Trauma and PTSD
Coping with Trauma
Have you lived through or witnessed a traumatic event that felt as if it shattered your world? Have you had difficulty regaining a sense of safety? Do painful memories keep popping up that interfere with your life here and now?
What is trauma anyways?
Trauma is a lasting emotional response that can be experienced from witnessing a deeply distressing or disturbing event or series of events. Your sense of safety can be impacted when you survive a traumatic event. You may find yourself being frustrated or irritable towards yourself or others because you can't simply 'snap out of it' and 'feel okay'. A large component of coping with trauma and PTSD is understanding your symptoms, turning towards your mind and body with compassion, and reshaping how your brain interprets danger and safety cues in your environment. Trauma can also impact your core beliefs of yourself and others that typically can be grouped into five themes: safety, trust, power and control, esteem, and intimacy. You may have different beliefs about who you are now versus who you were before the trauma. You may also experience difficulty regulating emotions; it's important to remember that these are common and normal reactions to abnormal circumstances. If left untreated, living with trauma can make you feel shameful, powerless, and hopeless at times.
How do you know if your trauma is interfering with your life?
Start by asking yourself two questions:
- Do your symptoms of trauma (i.e., avoidance, mood/thinking changes, arousal, re-experiencing) prevent you from engaging in important aspects of your life?
- Do your symptoms of trauma negatively impact your work, school, relationships, and daily routine?
If you answered yes to either of these questions, read our brief guide below to learn more about what you can do.
Step 1 - Learn more about trauma
Are my reactions to trauma normal?
You are not alone. People can experience trauma in many forms and levels of severity, which can occur as acute, chronic, or complex traumas. Below is a list of traumatic events that people are commonly negatively impacted by:
- Intimate Partner Violence (IPV)
- Domestic violence
- Early childhood traumatic experiences
- Motor vehicle accidents
- Traumatic grief
- Natural disasters
- Medical trauma
- Physical abuse
- Sexual abuse
- Human trafficking
- Refugee trauma
- Terrorism and violence
- Verbal and emotional abuse
People can experience lasting effects from childhood experiences that were notably stressful or painful without being life-threatening. Common examples include dysfunctional family dynamics, bullying, or neglect.
If I have trauma, does that mean I have PTSD?
Post-traumatic stress disorder (PTSD) is a term that's commonly used in reference to trauma. However, PTSD is a diagnosable, severe psychological disorder in the DSM-5, and not everyone that experiences trauma develops PTSD. In fact, one of the most significant contributing factors for the development of PTSD is avoidance [of thoughts, emotions, memories, and physical reminders] following a traumatic event. Therefore, seeking support from family, friends, community, and a trauma-informed mental health professional following a traumatic event is critical for a positive prognosis for recovery. The term 'trauma' can relate to a number of significantly negatively impactful events, including PTSD, addiction, relationship issues, chronic pain syndrome, depression, and more.
How can symptoms of post-traumatic stress be problematic and a cause for concern?
Trauma can overtake your life in a number of ways. It can disrupt your ability to function in relationships, at work, school, home, and your relationship with yourself. Over time, trauma can start to erode your social, mental, and physical well-being.
You might notice your mind attempting to make sense of the trauma by 'over-acccommodating', or forming new beliefs about yourself, others, and the world around you that align with the trauma. Alternatively, it could serve to reinforce (i.e., 'assimilate') previously held negative and distorted beliefs. For example, beliefs following a trauma might include, "I am not good enough", "The world is completely dangerous", and "I can't trust people". It makes sense that people living with these beliefs likely have issues in relationships, work, or school.
Post-traumatic stress can also feel as if you're on high alert, guarded, or unsafe in situations that you were once able to enjoy. For example, if you get bitten by a dog, you might experience high levels of fear and urges to avoid the local dog park. You might notice your heart racing, rapid breathing, and shaking when thinking or talking about reminders of the attack. Moreover, you might experience flashbacks of the dog attack, or notice pervasive thoughts about safety or lack thereof. While these internal reactions may seem abnormal, they're completely normal responses that your autonomic nervous system has developed for your protection.
In fact, following a traumatic event(s), your brain might not be able to differentiate between the initial trauma and neutral events. There are many evidence-based psychotherapy treatments that have been developed to help survivors of trauma better understand their reactions, learn skills to better manage symptoms of post-traumatic stress, and develop healthier insights and narratives about the event(s). Psychotherapy treatment for trauma is one method of helping you start to feel as if you're living your life again with a greater sense of agency and purpose.
