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Trauma and posttraumatic stress disorder

Thursday, May 2nd, 2013

“Trauma can be thought of as anything that exceeds one’s ability to cope” (Maltby and Hall, 2012). We tend to think of trauma on a continuum of severity. We might conclude that a serious accident is more traumatic than a fender-bender. The Boston Marathon bombing is more traumatic than a burglary where no one is injured. Being raped is worse than being touched inappropriately by a relative on a random occasion.

I suppose in some sense this is true. Worse crimes receive more severe punishment. When outside the traumatic experience, we assign degrees of severity and thus degrees of expected response in those who are traumatized. However, life is much more complex than that, and individual dynamics and perspectives significantly shape the impact of traumatic events on individuals. The majority of combat veterans still manage to come home without suffering from Posttraumatic Stress Disorder (PTSD). About half of rape victims manage to come through what may be the worst form of trauma without developing PTSD. The reasons for this are both manifold and sketchy. We are complex beings, and clarity about such things does not come readily. Do your research and you will learn a great deal about various views on why trauma sometimes leads to PTSD and sometimes does not.

An area where we do have increasing clarity relates to the notion of complex trauma, or the impact of chronic exposure to trauma. We have long known that the body releases stress hormones known as glucocorticoids when we experience traumatic events. Although this is wonderfully adaptive in the short run (it gets you to ‘hunker down’ and cope when facing a traumatic event or moment), continued trauma can result in a continued wash of glucocorticoids and actual damage to hippocampal neurons. The traumatized individual can end up with elevated baseline levels of stress hormones and abnormal rhythms of hormone release.

Keep reading. I think I can say this in a way that makes sense and can be useful to you.

When we experience chronic trauma we sometimes end up with a compromised hippocampal region of the brain, and this results in a compromised memory system. Memory includes not only what you consciously remember, but also what you unconsciously remember. You know some things deep down inside that you don’t consciously have access to, and those memories (reactions or responses to trauma) create a filter through which you live your life and engage in your relationships. The curse of this is that you aren’t even aware or able to be aware of that internal filter until after it has been triggered.

That is why those of you who have been traumatized sometimes find yourself suddenly flooded with anxiety, a pounding heart, sweaty palms, difficulty breathing, and an overwhelming sense of danger while having no idea why. Then, after the sudden flood of discomfort, you sometimes realize that something in your environment triggered you or set you off. Maybe it was something on a TV show that reminded you of a past traumatic event. Maybe a color, a smell, or a type of clothing is what sent you into a reactive place. From a brain perspective, your implicit memory (a damaged hippocampal region of the brain that develops into a distorted memory filter) leads to a distorted personal story by which to live. You are changed by the trauma – changed psychologically and changed neurologically.

You can learn to live with your history of trauma and its impact, and to live in a healthy and adaptive way. There is no quick fix to a history of trauma and its impact, but there is great help available when you engage in a therapy relationship with a counselor or psychologist who is skilled in understanding trauma and in helping people come to terms with and overcome their history of trauma. There is hope.

Don’t beat yourself up for not being able to manage as well as you think you should when you have a history of trauma. Your brain has taken a hit and the very systems in your brain that are meant to work in your favor to help you cope may be so impacted that you are in need of help.

The good news is that help is available. PTSD is treatable, and many people respond very well to psychotherapy processes that treat PTSD. Seek out a good therapist who knows about PTSD and the treatment of trauma and get your life going in a more positive direction. Don’t let a history of trauma shape your personal story. Maybe it’s time for you to write a new chapter.