WHAT IS PSYCHOLOGICAL TRAUMA-PTSD AND DISSOCIATION?
Psychological trauma can be understood as the distressing direct experience (either short or long lasting) of an event that is experienced as being exceptionally threatening to our physical and/or psychological survival and that can shatter our sense of security and safety. To put it simply, it is a threatening experience that is either too much, too fast, too soon, or for too long so that it overwhelms our body’s ability to recover and reach stability. Psychological trauma can cause severe emotional and bodily distress in the totality of our central and peripheral nervous system (our brain, spinal cord and all major organs) that can create a sense of helplessness, often accompanied by feelings of intense fear, pain, confusion and insecurity.
Psychological trauma can be caused by a wide variety of often sudden or unexpected events such as: traffic accidents, serious injuries, sexual abuse and rape, terrorist attacks, war, violence and torture, the unexpected or violent death of a loved one, serious harm or threat of death, suffering or witnessing domestic violence, injury experienced by a family member, separation from parents, life threatening medical conditions or medical procedures (e.g. surgery), physical and/or emotional abuse, childhood neglect, natural disasters (e.g. hurricanes, earthquakes, floods), or witnessing someone else being traumatised. It can also be caused by ongoing, relentless, chronic stress and anxiety, such as enduring deprivation, living in a crime-ridden neighbourhood, battling a life threatening illness, or living in a war zone, military combat area or a concentration camps.
Psychological trauma is also often caused as a result of developmental trauma, that is, traumatic experiences that were repeated often during childhood (often interpersonal in nature and happening within a close relationship with someone well known). This can include abuse and adverse childhood experiences that were chronic and cumulative such as sexual abuse, physical abuse, physical and emotional neglect, living in care (adoption or foster care). It can also include witnessing domestic violence, parental substance misuse, separation or incarceration, or mental illness. Developmental trauma can also be caused by harassment, embarrassment, abandonment, abusive relationships, rejection, co-dependence or bullying. Additionally, long-term exposure to situations such as extreme poverty, in particular during childhood, have the potential to cause psychological trauma.
Developmental trauma (sometimes called ‘relational trauma’) is the most common form of trauma and often has a pervasive effect on the development of identity and the self during childhood and adolescence. Developmental trauma shapes adult identity in such a way that the sense of self is often shattered, which often results in low self-esteem and confidence, self-loathing and self depreciation. What it is more, developmental trauma has a much more pervasive and long range influence on people’s self-concept, on their sense of the world and on their ability to regulate their emotions, because it happens during a period where the child’s brain hasn’t fully developed. People that have experienced developmental trauma during childhood therefore often develop distressing problems as adults and/or have poor mental health.
It is worth mentioning that nobody can choose whether a distressing or threatening childhood experience or event will be experienced as traumatic or not. It depends on the nature of the actual event, how long it lasted, how you were able to cope with it at the time, the resources that were available to you, how others (in particular parents) around you responded and coped, the after effects and further consequences of the event, your age and level of understanding when it happened, and other factors outside of your control.
SYMPTOMS OF PSYCHOLOGICAL TRAUMA, PTSD & DISSOCIATION
Trauma can affect people in many different ways. Overwhelming traumatic life events or experiences of unrelenting stress can have a profound and lasting psychological and physical effects. It is quite common for some people to have a fragmented sense of self, to feel their self-efficacy impaired, to have a damaged sense of safety and trust, as well as often having difficulties with regulating their emotions. In cases of developmental/relational trauma, people’s ability to relate to others (friends, partners/colleagues) may be impaired and they may therefore experience attachment difficulties, in particular when it comes to creating and maintaining meaningful and intimate relationships. It is not uncommon for people trauma to resort to drugs and alcohol as a way of self-medicating or to escape the symptoms of trauma. However, this can often result in the development of various addictions, which in the long run only makes the symptoms harder to deal with.
Post-traumatic stress disorder (PTSD) is a general term, which is often used to describe the symptoms that some people experience after having been traumatised, in particular in war zones. Some people also have recurring experiences of the trauma (both in their bodies and minds). They might develop a range of symptoms such as flashbacks and nightmares, especially when they are exposed to situations and events that remind them of the original traumatic experience. Additionally, their autonomic nervous system might be constantly on alert, which may cause them to be in a state of hyper-arousal and hyper-vigilance, causing them to feel constantly irritable and reactive or jumpy, as well as causing regular panic attacks for some people.
Dissociation or Dissociative Identity Disorder (DID) is another term used to describe one or the possible symptoms from having experienced repeated traumatic incidents, especially during childhood trauma. Dissociation, which can happen either with or without the development of PTSD, is characterised by a sense of detachment and disconnection from ones’ mind and body and/or from the world around you. There is often a feeling of things and the self being unreal (derealisation) or not being quite right. There is also a sense of emotional numbing and a general sense of being unable to connect with emotions (positive or negative), often accompanied by a feeling of ‘inner emptiness’. Another symptom of dissociation can be a temporary dissociative amnesia where you may have ‘gaps’ in your memory or not be able to remember what just happened, or significant events or people. It is very important to note that dissociation is an entirely normal response as one way our body protects us from the emotional, psychological or physical pain of traumatic overwhelming experiences, by ‘switching off’ consciousness and cutting off the information from the conscious mind. Simply put, it is a way of surviving something that could otherwise be too painful or threatening to bear.
Summarised below are some common symptoms of PTSD and dissociation:
Psychological symptoms (mind)
- Anxiety and fear, panic attacks, agoraphobia, being easily startled
- Anger, irritability, rage and mood swings
- Confusion, difficulty concentrating
- Shock, denial, or disbelief
- Guilt, shame, self-blame
- Isolation and withdrawal from people and social situations
- Feeling sad, depressed, helpless or hopeless
- Dissociation and feeling disconnected from your feelings/body or feeling numb and empty
- Addictions and substance misuse
- Impulsivity and risk taking behaviours
- Obsessions and compulsivity
- Edginess and agitation
- Having a constant sense that you are in danger and being constantly watchful or on guard
- Self-harming or regularly contemplating or attempting suicide
- Hearing ‘voices’ (not the same as psychosis)
- Having a sense of being someone else or being nobody
- Having difficult managing emotions
- Having difficulty exposing positive emotions or finding pleasure
Physical symptoms (body)
- Insomnia, poor sleep, nightmares
- Fatigue, exhaustion, chronic fatigue syndrome
- Racing heartbeat
- Have a range of unexplained medical symptoms (e.g. chronic pain, severe fatigue)
- Aches and pains, muscle tension
- Severe migraines
- Sexual difficulties
- Gastrointestinal problems (IBS or Crones disease)
- Digestive issues
- Skin problems
- Autoimmune diseases
- Tinnitus (ringing in the ears) and hyperacousis (increased sensitivity to everyday sounds)
People that experience many of the symptoms above can also be affected by various psychological difficulties such as: dissociative disorders, anxiety and depressive disorders, personality and mood disorders (e.g. bi-polar disorder, borderline personality disorder), disorganised attachment disorders, attention deficit hyperactivity disorder, obsessive compulsive disorders, addictions and substance misuse.
If you believe that that you have experienced trauma and you are affected by some of the symptoms above, I want you to know that there is no reason to suffer alone and that there is a way to heal yourself.
The trauma that you have experienced is not who you are; it is something that has been done or has happened to you. You do not need to continue suffer in silence ; change is possible and I will be honoured to work with you to help you to recover and heal from trauma. I offer psychotherapy for trauma, PTSD and dissociation in Wiltshire and online.