What does psychological trauma look like?

Each of us has mental images of medical trauma. These images may include flashing lights, ambulances, and emergency rooms. But what does psychological trauma look like? The symptoms are diverse. Most are not visible. But psychological trauma can be just as life-changing as medical trauma. And like medical trauma, psychological trauma can heal.

 What is psychological trauma?

Let’s begin with a definition:

Psychological trauma is an intensely disturbing or distressing experience that overwhelms our ability to cope.

For the rest of this blog post, for brevity, I will use the word “trauma” to mean “psychological trauma.”

 What happens when you experience trauma?

•        Your brain is unable to do its normal processing of that event.

•        Your brain is unable to put the memory in a form that is useful for the future.

•        The memory gets stuck in its original, raw, disturbing form.

•        You experience distressing thoughts, emotions, and body sensations.

 Which is harder to heal from: one major traumatic event, or repeated “minor” ones?

 If asked about trauma, many people say, “I haven’t had any trauma in my life. Other people have been through terrible things, but my life has been very ordinary.” Often what they mean is that they have not experienced a dramatic, disastrous event, such as being wounded in battle, surviving a horrific crime, or having their home flattened by a tornado.

  Gradually some people will realize that they received very little attention, approval, or love as small children. Others will recognize patterns of emotional or psychological abuse in their family of origin. A child may assume that neglect or emotional abuse is “normal,” if it is all that they have ever known. The absence of sufficient love is much harder to recognize than the presence of physical abuse. It is much more difficult to see the lack of something than it is to see the presence of something.

  The time period from birth to age 4 is crucial. This is called the “attachment period,” when the young child ideally forms a strong bond of loving attachment to his or her parents and/or primary caregivers. What we learn during our first 4 years of life tends to form a template for how we view the world, people, relationships, and love. Whatever goes wrong for a small child during the “attachment period” has lasting effects. Any harm done to the child during this period is called “developmental trauma” or “attachment injury.”

  Research has shown that it is much easier to heal from one, single, major trauma than it is to heal from many, repeated “minor” traumas. This is especially true if the person is very young or vulnerable when the repeated “minor” traumas occurred; or if the repeated traumas occurred within key relationships. Sometimes we use the term “adverse life experiences” to describe these smaller, repeated traumas.

  Experienced therapists who work with trauma survivors report that it is comparatively quick for an adult to heal from a single, recent trauma, such as being the victim of a terrible crime. However, if the person has experienced “attachment injury” as a small child, most of the time and effort in therapy goes into healing that childhood trauma.

 What are some symptoms of trauma?

  The symptoms of trauma are remarkably diverse. For ease of understanding, we can sort them into groups, or themes. One group of symptoms is related to sadness, namely:

• Depression

• Hopelessness

• Feeling blank about the future

• Losing interest in favorite activities

• Inability to concentrate

Another group of trauma symptoms is related to worry, namely:

•  Anxiety

• Constantly feeling “on alert”

• Startling easily

• Panic attacks

• Feeling overwhelmed emotionally

• Inability to trust anybody

• Irritability

• Insomnia

• Nightmares

• Flashbacks: experiencing a painful memory as if it were happening right now

Another group of trauma symptoms impacts the body, namely:

• Chronic headaches

• Chronic pain

• Autoimmune diseases, which can have many causes, but which are more frequent among trauma survivors

• Other chronic illnesses for which trauma can be a contributing factor

Another set of trauma symptoms involves anger or hostility turned inward, toward oneself. Examples include:  

•  Shame

• Feeling worthless

• Eating disorders such as anorexia or bulimia

• Eating too much to comfort yourself

• Substance abuse: alcohol and/or drugs

• Taking risks recklessly

• Self-harm behaviors, such as cutting

• Suicidal ideation

Another group of trauma symptoms involves disconnecting from oneself, or disconnecting from reality. This set of symptoms is called “dissociative symptoms.” Examples include:

•  Feeling numb

• Feeling frozen

• Feeling “shut down”

• Feeling that your surroundings are unreal

• Loss of sense of identity: feeling “Who am I?’

• Feeling that you are outside of your own body, like an observer

• Feeling that your body parts do not belong to you

• Having gaps or “blank areas” in your memories of the past

 Significance of trauma symptoms

  As you can see, trauma deeply impacts our thinking, our emotions, and our bodies. All of the above symptoms are ways in which our minds and bodies survived an overwhelming, negative experience—or the cumulative effect of many negative experiences. Be glad that you survived your trauma. Your survival gear is good. It is a gift. But humans need more than survival. We need to heal. We need to thrive.

 Be hopeful! You can heal!

  If you have some of these symptoms, please ask for help! Research has proven that there are several forms of psychotherapy that are very effective in helping people heal from trauma. Therapy methods that are backed by solid research are called “evidence-based.” The following therapy methods are effective, “evidence-based” treatments for trauma:

•  Dialectical Behavior Therapy (DBT)

• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

• Cognitive Processing Therapy

• Prolonged Exposure Therapy

• Eye Movement Desensitization and Reprocessing (EMDR) Therapy

• And others…

  Therapy is not easy. It is hard work. But continuing to live with symptoms like those listed above is much, much harder. If you are a trauma survivor, you do not need to keep suffering and struggling in this way.

 Key takeaway

  Once you heal from your trauma, you may recognize in yourself an increased capacity to give love, empathy, and compassion to others—and to yourself. As one of my mentors said, “Healed wounds are glorious.” And as Khalil Gibran wrote, “Out of suffering have emerged the strongest souls; the most massive characters are seared with scars."

[I wish to thank Rick Levinson, LCSW, Kasey Shaw Salyer, LCSW-S, and Trina Welz, LPC, for teaching me the above material. I also referred to “Transforming the living legacy of trauma: A workbook for survivors and therapists,” by Janina Fisher, Ph.D.]