PSYCHOTHERAPY FOR TRAUMA
Trauma is the experiencing or witnessing of an event or multiple events, which are likely to cause humiliation, terror, serious injury, or death. These events evoke fear, helplessness, and shame. It is now also being understood that childhood neglect or being raised by someone with PTSD (inter-generational trauma) can also be traumatic.
POST-TRAUMATIC STRESS DISORDER*
Post-traumatic stress disorder is a condition that can occur after a traumatic event. The symptoms exist on a continuum, and some people are able to manage day-to-day life quite well in spite of distress, while others are left unable to function. A person who suffers from PTSD has symptoms in each of the following four categories:
Dissociation is another possible symptom of PTSD, which crosses several of these categories. It can be understood as detaching from traumatic experiences that would be too much to tolerate. During a traumatic event, dissociation is mental escape, when escaping physically is not possible. Where typically, experience (behaviour, emotions, sensations, knowledge, meaning) would be held together in awareness, dissociation separates these to protect against becoming overwhelmed.
As with all PTSD symptoms, the person may continue to use the strategy even after the danger has passed. A person may “zone out” and not be connected with what is going on around them, have gaps in memory, not feel their emotions, or have sensations that they don’t understand. Dissociation can also include a sense of depersonalization (feeling detached from one’s self or one’s experience) or derealization (feeling a sense that things in the environment are not real). In some cases it can be experienced as having different “selves/parts” that are blocked from awareness (Dissociative Identity Disorder).
*This information is provided for information purposes, not as a substitute for seeking professional diagnosis.
WHY DOES PTSD DEVELOP?
An important fact to keep in mind is that although PTSD is a distressing and debilitating condition, the symptoms are actually natural responses to traumatic events. Each of the responses is an attempt to cope and survive in a traumatic environment.
During a traumatic event, normal functioning stops and the body's primitive survival defences are activated. Survival mode strategies include fight, flight, freeze, submit, and cry for help. These are our best hopes of surviving through a potentially life-threatening situation. For many situations, once the danger has passed, the body resumes it normal functioning. However, if afterwards, when the environment is no longer dangerous, these defences remain active, the person may continue to suffer and be in distress.
Factors affecting the development of PTSD include level of isolation and support, pre-existing sense of safety, childhood exposure to trauma, repeated experiences of trauma, severity of trauma, self-judgment about one’s actions during the events.
TRAUMA TREATMENT
Recovery from PTSD is possible. The treatment of trauma has various stage. The first stage of treatment focuses on creating safety and managing the responses and after-effects of trauma. The most distressing symptoms are targeted first. Healthy coping skills are developed for the relevant areas such as managing anger, substance use, risky behavior, self-harm, nightmares, flashbacks, etc. This stage would also focus on developing an understanding of the responses and developing self-compassion. The second stage explores and integrates the memories of the traumatic event(s), the story is told so that the memory can be put in its place – in the past. Emotions have the opportunity to be expressed in a safe way. The third stage focuses on creating meaning and re-engaging with the world. Some people use their experiences to help others. Although these stages are not completely linear and often overlap, it is important to pace treatment in such a way that feels safe.
I am now accepting new clients in Richmond Hill. Please contact me by phone or email to schedule an appointment.
Trauma is the experiencing or witnessing of an event or multiple events, which are likely to cause humiliation, terror, serious injury, or death. These events evoke fear, helplessness, and shame. It is now also being understood that childhood neglect or being raised by someone with PTSD (inter-generational trauma) can also be traumatic.
POST-TRAUMATIC STRESS DISORDER*
Post-traumatic stress disorder is a condition that can occur after a traumatic event. The symptoms exist on a continuum, and some people are able to manage day-to-day life quite well in spite of distress, while others are left unable to function. A person who suffers from PTSD has symptoms in each of the following four categories:
- Re-experiencing: The past events are “re-lived” as though they were happening in the present. This can take the form of nightmares, night terrors, intrusive memories, and flashbacks.
- Avoidance: The person may avoid situations, objects, people or places that are reminders of the traumatic event(s). Blocking the memory of the event(s) is another form of avoidance. People may also avoid emotions and thoughts related to the trauma, or avoid emotions altogether by feeling numb. Numbing can be exaggerated through the use of substances, over-eating/restricting, or other behaviours.
- Alterations in moods and thoughts: The person experiences intense self-blame and shame (“I’m bad”), negative beliefs about others (“Everyone is out to get me”), and the world (“The world is a terrible place”). The person may persistently feel depressed, hopeless, and unable to feel joy.
- Heightened Reactivity: This refers to the physiological state of being in ‘survival mode’. It can cause jumpiness, anxiety, being “on guard”, aggression, irritability, intense emotions, or a general sense of feeling overwhelmed. It can also result in difficulty with sleep, concentration, and feeling relaxed.
Dissociation is another possible symptom of PTSD, which crosses several of these categories. It can be understood as detaching from traumatic experiences that would be too much to tolerate. During a traumatic event, dissociation is mental escape, when escaping physically is not possible. Where typically, experience (behaviour, emotions, sensations, knowledge, meaning) would be held together in awareness, dissociation separates these to protect against becoming overwhelmed.
As with all PTSD symptoms, the person may continue to use the strategy even after the danger has passed. A person may “zone out” and not be connected with what is going on around them, have gaps in memory, not feel their emotions, or have sensations that they don’t understand. Dissociation can also include a sense of depersonalization (feeling detached from one’s self or one’s experience) or derealization (feeling a sense that things in the environment are not real). In some cases it can be experienced as having different “selves/parts” that are blocked from awareness (Dissociative Identity Disorder).
*This information is provided for information purposes, not as a substitute for seeking professional diagnosis.
WHY DOES PTSD DEVELOP?
An important fact to keep in mind is that although PTSD is a distressing and debilitating condition, the symptoms are actually natural responses to traumatic events. Each of the responses is an attempt to cope and survive in a traumatic environment.
During a traumatic event, normal functioning stops and the body's primitive survival defences are activated. Survival mode strategies include fight, flight, freeze, submit, and cry for help. These are our best hopes of surviving through a potentially life-threatening situation. For many situations, once the danger has passed, the body resumes it normal functioning. However, if afterwards, when the environment is no longer dangerous, these defences remain active, the person may continue to suffer and be in distress.
Factors affecting the development of PTSD include level of isolation and support, pre-existing sense of safety, childhood exposure to trauma, repeated experiences of trauma, severity of trauma, self-judgment about one’s actions during the events.
TRAUMA TREATMENT
Recovery from PTSD is possible. The treatment of trauma has various stage. The first stage of treatment focuses on creating safety and managing the responses and after-effects of trauma. The most distressing symptoms are targeted first. Healthy coping skills are developed for the relevant areas such as managing anger, substance use, risky behavior, self-harm, nightmares, flashbacks, etc. This stage would also focus on developing an understanding of the responses and developing self-compassion. The second stage explores and integrates the memories of the traumatic event(s), the story is told so that the memory can be put in its place – in the past. Emotions have the opportunity to be expressed in a safe way. The third stage focuses on creating meaning and re-engaging with the world. Some people use their experiences to help others. Although these stages are not completely linear and often overlap, it is important to pace treatment in such a way that feels safe.
I am now accepting new clients in Richmond Hill. Please contact me by phone or email to schedule an appointment.