What comes to your mind when you hear the word trauma?
Do you think of physical or psychological trauma?
Do you have preconceived notions about how trauma may affect human development?
Sadly, many people struggle to understand the emotional, psychological, and/or physical toll trauma can have on overall health. Trauma tears families apart. It divides and sadly, in some cases, it conquers.
This article will highlight some of the things I have seen, in my profession and life, that is difficult for others to understand about trauma. I have narrowed these things down to 9 for the purpose of keeping things structured and succinct.
Trauma is not well understood by our society which leads to miscommunication, misunderstandings, and sometimes further trauma. My experience has been that many people struggle to identify what trauma actually is, how it affects the brain, and how it can slow the progression of development. Many of these same people believe that trauma does not have to define or continue to define you. While this is a positive and sometimes balanced view, trauma is something that leaves many fingerprints that cannot be so easily erased.
Many assume that trauma is a bad experience that can be overcome with the “right combination” of things (i.e., social support system, medication or illegal use of drugs or alcohol, overindulgence in pleasurable activities or work, months or years of therapy, denial, avoidance, etc). But the reality is that trauma is way more complicated than we care to admit and sometimes more complicated to treat than we think.
One of the most common questions I receive when working with clients with trauma histories is: “What makes trauma so hard to get over?” I then go through a series of sessions focusing on why healing will take some time. For many of my clients (previous and current), trauma is defined differently and the intensity/duration of the trauma is different as well. This makes understanding the effects of trauma much more difficult because some people get over their trauma more easily than others.
As a result of trauma being so misunderstood, sufferers struggle with getting others to understand their daily battle. I have listed a few common reasons why trauma is difficult to understand:
- Talk therapy does not always work: As hard as this is for me to admit as a therapist, it is true. Talk therapy is not an “exact science” and often involves more art than science. Trauma therapy often involves more art than science, especially in the initial stages of treatment. Building rapport, building trust, making the client feel comfortable and understood, getting the client to open up and share, etc. all depends on the skill of the therapist and the willingness of the client. Without this, therapy is a waste of time. Many therapists can sit with clients and review scientific literature without a problem. But is this truly therapy? No. Other variables such as age, culture, religion, race/ethnicity, gender, etc. play a role as well. Therapy is good for some people, not all people.
- Therapy alone is not enough: As stated above, therapy does not always work for everyone. Some people may find therapy is not helping or that dropping out is a good option. Although therapy may be more helpful by the client engaging in healthy eating or dieting, taking an exercise, meditation, or yoga course, pursuing a more fulfilling line of work or hobby, engaging in daily prayer, talking with a spiritual counselor or pastor, etc., it still may not be enough. It may be at some point, but perhaps not now for some people.
- Psychological, emotional, physical, or sexual abuse can have lifelong consequences: Even if someone engages in therapy for a long period of time, that doesn’t mean symptoms of trauma (i.e., flashbacks, physiological symptoms, guilt, fear, anxiety, depression, worry, nightmares or night terrors, etc) will end right away. It may take some time to get these symptoms under control. A “one size fits all” approach to understanding trauma is not helpful. So many therapists have to allow the therapeutic process some time to work and this could be a while. Symptoms may never disappear. But if they do, it can take some time.
- Trauma is not just “a bad experience”: I have actually had families ask me why it was so hard for a loved one to just “get over it” and move on. One case I previously had, while working in a residential treatment facility (i.e., a campus of youngsters who struggle with mental illness and receive 24/7 staff supervision), involved an abused and neglected 8yr old who struggled with enuresis (i.e., incontinence) due to not being potty trained and severely neglected. He grew up in a home with two drug-addicted parents. Although he was removed from their home at age 2, he continued to struggle for years. His abuse and neglect was not just one bad experience. It was a very long road of traumatic stress, feelings of inadequacy, fear, lack of trust, and mental health challenges.
- Trauma therapy may actually make things worse: Talking through a traumatic experience can be very helpful, especially if there are newly developed insights about the trauma, an emotional breakthrough, or some kind of psychological healing. But talking through a traumatic experience, primarily if the person is not ready to talk about it, can lead to resentment, anger, or an increase in trauma-related symptoms such as flashbacks, fears, or anxiety. When I’m counseling a youth who has struggled with trauma I often discuss coping skills and help the youth learn some skills before we delve into the actual trauma and begin discussing what happened. Why do I do this? Because the discussion of the trauma can trigger unpleasant emotional, physiological, and psychological symptoms that are difficult to cope with without appropriate knowledge on how to cope.
- Trauma has neuro-biological components we often miss: Trauma literally affects brain structure. Brain development is often interrupted when infants and young children experience traumatic events such as abuse and neglect. The brain is “re-wired” by the experience which can lead to symptoms of PTSD. Research suggests, however, that children are very resilient and, with the right amount of support, can overcome their trauma.
- Every person’s definition of trauma is different: Your definition of trauma may be very different from someone else’s definition. When I ask a family what “trauma” means to them the responses are amazing. One person defined trauma as “something that is really, really bad that makes it hard to get over.” Another person defined it as “a car crash or unexpected death that no one is prepared for.” Although these definitions are correct, trauma is more accurately defined as any event, deemed traumatic to the sufferer, that occurs in the life of someone who does not have the appropriate coping skills to cope.
- Some people search for a therapist who may not understand trauma: For some people, a therapist is a therapist and “they must be trained to know something or they wouldn’t have a job.” Not so. Some so-called mental health professionals, in certain states, can claim the title of “psychotherapist” without a license and without professional training. Others obtain a degree in the field of psychology and hang out a shingle and wait for people to “buy” their services. You want to be very careful about who you are giving permission to treat you. Is this person certified in trauma? Is this person’s degree appropriate for the type of work they are producing? Are they licensed and if not, why? These are the questions you should be asking before committing to therapy. While there are some pretty good therapists who may not be licensed to provide services in your state, the #1 thing you want to ask about is certification in trauma, a license, and experience.
- Our research is lacking but we’re getting better: Believe it or not, the field of psychology is limited on how to treat and understand trauma. We are beginning to understand the neurological and neuro-biological affects of trauma and how to treat it. Mental health professionals, primarily those who are trained and certified in trauma, are able to educate the public to trauma and what trauma victims need in order to recover. Leading experts in the field are also providing online classes, certification programs, workshops, continuing education seminars, etc. on trauma to better inform mental health professionals and laypeople.
What are some of your beliefs of trauma? Have you (or someone you know) experienced a traumatic event? If so, do you think others understand your experience?
As always, I wish you well
Note: This article was originally published 8/1/18 but has been updated to reflect comprehensiveness and accuracy.
GoodTherapy. (2016). Post Traumatic Stress/Trauma. Retrieved 9/20/2016 from, http://www.goodtherapy.org/learn-about-therapy/issues/ptsd.
HelpGuide. (2016). Emotional and Psychological Trauma. Retrieved 8/15/2016 from, http://www.helpguide.org/articles/ptsd-trauma/emotional-and-psychological-trauma.htm.