Psychological trauma is a type of damage to the mind that occurs as a result of a severely distressing event or a series of distressing events over time. Trauma is often the result of an overwhelming amount of stress that exceeds one's ability to cope, or integrate the emotions involved with that experience. Trauma usually falls into two categories - single episode (i.e. robbery, accident) or a build of experiences over time (i.e bullying, losses, abuses).
Traumatic abuse causes lasting changes in our physiology, nervous system and brain chemistry. In the course of normal development, memories are consolidated as we evaluate each new situation in terms of the cohesive worldview we have previously formulated. When there has been trauma, this cognitive process is short-circuited by the surge of painful and intense stimulation. Instead of “processing the experience” by fitting it into our understanding of how the world works and thereby learning from it, we revert to a more primitive form of encoding—through physical sensations and visual images. Even years after the actual danger is past, the trauma, undigested and locked in our body, randomly breaks through into consciousness.
A person who has been traumatized may continue to relive the same event as if it were occurring in the present.
3 Areas to Know
Trauma can alter brain functioning in many ways, but three of the most important changes appear to occur in the following areas:
1. The prefrontal cortex (PFC), known as the “Thinking Center”
2. The anterior cingulate cortex (ACC), known as the “Emotion Regulation Center”
3. The amygdala, known as the “Fear Center”
The PFC, or thinking center, is located near the top of your head, behind your forehead. It's responsible for abilities including rational thought, problem-solving, personality, planning, empathy, and awareness of ourselves and others. When this area of the brain is strong, we are able to think clearly, make good decisions, and be aware of ourselves and others.
The ACC, or emotion regulation center, is located next to the prefrontal cortex, but is deeper inside the brain. This area is responsible (in part) for regulating emotion, and (ideally) has a close working relationship with the thinking center. When this region is strong, we are able to manage difficult thoughts and emotions without being totally overwhelmed by them. While we might want to send a snarky email to a coworker, the emotion regulation center reminds us that this is not a good idea, and helps us manage our emotions so that we don’t do things we regret.
A Reading On Trauma...
Trauma is a deeply disturbing event that infringes upon an individual’s sense of control and may reduce their capacity to integrate the situation or circumstances into their current reality. When most people think about trauma, they tend to think about those who have been exposed to war, combat, natural disasters, physical or sexual abuse, terrorism, and catastrophic accidents. These are some of the most profound, and some may argue the most debilitating, experiences one can endure.
However, a person does not have to undergo an overtly distressing event for it to affect them. An accumulation of smaller “everyday” or less pronounced events can still be traumatic, but in the small ‘t’ form.
How a situation impacts a person is largely dependent on predisposing factors, such as the individual’s past experiences, beliefs, perceptions, expectations, level of distress tolerance, values, and morals. For example, not all military service members who have engaged in combat are diagnosed with PTSD or develop post-trauma symptoms. The difference between developing trauma-reaction symptoms or not is for a multitude of reasons, some of which include the predisposing factors described above, in addition to the individual’s ability to process through their experience without the presence of significant avoidance.
It is worth noting that developing post-trauma symptoms is by no means an indication of psychological weakness or congenital deficiency. In fact, these difficulties typically develop due to the individual engaging in avoidance behaviors. Such behaviors are engaged to conceal distress with the belief that not addressing what has happened will free the individual of their emotional pain. Avoidance is also engaged so as not to reveal any “weaknesses” or difficulty to others.
By most standards, these individuals would likely be referred to as “strong-minded” or “tough”; their ability to experience such hardships and rise above them would be deemed honorable. While the individual’s efforts are intentional with the hope of reducing their psychological distress and not creating concern on the part of others, the literature has made clear that avoidance is the most significant developing and maintaining factor for trauma responses. So “tough,” perhaps yes, but effective, no.
The DSM-5 defines a PTSD trauma as any situation where one’s life or bodily integrity is threatened; these are typically large ‘T’ traumas. While small ‘t’ traumas for the most part would not lead to the development of pure PTSD symptoms, it is possible that a person can develop some trauma response symptoms. In other words, the person may experience increased distress and decreased quality of life.
SMALL ‘T’ TRAUMA
Small ‘t’ traumas are events that exceed our capacity to cope and cause a disruption in emotional functioning. These distressing events are not inherently life or bodily-integrity threatening, but perhaps better described as ego-threatening due to the individual left feeling notable helplessness. Some examples of small ‘t’ traumas include:
- Ongoing childhood abuse or neglect
- Conflict with significant others or children
- Infidelity
- Divorce
- Conflict with supervisor/boss or colleagues
- Abrupt or extended relocation/move
- Planning a wedding
- Starting a new job
- Having or adopting a child
- Legal trouble
- Financial worries or difficulty
- Expensive and unplanned home repairs
One of the most overlooked aspects of small ‘t’ traumas is their accumulated effect. While one small ‘t’ trauma is unlikely to lead to significant distress, multiple compounded small ‘t’ traumas, particularly in a short span of time, are more likely to lead to an increase in distress and trouble with emotional functioning. In fact, it is likely that the reason many individuals present for psychotherapy is due to an accumulation of small ‘t’ traumas. These traumas may have occurred over the course of one’s life or condensed in the recent past.
LARGE ‘T’ TRAUMA
A large-T trauma is distinguished as an extraordinary and significant event that leaves the individual feeling powerless and possessing little control in their environment. Such events could take form as a natural disaster, terrorist attack, sexual assault, combat/war zone, car or plane accident, etc. Helplessness is also a key factor of large ‘T’ traumas, and expectedly the extent of experienced helplessness is far beyond that of a small ‘t’ trauma. Large ‘T’ traumas are more readily identified by the experiencer, as well as those who have any familiarity with their plight.
