There is no universally agreed upon definition of trauma because what may feel traumatic to one individual does not mean another individual will have a similar response. I often find myself referring to Gabor Mate’s definition of trauma,
“it is not merely the bad things that happen to us, but what happens inside us as a result of those bad things. Trauma is psychological wound that leaves an imprint on the mind and body, affecting how we perceive ourselves, others, and the world around us. Trauma is not just the event itself but the emotional and physiological responses that follow, disrupting our sense of self and well-being.”
Trauma can disrupt our perception, our values, our aspirations, our life directions, our relationships, our self of self; all this and without our awareness.
Understanding Trauma
We understand trauma can manifest in a combination or isolated form, such as emotional, physical, and psychological. These forms can change over time or be stressor dependent.
- Emotionally, trauma can manifest as emotional dysregulation, anger, aggression, agitation, liable emotions (from sadness and crying to anger and back quickly).
- Physically, trauma can show up in physical ailments, illness, auto-immune disease flares, unexplainable pain and physical symptoms, chronic pain, headaches, sleep disturbances/difficulties, fatigue, nausea and vomiting.
- Psychologically, trauma can look like hypervigilance, depression, anxiety, dissociation, derealisation, depersonalisation, avoidance, tangential speech, forgetfulness, attention deficits, “scatteredness”, and disoriented.
Although trauma is largely the emotional and physiological disruption to our sense of self following single incident trauma events, what about reoccurring trauma or Adverse childhood experiences?. It is the same principle but instead of a single event, it is often a repeated patten of behavioural responses (our brain’s inbuilt protection system kicking in) – this type of trauma is complex. Hence why the ICD-11 refers to it as Complex-PTSD – the DSM-5-TR will catch up.. eventually.
Diagnosing Trauma
Whether you have experienced a single incident trauma, several single incident traumas, long term repeated exposure to traumatic events or adverse childhood experiences, the predisposed risk of developing mental health challenges are increased significantly. While we do have several diagnostic labels for varying trauma exposure, it is important to know many individuals with trauma exposure experience other mental health symptoms by proxy to their trauma experience. Some of the more common difficulties patients with trauma exposure typically present to therapy for include:
- PTSD and C-PTSD
- Depression
- Anxiety
- Substance use/misuse
- Emotional dysregulation
- Sleep disturbances
- Chronic pain (unrelated to injury or illness)
- Relational difficulties
Whilst trauma is a deeply personal experience, and this is why a universal definition is not widely endorsed, because trauma affects every person differently. Some behavioural scientists use different language to define trauma between little T and big T trauma. However, no matter what definition you resonate with or not, you are the only person who can define what was a traumatic for you.
How Can a Psychologist Help?
Psychologists play a crucial role in the treatment and management of trauma, including delivery of evidenced-based interventions to process and recover from traumatic experiences. Psychologists conduct comprehensive assessment and can diagnose trauma-related mental health conditions such as Post Traumatic Stress Disorder (PTSD), Complex- PTSD, and Adjustment Disorder, to name a few.
Psychologists are highly trained in treatment planning, delivery of therapeutic interventions, stabilisation, crisis intervention, and long-term care. While these points are general to the nature of work psychologists do, they are critical to consider when seeking support for trauma exposure.
When to Seek Help?
There is no right or wrong time to seek help after being exposed to a single incident traumatic event. The research shows debriefing and talking about it sooner than later can reduce the likelihood of developing PTSD. However, that is not always the case. We have compiled a few questions below that you may use to think about if you are unsure what impact trauma may be having on you.
- If you are experiencing distressing thoughts
- If you have noticed a change in your alcohol intake or substance use
- If you have noticed a change in your sleep patterns, appetite, or mood
- If difficulties are arising in different parts of your life, work, school, home, relationships
- If you feel like you are constantly walking on egg-shells or hypervigilant
- If you are experiencing re-current flashbacks or distressing mental images, or distressing dreams/nightmares
If any of these resonate with you, have a discussion with your GP about a referral to a psychologist. You may be eligible for a Medicare Mental Health Care Plan for a rebate on your sessions with your psychologist.
If you are in crisis or concerned about your welfare or the welfare of someone you know – present to your emergency department immediately or call triple zero.
Engaging with a psychologist can be daunting for the first time, and you may have to try a few to find one that suits you, this is referred to as a therapeutic relationship and it is crucial to effective therapeutic outcomes.
Why is the Therapeutic Relationship Important?
Therapeutic relationship is collaborative in nature and central to effective therapeutic outcomes. The therapeutic relationship is built on several key elements including, trust, respect, confidentiality, non-judgement, communication, support, and consistency.
So why is the therapeutic relationship related to trauma processing you may ask, well…. Trauma processing to some degree or another will require patients to recall a distant memory or partial memory of the traumatic experience. If you do not have a good therapeutic relationship with your psychologist prior to starting processing work, you may experience more harm than help, thus leaving you unable to fully integrate the trauma processing work or in a heightened state of distress.
The therapeutic relationship is a two-way relationship, while it is expected this relationship with go through ebbs and flows as you move through your therapy process. Your psychologist should welcome discussion about any challenges faced in the therapeutic relationship over the course of therapy.
What About Therapy Modalities?
There are over 250 therapeutic modalities that psychologists can train in and practice, many of them are supported by evidence and peer reviewed research. Currently, the gold standard approach for trauma processing is Eye Movement Desensitisation and Reprocessing (EMDR). EMDR is a highly effective treatment for trauma but as always it will not be suitable for every individual.
What about Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Mindfulness-based Therapy, Exposure Therapy, Internal Family Systems, Structural Dissociation, Gestalt, Psychedelic-Assisted Therapy, Art Therapy, Equine Therapy, Somatic Therapy – This is not an exhaustive list, and the full list is truly endless, you will find varying arguments for which modality is better and why.
However, the efficacy of therapeutic modalities for trauma processing is dependent on how you as the individual responds. There is far more to trauma work than therapeutic modality alone, consider some of these questions below:
- Do you feel a sense of safety with your psychologist?
- How often can you see your psychologist?
- How well do you connect with your psychologist?
- How comfortable do you feel with your psychologist?
- Can you tell your psychologist when you are uncomfortable?
- Are you invited to, or do you give feedback to your psychologist about what is and isn’t working?
TLDR; Summary
In summary, trauma is an internal and personal experience to an external event that can significantly increase our predisposed risk of mental health challenges. Trauma can manifest in many different ways, emotionally, physically, and psychologically while disrupting our sense of self. But there is help available, psychologists are highly trained to work with trauma presentations and challenges. There are multiple types of therapeutic modalities that are effective for processing trauma, however, the therapeutic relationship is one of the single most important factors in effective therapeutic outcomes. Recovery from trauma exposure is possible with the right support.
If you or someone you know is struggling following a traumatic experience or has a history of trauma exposure, contact our Administration Team at Conscious Mind Centre to book an appointment with one of our psychologists.
- Contact your GP to see if you are eligible for a Medicare Mental Health Care Plan
If you are in crisis, or concerned about risk of harm to yourself or someone else – present to your nearest emergency department immediately or call triple zero.
If you need to speak with someone outside of office hours – contact
- Lifeline 13 11 14
- Beyond Blue – 1300 224 636
- YARN – 13 92 76
- MATES 24/7 – 1300 642 111