Many times people have the question: “Have I been traumatized?” Although a diagnosis of Post-Traumatic Stress Disorder (PTSD) or Acute Stress Disorder should only be made with a licensed practitioner here are some things to consider when evaluating the impact of a particular event (or events) in our life. Considering these items can be helpful in determining to what degree “the past has become present” with us in negative ways.
What is “trauma”?
People use the word “trauma” in different ways. However, in a general sense, “trauma” occurs when an event has overwhelmed our mental and emotional resources. Trauma occurs when something activates the unconscious parts of our brain responsible for responding to threat and danger. The result of trauma is to be “frozen in time” while our brain, body, and nervous system try to work out how to process our experiences. While unable to fully process the experience our system become dis-integrated (or broken up into “parts” in unhelpful ways). This is why people in trauma often feel like they are fighting against their own bodies.
While in trauma “the past is present” in a way that makes it difficult to pursue our goals, growth, and development. It may also be helpful to remember that while some experiences could be thought of as “uppercase T” traumas and other experiences “lowercase t” traumas—they are still trauma and the result is the same. Trauma is not just about car accidents, reliving combat scenarios, or flashbacks; it’s also about relationships, shame, and upbringing.
Lower case t Traumas
Sometimes clients will be surprised that what they have experienced in their lives constitute "trauma". "I've never been in a war zone or involved in a serious accident," they may say, "So, why can't I get myself to feel how I want to feel?" However, if you remember our definition of trauma above---experiences that overwhelm our emotional and mental resources and freeze us in time---we can see how many experiences in our childhood "fit the bill". Events that are highly impactful, but not necessarily life threatening are often the origin of severe emotional problems in both children and adults. These we refer to as "Small-t" traumas, not because their occurrence had a minor or small impact (often quite the opposite!), but because they don't always fit the images we associate with more dramatic, one-time-event traumas. Small-t traumas include: domestic violence, domestic verbal abuse from parents/caregivers, parental divorce, harsh punishment, witnessing addictive disorders in parents, parental depression, parental suicide potential, parental incarceration, sexual abuse or assault, and physical abuse. Additionally, Small-t traumas include failure to receive adequate nurturing, emotional mirroring, parental engagement, or guidance during childhood.
In fact, some research indicates that these Small-t traumas can affect us more deeply than some one-time event Capital T-traumas.
Identifying Symptoms of Trauma
Daniel Weiss and Charles Marmar created an “Impact of Event Scale” that many have found useful in determining the extent of someone’s Capital T - trauma. The following is taken from that scale:
Consider how distressing each of these items has been to you DURING THE PAST SEVEN DAYS with respect to a particular experience/memory. (If it helps you can answer with a 0-4 scale with “0” representing “no distress” and “4” representing “Extreme distress”).
• Any reminder brought back feelings about it.
• I had trouble staying asleep.
• Other things kept making me think about it.
• I felt irritable and angry.
• I avoided letting myself get upset when I thought about it or was reminded of it.
• I thought about it when I didn’t mean to.
• I felt as though it hadn’t happened or wasn’t real.
• I stayed away from reminders about it.
• Pictures about it popped into my mind.
• I was jumpy and easily startled.
• I tried not to think about it.
• I was aware that I still had a lot of feelings about it, but I didn’t deal with them.
• My feelings about it were kind of numb.
• I found myself acting or feeling like I was back at that time.
• I had trouble falling asleep.
• I had waves of strong feelings about it.
• I tried to remove it from my memory.
• I had trouble concentrating.
• Reminders of it caused me to have physical reactions, such as sweating, or trouble breathing.
• I had dreams about it.
• I felt watchful and on guard.
• I tried not to talk about it.
These questions help us tease out three common reactions to trauma: avoidance, intrusive thoughts, and hyperarousal. The presence of these symptoms could mean that we would benefit from treatments that target trauma, such as EMDR.
Identifying the Sources of our Trauma
Many times we know immediately what in the past is connected to our current trauma symptoms. A car accident, an assault, etc. However, another important aspect of treating trauma is to realize that sometimes we have been traumatized by things that are not easily recognizable.
Jim Knipe clarifies that especially when it comes to Lower-case t traumas "there is usually an internally contradictory personality structure, with distinct states of mind that are activated at different times and which are functioning at cross-purposes with regard to each other; sometimes they even lack conscious awareness of each other. For example, one part of the personality may long for a satisfying life, connection with others, positive experiences, and healthy adaptation, while other parts are stuck in continually reliving the emotions and self-doubts of the worst moments of the person's past. Difficult life experiences, especially during childhood, can prevent healthy personality integration; instead, children living in adverse circumstances may develop different and separate parts of the personality--different self-states--which may or may not be fully aware of each other, and which may have different purposes, functions, values, agendas, histories, perceptions, and predictions about the anticipated future--resulting in much confusion and a helpless unhappiness in the client. This type of confusion and unhappiness is typically the reason a person is motivated to pick up their phone and call a therapist for an appointment." (EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation).
Some events are buried in our subconscious—out of current awareness—and only come forward with the help of trained professionals. Sometimes people are surprised to find what forgotten events in their past their current symptoms are coming from. A resource helpful in identifying these kind of traumas is Francine Shapiro’s Getting Past Your Past.
To read more about a type of therapy that specifically targets and resolves trauma read “The Past is Present” — An Introduction to EMDR.”
To watch a video I created to help people think about their current source of distress from a trauma perspective click the link below:
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