Avoidance takes a much different form with large ‘T’ traumas. The individual tends to more overtly and decisively engage in actions that are classified as avoidance. They may deliberately avoid phone calls from investigators, bury their military uniform and memorabilia in the attic, or avoid crowded places. Their attempts to minimize distress and reduce reminders of the traumatic event are time and energy-consuming, as opposed to the more passive avoidance that occurs with small ‘t’ traumas. One large ‘T’ trauma is often enough to cause severe distress and interfere with an individual’s daily functioning, and this effect is intensified the longer avoidance behaviors endure and treatment is circumvented.
THE HOPE
If you have endured multiple small ‘t’ traumas or even one large ‘T’ trauma and are aware of its impact on your life, there is good news. You don’t have to suffer in silence and there are treatments that can help. Trauma-focused therapy typically includes evidence-based treatments such as prolonged-exposure and cognitive-processing therapy, as well as EMDR. These are effective (and research-based) treatments that can reduce, if not eliminate, trauma-symptoms and PTSD. They are facilitated with the goal of decreasing trauma symptoms, and therefore distress, while simultaneously increasing the individual’s quality of life. Each treatment is quite different, and includes strategies from recalling and fading the memory of the trauma to addressing and reprocessing memories, thoughts, and beliefs.
It must be stated that there is no quick fix and there are no “cures” for trauma. Some individuals are successful in eradicating the impact of the traumatic memory on their lives, while others report significant improvement in their quality of life. Regardless, one thing is for sure: when trauma is on the table, avoidance does not work. Rather, “the best way out is always through.”
Highlights from The Body Keeps The Score
Trauma and Memory
The Trauma Addiction Connection
Let’s imagine that you can float up above the timeline of your life, turn and face the past as it stretches out behind you, and gently drift back to when your addiction first started. Now, let’s drift back a little farther to before that moment. What was happening back in those days, weeks, months or years prior to when your addiction began? Did you experience an event that was less than nurturing? Did you survive a moment that overwhelmed your ability to cope? Did you live through an ordeal that changed how you perceive your place in the world? If so, then you’ve experienced trauma.
The reason it’s significant to identify and acknowledge this is because research proves that trauma can activate survival oriented behaviors that lead to addiction.
Addictions often help reduce the sensation of overwhelm that post-trauma changes create. In fact, when addictions are implemented as an attempt to manage what becomes unmanageable after trauma they can become a negative example of a very positive survival instinct. The key is to recognize this and learn how to turn it around.
The more whole and healed we become the less we need that old coping mechanism until we released it completely.
…if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control.-Michele Rosenthal
You didn’t wake up one day and decide to become an addict. More likely, if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control. The good intention behind your addictive behavior, then, has its roots in positive outcomes, including relaxation from the hyper vigilance of fear; relief from the up swell of memories; restoration from the inability to choose your behavior.
You can look at your addictive behavior and feel embarrassed, ashamed, frustrated, or a whole slew of other negative emotions. Or, you can observe your addiction for the good intention that lies beneath it: the desire to make yourself feel better. Acknowledging this allows you to begin understanding that while the addiction outcome is less than desirable the behavior makes perfect sense.
A Look at the Trauma Brain and Addiction Connection
Let’s imagine that you can float up above the timeline of your life, turn and face the past as it stretches out behind you, and gently drift back to when your addiction first started. Now, let’s drift back a little farther to before that moment. What was happening back in those days, weeks, months or years prior to when your addiction began? Did you experience an event that was less than nurturing? Did you survive a moment that overwhelmed your ability to cope? Did you live through an ordeal that changed how you perceive your place in the world? If so, then you’ve experienced trauma.
The reason it’s significant to identify and acknowledge this is because research proves that trauma can activate survival oriented behaviors that lead to addiction.
Addictions often help reduce the sensation of overwhelm that post-trauma changes create. In fact, when addictions are implemented as an attempt to manage what becomes unmanageable after trauma they can become a negative example of a very positive survival instinct. The key is to recognize this and learn how to turn it around.
The more whole and healed we become the less we need that old coping mechanism until we released it completely.
…if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control.-Michele Rosenthal
You didn’t wake up one day and decide to become an addict. More likely, if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control. The good intention behind your addictive behavior, then, has its roots in positive outcomes, including relaxation from the hyper vigilance of fear; relief from the up swell of memories; restoration from the inability to choose your behavior.
You can look at your addictive behavior and feel embarrassed, ashamed, frustrated, or a whole slew of other negative emotions. Or, you can observe your addiction for the good intention that lies beneath it: the desire to make yourself feel better. Acknowledging this allows you to begin understanding that while the addiction outcome is less than desirable the behavior makes perfect sense.
A Look at the Trauma Brain and Addiction Connection
- The amygdala (your brain’s threat detection center) can become overactive, engaging in a constant program of looking for, seeing and assessing threat. This will cause you to feel intensely anxious, vulnerable and fearful.
- The hippocampus (your brain’s center for processing memories) can become underactive. Rather than consolidating and then placing memories in the outer layer of the brain for long-term storage, memories get hung up in a present-day loop. The result: You will experience and re-experience intrusive, disturbing and uncomfortable recollections.
- The cortex (your brain’s center for executive control) becomes interrupted by survival-oriented instincts from deep inside your inner brain. These instincts overrule logical thinking, diminish cognitive processing and decrease your ability to inhibit behavior. Even when you try to refrain from addictive behavior you will experience an unstoppable urge to engage in it.