"When all you know is fight or flight, red flags and butterflies all feel the same." - Cindy Cherie
Step 2 - Assess symptoms of post-traumatic stress
Quick Screening Tool: Is your suffering trauma-related?
If you're wondering, "Do I suffer from trauma?", ask yourself:
- Have you witnessed a direct or indirect experience of a traumatic event(s)?
- Do you have distressing emotional, cognitive, and physiological reactions when something triggers or reminds you of the trauma?
- Do you feel a loss of control or have an inability to cope effectively or in healthy ways with your distressing reactions?
Results: If you answered “Yes,” please read further to see what symptoms you may be experiencing and how trauma treatment can help.
Quick Screening Tool: Find out if you're experiencing symptoms of post-traumatic stress
It is possible to have trauma, but not PTSD. PTSD is a diagnostic category in the DSM-5 that includes the following symptoms following a month of the traumatic event. Symptoms of post-traumatic stress can be grouped into four categories:
- Re-experiencing symptoms
- Mood/thinking changes
The following is a list of symptoms from the PTSD checklist for DSM-5 that you might experience in varying degrees of severity:
- Repeated, disturbing, and unwanted memories
- Repeated nightmares
- Suddenly feeling or acting as if the stressful experience were actually happening again
- Feeling very upset when something reminded you of the stressful experience
- Having strong physical reactions when something reminded you of the stressful experience (i.e., heart pounding, trouble breathing, sweating)
- Avoiding memories, thoughts, or feelings related to the stressful experience
- Avoiding external reminders of the stressful experience
- Trouble remembering important parts of the stressful experience
- Having strong negative beliefs about yourself, other people, or the world
- Blaming yourself or someone else for the stressful experience or what followed from it
- Having strong negative feelings such as fear, horror, anger, guilt, or shame
- Loss of interest in activities that you used to enjoy
- Feeling distant or cut off from other people
- Trouble experiencing positive feelings
- Irritable behaviour, angry outbursts, or acting aggressively
- Taking too many risks or doing things that could cause you harm
- Being "superalert" or watchful or on guard
- Feeling jumpy or easily startled
- Having difficulty concentrating
- Trouble falling asleep or staying asleep
If you're experiencing symptoms of post-traumatic stress and you're having difficulty coping with them or responding effectively to them, then it is likely a good course of action to seek treatment and speak with a licensed mental health professional. Read below for additional tips on coping with your trauma.
Please note: the information provided below is for psycho-educational purposes and it is not a substitute for therapy nor does it constitute a diagnosis.
Step 3 - Identify the practices that help
1. Increase awareness and functioning of your nervous system to learn how to self-regulate.
It's common to feel as if you're lost inside your own body and mind when you're triggered by your trauma. You might experience flashbacks, intrusive thoughts, or nightmares related to the memories, feelings, and sensations of the trauma. It's also common to feel 'out of control', which can be a terrifying experience for many and often mimics the reality of the trauma.
Steps to ground yourself when you're triggered:
Focus your attention non-judgmentally on your breath. It can help you return to the safety of the present moment. Diaphragmatic breathing is a particular type of mindful breathing practice, whereby you inhale deeply from your diaphragm (i.e., belly rises before your chest), and slowly extend your exhale longer than your inhale. Mindful breathing, including diaphragmatic breathing, boxed breathing, and paced breathing can help regulate your nervous system as it experiences fight, flight, or freeze response. Focusing on your breath is a proven method for activating the parasympathetic nervous system (PNS), which helps slow heart rate and racing thoughts, and regain attention, thereby giving you a sense of control. A sense of control, or 'anchoring', is typically the opposite of the out-of-control experience that's associated with an involuntary trauma response.
Sensory input. Attuning to your five senses is a great way to regulate your body and emotions, particularly if mindful breathing isn't really your thing. To start, use your five senses (i.e., smell, taste, touch, sound, and sight) to soothe yourself in the present moment. Try to experiment and allow yourself to be creative using each of your senses. This practice could include using different sensory exercises involving music, tasting something pleasant, or petting an animal. Alternatively, you could simply try taking the time to really notice how each sense feels in the moment with typical experiences (i.e. while you're walking, notice the sensation of the breeze or sunshine on your skin; feel your feet against the ground and focus your gaze on a nearby tree or water). Exercising mindfulness of your senses either formally or informally helps bring the mind and body to the present moment, as well as give you a buffer in your window of tolerance. Each mindful moment can serve to fill up your cup little by little. Strengthening your ability to notice that you're triggered and bring yourself back to the present moment is a critical grounding skill for dealing with trauma or post-traumatic stress.
