2014 article in the New York Times Magazine describes a session in which a patient recreated a trauma and asked other people to play certain roles. The participants responded to the trauma patient in the way he needed, by forgiving, apologizing or validating his feelings.
- Prolonged exposure (PE) – People who experience traumatic memories often try to avoid recalling them as much as possible. In exposure therapy, the memories are consciously recalled in an attempt to reduce their power. The therapy involves learning about trauma reactions, intentionally relaxing through breath exercises and other techniques, talking through the trauma, and intentionally practicing real-world exposure to triggering events.
- Cognitive behavioral therapy (CBT) – CBT involves identifying and addressing thoughts that prompt feelings and behaviors. For trauma-related events, CBT is often used in conjunction with other therapies.
Integrated Treatment for Trauma and Addition
Trauma and addiction often co-exist and are best treated in an integrated and coordinated manner. If you would like to find a treatment program that integrates trauma and addiction treatment, give us a call. Our helpline is toll-free and available 24 hours a day. We can help you identify your treatment options and can even check your insurance coverage for you if you wish, at no cost or obligation. Why not call now?