The Basics of Trauma
Trauma alters three primary parts of the brain: the prefrontal cortex (thinking center), the anterior cingulate cortex (emotional regulation), and the amygdala (fear center). The thinking center is located behind your forehead and is responsible for rational thought, problem solving, personality, planning, and empathy. The emotional regulation center is located next to the thinking center, and is responsible for regulating emotion, and when healthy, works closely with the thinking center. The fear center is located deep inside the brain and cannot be controlled by our conscious. It is responsible for determining what is and is not a threat, and when danger is detected, it produces fear. When trauma is present, the thinking and emotional regulation centers are under activated and the fear center is over activated.
It is key for people to understand that trauma survivors cannot just leave their trauma in the past or choose to forget about the trauma. In order to move forward, their brains need to be changed, which takes great effort, repetition, and time. Psychotherapy is the most beneficial way to bring about this result as it works with both the body and mind to help transition the brain back to a healthy state. In addition, psychotherapy aids with integration of the trauma, which can help a survivor recover key traumatic memories that his or her brain blocked out due to the intensity of the event.
If you are a trauma survivor or have a loved one who is battling with trauma, learning about the symptoms of PTSD and the phases of trauma will help inform you as you walk through this process yourself or alongside another.
4 symptoms of PTSD
The American Psychiatric Association states that to have posttraumatic stress disorder (PTSD), “a person must have experienced or witnessed an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and which involved fear, helplessness, or horror.”
The four main symptoms of PTSD are re-experiencing, avoidance, hyperarousal, and negative thoughts and feelings.
Even when the traumatic event or events are no longer present in a survivor’s life, the events have a lingering affect, which often leads survivors to feel that they are experiencing the trauma over and over again. Survivors of traumatic events re-experience their trauma in the following ways:
Triggers: Triggers are psychological stimuli that cause the survivor to recall his or her traumatic experiences. The stimulus itself does not need to be traumatic or even directly associated to the event.
Nightmares: For traumatized individuals, nightmares involve the horrific elements that were present in the trauma as well as elements associated to the trauma.
Flashbacks. Flashbacks stir up images, sensations, and emotions of the original event or events, and cause similar levels of stress and hormones in the body that the survivor had at the time of the event.
Physical Response: When reminded of the traumatic event, a survivors can experience a surge in his or her heart rate or begin sweating, which often leads to a panic attack.
Survivors of trauma who struggle with PTSD subconsciously implement avoidance techniques, so that they are not triggered as much or don’t have to think about the trauma. Some of the most common characteristics of avoidance include:
Avoiding people, places, or situations that are reminders of the traumatic event.
Avoiding conversations or feelings that bring up the traumatic event.
Busying your life to ensure that there is no time for your brain to be invaded by the traumatic event.
Hyperarousal is when a survivor’s body quickly jumps into high alert mode when triggered by his or her trauma. Imminent danger does not have to be present for a trauma survivor to feel as if it is. As a result, trauma survivors in hyperarousal mode generally have the following symptoms:
Highly irritable, with outbursts of anger.
Struggle to concentrate or remain focused for prolonged periods of time.
Jumpy, startled, and constantly on guard as if the danger is present.
4. Negative thoughts and beliefs
After a traumatic event or series of events are over, survivors are often confused, ashamed, fearful, and in shock. When the shock wears off, additional negative thoughts and belief creep in. In addition, trauma survivors generally receive responses early on that are not helpful to their healing process, which also plays into the most common elements of negative thoughts and beliefs including:
Dissociation - an experience where a survivor feels disconnected from herself or himself. With disassociation, a survivor can temporarily lose touch with what is happening, or in extreme cases, lose memories completely for prolonged periods of time.
Loss of interest in activities that were once important to the individual.
Difficulty to experience feelings or associations that are positive and beneficial.
Feeling distant from loved ones and close friends.
Phases of Trauma
Safety & Stabilization
In shock, not in a safe place to begin processing the trauma.
Feel unsafe in their bodies and with others.
Struggle to regulate and manage difficult and overwhelming emotions.
Avoid speaking about the trauma because it is emotionally overwhelming.
Need to focus on calming the nervous system by determining which areas of life need stabilization and how that will be accomplished.
Remembrance & Mourning
Processing the trauma begins by putting words and emotions to the trauma.
Focus on integration of the trauma rather than fight, flight, freeze responses through safety and stability.
Need space to explore grief and mourn the losses from the trauma.
Reconnection & Integration
Creation of a new sense of self and a new future.
Redefining meaningful relationships.
Life is not defined and organized by the trauma - the trauma is integrated into their life story.
Recognition of victimization, while taking steps toward empowerment and resilience.
Thoughts or feelings associated with the trauma can be present, but are not in control anymore.