Stay grounded using your body. Don't make your mind do all the work! Use your body to anchor yourself in the safety of the present and increase your sense of control. Often, people become distressed with the big emotions associated with trauma, and unfortunately, we cannot control the automatic, involuntary experience of emotions that arise. However, we can get better at becoming aware of them and responding to them in more helpful ways. Moreover, while we cannot control the emotions that arise, we can notice our urges and control our actions. Practicing body awareness and intentional movement is one way to start increasing your ability to stay grounded. You can do this by wiggling your toes or fingers, feeling your feet against the ground, stretching your arms and back, gently or firmly squeezing up and down your arm, or placing a hand over your heart [skin to skin contact is encouraged]. Notice how when you do this intentionally and non-judgmentally by simply observing without expectation, your breathing deepens.
2. Allow yourself to feel whatever you feel.
It's normal to fight against your feelings or do your best to avoid feeling them when you live with trauma. Avoidance strategies are effective in the short-term because you might escape feeling pain temporarily. However, avoidance can have long-term negative impacts on your physical health, relationships, the ability to connect and engage in the world, and experience emotions altogether. The cost of emotional numbing could mean that you give up activities, people, and situations that are actually important for healing.
Slowly beginning to appreciate your painful emotions, turning towards them with curiosity rather than judgment, and accepting them for what they are allows you to drop the struggle against them, especially if it means you get to start living your life again. A helpful strategy to increase emotional awareness is the practice of noticing and naming where you're experiencing an emotion in your body. For example, an emotion like sadness might sound like, "I'm noticing a heaviness in my head and chest and a sinking feeling in my stomach. I'm noticing a deep, hollow sensation. I'm noticing an urge to lie down and cry. This is sadness." Noticing emotions and urges can give you the opportunity to respond in more helpful ways, depending on what needs of yours are most important in the moment. For example, if you're feeling sad about having no plans over the weekend, you might text a friend, schedule plans with friends for another time, or make a plan for how you'd like to spend your time solo. If no friends are available, you could simply validate that it's normal to feel sad when you're missing people or feeling lonely, and then do something nice for yourself, such as a hot shower, eat something tasty, or curl up with a book or movie.
3. Get moving.
What can help with trauma? Movement! Trauma can lead to changes in your body's natural state, or a narrowed window of tolerance. You might start to experience more frequent states of hyper-arousal and hypo-arousal.
Hyper-arousal is often called the 'fight or flight response', which is often described as feelings of hypervigilance, anxiety/panic, and racing thoughts. Hypo-arousal is often called the 'freeze response', which is described as feelings of numbness, emptiness, or paralysis.
Daily light to moderate exercise for at least 20 minutes can help ground the central nervous system, expand your window of tolerance, and reconnect you to your body through physical movement. Rhythmic exercise is also recommended to reinforce the mind-body connection. This includes repetitive movement using the arms and legs, such as dancing, running, yoga, swimming, and sports. For emphasized effect, try adding a grounding exercise, such as focusing on the sensations of your body as you move through each exercise. You might try working out at a slower pace (i.e. reduce by 50%) to allow yourself to mindfully focus on each movement. As your mind continues to distract you, gently notice and acknowledge that it's happening, and guide your attention back to your movement. Incorporating intention to your movement and mindfulness of breath in your exercise routine could even have an added benefit of improving your form and performance!
Step 4 - Find a psychotherapist that works with trauma
Trauma-informed therapists have a working knowledge of the impact of trauma on the brain, they're aware of best practices for trauma treatment, and they're trained in trauma-informed interventions. Working with a trauma-informed therapist on your trauma can help you:
- Feel validated in your experience
- Normalize your thoughts, emotions, and reactions
- Process difficult memories, thoughts, and emotions
- Develop alternative coping strategies to avoidance
- Allow natural emotions to come through your body
If you're looking to get answers on how trauma may be impacting your life and what to do about it, then speaking with a registered psychotherapist can help.
Once you're connected with one of our therapists, you'll start with an initial session. During the first session, your therapist will assess your symptoms, listen to your concerns, and collaborate with you to learn how your presenting concerns interfere with your life. Your psychotherapist will take a brief psychosocial history to get to know what's most important to you and how you want things to change. You'll work collaboratively with your psychotherapist to form a treatment plan that's best suited for your needs over the first 1-3 sessions. Throughout the entire process you have the opportunity to ask questions and provide your feedback as you continue to progress.
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