Trauma and PTSD
“Fairy tales do not tell children the dragons exist. Children already know that dragons exist. Fairy tales tell children the dragons can be killed.” ― G.K. Chesterton
We all use the word “trauma” in every day language to mean a highly stressful event.
It is an individual’s subjective experience that determines whether an event is or is not traumatic.
Psychological trauma is the unique individual experience of an event or enduring conditions, in which:
- The individual’s ability to integrate his/her emotional experience is overwhelmed, or
- The individual experiences (subjectively) a threat to life, bodily integrity, or sanity. (Pearlman & Saakvitne, 1995, p. 60)
Thus, a traumatic event or situation creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death, annihilation, mutilation, or psychosis.
The circumstances of the event commonly include abuse of power, betrayal of trust, entrapment, helplessness, pain, confusion, and/or loss.
It includes responses to powerful one-time incidents like accidents, natural disasters, crimes, surgeries, deaths, and other violent events or responses to chronic or repetitive experiences such as child abuse, neglect, combat, urban violence, concentration camps, battering relationships, and enduring deprivation.
“It is the subjective experience of the objective events that constitutes the trauma…The more you believe you are endangered, the more traumatized you will be…Psychologically, the bottom line of trauma is overwhelming emotion and a feeling of utter helplessness. There may or may not be bodily injury, but psychological trauma is coupled with physiological upheaval that plays a leading role in the long-range effects” (p.14). Jon Allen, Coping with Trauma: A Guide to Self-Understanding (1995)
Summary
Psychological effects are likely to be most severe if the trauma is:
- Human caused
- Repeated
- Unpredictable
- Multifaceted
- Sadistic
- Undergone in childhood
- And perpetrated by a caregiver
Abuse survivors may meet criteria for diagnoses of:
- substance dependence and abuse,
- personality disorders (especially borderline personality disorder),
- depression,
- anxiety (including post traumatic stress disorder),
- dissociative disorders, and
- eating disorders, to name a few.
PTSD is the only diagnostic category in the DSM that is based on etiology.
Symptoms as Adaptations: re-experiencing
The traumatic event is over, but the person’s reaction to it is not. The intrusion of the past into the present is one of the main problems confronting the trauma survivor. This intrusion may present as distressing intrusive memories, flashbacks, nightmares, or overwhelming emotional states.
Survivors of repetitive early trauma are likely to instinctively continue to use the same self-protective coping strategies that they employed to shield themselves from psychic harm at the time of the traumatic experience e.g. Hypervigilance, dissociation, avoidance and numbing.