The experience of having lived (or living) in trauma is probably the number one reason that brings people to psychotherapy.
The word “trauma” is used to describe experiences or situations that are emotionally painful and distressing, and that overwhelm people’s ability to cope, leaving them feeling powerless. Trauma has sometimes been defined in reference to circumstances that are outside the realm of normal human experience. Unfortunately the definition doesn’t always hold true. For some groups of people trauma can occur frequently and become a part of the common human experience.
There are two types of trauma – physical and mental.
Physical trauma includes the body’s response to serious injury and threat. Mental trauma includes frightening thoughts and painful feelings. They are the mind’s response to serious injury. Mental trauma can produce strong feelings. It can also produce extreme behavior; such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that event is reoccurring).
A response could be fear. One could fear that a loved one will be hurt or killed. It is believed that more direct exposures to traumatic events causes greater harm. For instance, in a school shooting, an injured student will probably be more severely affected emotionally than a student who was in another part of the building. However, second-hand exposure to violence can also be traumatic. This includes witnessing violence such as seeing or hearing about death and destruction after a building is bombed or a plane crashes.
People cope with trauma in various ways, although there are some common coping strategies that are typically associated with better posttraumatic adjustment. For example, it is helpful to obtain comfort from loved ones, talk with friends and loved ones about their experience, find respite from daily demands, and engage in forms of relaxation (e.g., naps, walks, quiet time, and meditation). The other thing to keep in mind is that the old adage about “time healing all wounds” is mostly correct. Intense fear, anxiety, and the pain of remembering something awful will gradually decrease over time. Surprisingly, most people are able to return to their normal routines in about a month.
A small percentage of people suffer from intense emotional or physical distress, called acute stress disorder (ASD), which typically occurs in the first month following a catastrophic event. Individuals may be suffering from posttraumatic stress disorder (PTSD) if the problems remain or become worse and if the problems go beyond 1 month.
Complex Trauma
The majority of people who present to services with trauma-related problems have multiple unresolved traumas (complex trauma) which often leads to severe, diverse and persistent impacts. Complex trauma can be caused by:
- Childhood abuse in all its forms as well as neglect and growing up with family violence or dysfunction.
- Any form of violence experienced within the community – civil unrest, war trauma, genocide, cultural dislocation, sexual exploitation or re-traumatization of victims later in life can also cause complex trauma.
In complex trauma the traumatic stressors are usually interpersonal – the trauma is premeditated, planned, and often repeated and prolonged and the impacts are cumulative.
Exposure to child abuse and neglect can lead to a wide range of adverse consequences that can last a lifetime. Child abuse is the most bitter betrayal. A child, helpless and unable to make fully informed choices, present strong resistance, or pursue a safe escape, has a right to expect adult protection and support. Child abuse, whether through violence, emotional abuse, or sexual molestation, breaks faith with the obligation owed to all children. When abuse happens to a child, it is imperative that efforts be made to provide new security for a child, and then to heal the damage done as humanly possible.
The different kinds of abuse can be experienced as a child or as an adult. Neglect of basic needs and physical or emotional abandonment for a child are as devastating as physical abuse. Long term consequences of childhood abuse include:
- mental health problems
- physical health problems
- eating disorders and obesity
- suicidal behavior
- difficulty in relationships
- re-victimization which includes becoming involved in abusive relationships
- risky sexual behaviors
- aggression, violence and criminal behaviors
- addictive behaviors including alcohol, drugs, gambling, or sex
- homelessness
Types of Abuse:
Physical Abuse: Standing over you, getting “in your face,” blocking a doorway, grabbing you if you try to leave, kicking, punching, biting, slapping, choking, threatening to harm you, using weapons, throwing things, breaking things, punching walls or doors, driving recklessly, burning, cutting, pulling hair, stabbing, strangling, tying or confining you, preventing you from seeking medical care, murder, touching your body without permission, intimidating you with the threat of violence such as driving too fast.
You might think that because some other member of your family was receiving the blows you are not a victim of physical abuse . . . if the underlying fear is, “When will it be me?”, you are a victim too.
Sexual Abuse: Rape, unwanted sexual touching, vulgar comments, pressure for sex using coercion or guilt, forcing you to have unprotected sex, forcing you to get pregnant or to have an abortion, sexting, forcing you to have sex with other people or to watch your partner have sex with someone else, forcing you to use or participate in pornography.
Whenever an adult is being sexual with a child, it is abusive to the child. Physical sexual abuse is bodily sexual activity with a child or touching in a sexual way. It includes: intercourse, oral sex, anal sex, an adult masturbating a child or having a child masturbate an adult, sexual hugging, sexual kissing, and sexual touching. Inappropriate seductive behavior by a parent toward a child, or any adult toward a child, an adult sharing explicit sexual information with a child (which only serves the adult and not the child), teasing the child during maturation, and making the child into a surrogate spouse.
When the perpetrator is a family member it is called incest, and when it is a non-family member it is called child molestation.
Many people who have been molested or experienced incest feel responsible for what happened, feel that they caused it to happen or wanted it to happen. I have also heard clients express acceptance since it was the only kind of attention that they received. You are not responsible and it is not acceptable behavior. A child will not seek out sexual encounters except what may be age-appropriate sex play with other children. It is the adult’s responsibility to set appropriate boundaries and protect the child.
Emotional Abuse: threats, isolation, manipulation, insults, destruction of property, public humiliation or embarrassment, accusations of affairs, threats of suicide, self injury, or homicide if you leave, put downs, intimidating you, talking down to you, not listening to or respecting your feelings, making threats, being jealous, possessive, controlling; excessive or threatening texts, wanting access to your messages, email, social media, spying, checking up on you, accusations of cheating, making you feel like you need to justify yourself, giving you no privacy, shaming you for your sexual orientation.
Verbal Abuse: Yelling, screaming, shouting, swearing, continuously arguing, interrupting, talking over you, put downs, using loud and threatening language and tone to cause fear, name calling, intimidating you, mocking you, abusive language, telling you that you are worthless, telling other people that you are crazy, blaming you for the abuse, or witnessing someone else receive verbal or any type of abuse
Insults, put downs, intimidating you, embarrassing you in public, talking down to you, not listening to or respecting your feelings, making threats, being jealous, possessive, controlling; excessive or threatening texts, wanting access to your messages, email, social media, spying, checking up on you, accusations of cheating, making you feel like you need to justify yourself, giving you no privacy, shaming you for your sexual orientation.
Financial abuse: includes controlling all income, giving an allowance, taking your money, or running up debt under your name, opening up a joint account but you don’t have access, not letting you work or forcing you to leave your job, forcing you to get fired, shaming you for how you spend your money, not allowing you to get an education, putting all the bills/credit cards in your name, preventing you from using a car.
Mental Abuse: Playing mind games with you, twisting everything around so nothing is their fault and all of their behavior was caused by something you did or didn’t do, accusing you of doing things that they are doing, lying, manipulating you for control or sex, distorting reality so you think you are losing your mind.
Spiritual/Religious Abuse: Spiritual abuse occurs when the parent is so rigid that they are the final word in everything. The child is not allowed to have their own desires, wants and needs; it must coincide with what the parent wants and needs, there is no room for questions or alternative thought. Religion can be used to scare and control, which is abusive. If you recall the Brian De Palma movie, Carrie, it is a good example of religious addiction; the mother’s religion controlled Carrie’s life and did not allow for alternative thought or experience.