Trauma

Most people will experience some form of trauma in their life and will recover normally, without any professional assistance.  Sometimes, the nature of the trauma is simply overwhelming and then it is best to seek professional help.

Trauma can be the result of being exposed to a single, life-threatening event; it may also result from much smaller, regular exposures over time or adverse childhood experiences or childhood trauma.  Trauma has a cumulative effect – the greater the exposure, the more damaging the effects are likely to be, especially for children.

Trauma is an assault on the body and psyche.  Not everyone who is exposed to trauma will be traumatised and most people will recover naturally from trauma, without professional help.  However, every person and everyone’s circumstances are different; when different people are exposed to exactly the same event, some may recover without assistance while others may need intensive support.

Exposure to traumatic events

After exposure to a life-threatening event, it is common to experience a kind of “high” as the body’s fight-or-flight response is activated and the body is flooded with adrenaline and cortisol.  This is a normal survival response and for the first 24 – 48 hours after an event it is common to experience the “shock” of the event.  During this time, it is not business as usual and the best response is to seek a calm environment where recovery can begin.

After the initial shock wears off, people may begin to experience a combination of various symptoms of trauma.  These can include:

  • Having distressing, memories and thoughts
  • Dreams and nightmares
  • Flashbacks about the event
  • Becoming emotionally of physically distressed when reminded about the event
  • Avoiding thoughts, feelings, conversations, activities, places or people that are reminders of the event
  • A loss of interest in usual activities
  • Some loss of memory of the event
  • Feeling detached, estranged or having a reduced sense of feelings
  • Sleep disturbance
  • Irritability or anger
  • Difficulty concentrating
  • Feeling constantly alert

These symptoms may develop within the first few days after a traumatic event and can persist for the following 3 – 4 weeks.  Most of the time the symptoms will fade and disappear as the trauma is normally processed by most people.  However, if the symptoms become unbearable or interfere with a person’s ability to function at home or in the workplace, it is a sign to seek help.  If the symptoms increase in severity or persist beyond the initial 3 – 4 weeks, it is also a sign to seek help.

Some people may be more vulnerable to the negative effects of trauma than others.  People who live or work in stressful environments, have limited access to resources because of financial constraints or have few healthy relationships are more at risk for developing post-traumatic stress disorder.  A history of prior trauma or mental illness may also contribute to greater vulnerability – in these cases it is best to seek counselling immediately.

Treatment

Treatment for trauma may consist of initial counselling or debriefing, more intensive and longer-term or medical intervention – or a combination.

Although it is commonly believed that a person must receive debriefing immediately after exposure to an event to prevent the development of post-traumatic stress, it is not true that this is always the best intervention.  Intervention immediately following an event should focus on addressing concerns of safety, returning to a calm environment and reducing other stress and activating and making use of supportive relationships.  Debriefing – a process where the person is encourage to talk about the event repeatedly – is strongly discouraged as recent research found this to be ineffective and even potentially harmful.  However, for people who are at risk for complicated recovered because of risk factors, or who are struggling to cope following the exposure – counselling should start as soon as possible.