TRAUMA

Trauma is the experience of severe psychological distress in response to a highly distressing or life-threatening situation. Trauma typically occurs in situations where an individual feels a loss of control, betrayal, abuse of power, helplessness, pain, confusion and/or loss. Trauma experiences can be classified in the following ways:

Acute trauma: This can arise from exposure to a single overwhelming event/experience (for example, car accident, natural disaster, single event of abuse or assault, sudden loss or witnessing violence).

Post-Traumatic Stress Disorder (PTSD): PTSD is generally diagnosed when a person is experiencing the following symptoms for more than a month since exposure to an overwhelming situation: Intrusive thoughts, nightmares and flashbacks, Persistent avoidance of stimuli associated with the traumatic event, Negative alterations in cognitions and mood, and Marked alterations in arousal and reactivity (DSM-5, 2013).

Complex Trauma: Arises from multiple, chronic and prolonged overwhelming traumatic events/experiences which are compromising and most often within the context of an interpersonal relationship (i.e., sexual abuse, family violence).

Developmental/Childhood trauma: Arises from early onset exposure to ongoing or repetitive trauma (as infant, children or youth). This includes physical or emotional neglect, abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or betrayal. This often occurs within the child’s care giving system and interferes with healthy attachment and development.

The effects of complex or developmental trauma are usually long-lasting and persists into adulthood. Adult survivors of complex or developmental trauma tend to find it hard to form and maintain healthy relationships, have trouble developing and maintaining healthy boundaries, engage in negative self-talk, can experience ongoing anxiety and depressive symptoms, can find it a challenge to regulate their emotions, find it harder to cope with daily stressors, and can experience more tiredness/fatigue than usual. They are often in a chronic stress response or hyper-vigilant state, which keeps them perpetually in survival mode.

Psychotherapy would involve helping the client to unpack the trauma, create safe boundaries, develop healthy routines, improve coping and emotional regulation, help the client meet their needs for safety, nurturance, stability, acceptance, connection, autonomy; develop healthy relationships and work through feelings of grief and anger. In addition, therapy could incorporate somatic work to help the client to reconnect with their body, reduce the fight/flight/freeze response states and engage more of the parasympathetic (calm) response state. My work with trauma is informed by the research and work by Dr. Bessel van der Kolk, Dr. Stephen Porges and Dr. Peter Levine. I primarily use the NeuroAffective Relational Model (NARM) by Dr. Laurence Heller to address complex/developmental trauma.