What is trauma? A Broad perspective on Trauma and How we work with it
I sat down, trying to plan for this blog post and quickly realised that this is not going to be easy. In my mind, I was conflicted, on one side, hearing my Uni lecturers urging me to “be concise” and keep to the word count, while also on another side, holding the tension that this is a HUGE topic, that has been a specialisation for me and so has consumed my professional development and learning over the past decade and also one that is so broad and hard to cover well in just a few words. Way to go Vanessa, setting a terribly high bar for yourself. So, I did some cognitive reframing, decided to unburden myself with expectation and instead, try and do the best I can while also including this disclaimer: the following blog post is not a comprehensive coverage of this topic but rather, a broad overview of what trauma is, how it affects us and how we work with this at Our Wellness Collective. My hope is that this demystifies trauma as you read, that it provides clarify and simplifies your understanding of a very big topic. Breaks are recommended!
Broad lenses first: The definitions
What is Trauma and Complex Trauma?
Trauma is a term used to describe the psychological wound or injury that occurs when we go through an event or experience that is more overwhelming to us than we have the capacity to cope with at the time. This event could be a single event trauma, or a repeated experience which would create what is known as complex trauma. It can also occur from an experience we perceive as harmful or deeply threatening, it does not need to be a fact as for the brain, perception is reality.
To differentiate a little, complex trauma gets its complexity marker because of the repeated, prolonged exposure to traumatic events or in other terms the continuous persistent experience of trauma that doesn’t have a clear start, middle and end – think of it like a cumulative effect of living through multiple traumas. When we have this complex trauma experience, we can develop (though not always) Complex Post Traumatic Stress Disorder (CPTSD) and/or PTSD. Think of this as the nervous system’s wear and tear reaction following such intense continuous emotional duress.
Trauma is deeply disruptive to a typical brain functioning and development, it sets up neurologically a persistent sense of danger in the brain, leaving people in a constant state of hyper-vigilance, feeling on edge and unable to trust themselves or others and to feel safe in the world.
A key note, when it comes to trauma and the brain is that, no two people will have the same reactions. Two people can experience the same distressing events in feature, duration, etc. but only one be left with sequelae into their future. Trauma is really a case-by-case occurrence and understanding it cannot be done without keeping the person with trauma at the forefront of our mind, holding them with grace, understanding and compassion first.
How does Trauma occur?
Rather than focusing on the modes in which trauma is transmitted or trauma occurs, I would like to look at two concepts first: explicit and implicit trauma. These concepts are important in understand how trauma is processed, stored and recalled from memory in the brain. This understanding is important as clarity here enables us to recognise how the specific trauma affects a person, which then allows us to work out the best therapeutic option for them. If trauma is anything that is overwhelming beyond our capacity to process it, so - too much, too soon too fast for our nervous system to handle - then it becomes locked in our bodies, our memories and our minds. These two concepts then are a way to understand how this information is accessed, or locked inside our minds, bodies and memories and how it comes out whether voluntarily or reactively.
Explicit trauma describes traumatic memories of events or situations that we know and remember or have a tangible concrete frame around. They are experiences we can recall in great detail and are able to talk about/write about in a narrative (storytelling) way. We are consciously aware of these things happening in our lives and can give information about the where, when, who, what. Think of this as the big bad things that we think of as traumatising, things like: Physical or physical abuse, domestic and intimate partner violence, environmental disaster, pandemics, car accident, terminal illness. The big “T” trauma.
Implicit trauma describes traumatic memories of events or situations we do not necessarily remember but might see come up through our bodies or our senses. They may show up as physical memories (somatic memories) or emotional, behavioural patterns of reactions without a clear cause that we can make sense of. These tend to be stored in our limbic region, or in the threat response part of our brains (the amygdala) and might become activated without a conscious direct cause that we are aware of (like a sudden feeling of panic, rage, hopelessness, despair, fear without a direct cause or a logical cause). Think of this as the minor “t” trauma. Experiences that result in implicit trauma are subtle and so often dismissed but they can be pervasive developmentally which can result long term challenges. The types of things that can lead to implicit trauma are chronically, feeling unheard or unseen, being chronically dismissed, social or individual rejection of parts of yourself, chaotic and inconsistent environments in early life, parentification or caregiving responsibilities that are mismatched with developmental stage. The hardest part for those with implicit trauma is that they don’t have an experience of anything “that bad” happening to them and so they often live in a dissonance and uncertainty about their own lived experience.
Zooming in: Applications and Implications
How does trauma or complex trauma impact us?
As I mentioned above, trauma interrupts or disrupts the typical neurobiological development of the brain, in other words trauma changes the brain. Research into the impacts of trauma on the brain shows that there can be structural functional changes in the brain due to the way trauma seems to alter/disrupt or reorganise multiple areas in the brain at the one time. Good news is, through research as well, we now also know that neuroplasticity means that the brain can be changed multiple times and so healing post trauma can also create tremendous growth and increased capacity.
When we have experienced trauma especially in early life (see our blog post about dysfunctional family trauma), it can show up as internalised trauma or externalised trauma. Trauma breaks down our relationship with ourselves and our inner connectedness, our life source and our sense of internal integrity and it also breaks down our relationship with others and our sense of connectedness with the outer world, our community and sense of belonging with others.
This means that we can have difficulties in building trust in relationships, belonging and connectedness and a feeling of safety in the world and we can struggle to form secure attachments, regulating emotions (feeling our emotions too much or not enough) or forming a clear sense of self (differentiated self) in relationships. This can look like people pleasing behaviours or controlling and manipulative behaviours in relationships, it can be poor boundary setting or poor boundary keeping, it can be a low self-esteem or a pervasive sense of shame and fear leading to an inflated grandiosity and ego. It can be intense unstable emotions leading to mood disorders and personality disorders or more commonly, persistent depression, anxiety, hopelessness and despair, guilt and shame, anger, sadness, hypervigilance and chronic stress that breaks down our immune systems and cause our bodies to attack themselves.
What happens to us when we’ve been through trauma?
When we have been through trauma, we can experience a pervasive disconnection from our own thoughts, feelings, body and our own identity (who I am in the world) – also known as dissociation. We can also exist or move through our lives in a fragmented way, like scattered pieces of a bigger whole that are detached one from the other as a coping mechanism to manage the intense distress caused by trauma.
The good news as I mentioned is that trauma is treatable. The brain can always be changed and rewired, and we can and do heal. Beyond trauma treatment, we can live wholehearted lives and be secure and regulated and feel safe. The road there can be challenging take a long time and be slow but with the right information, the right support starting with connection with a trauma-informed practitioner, lifestyle changes and re-connection to ourselves, our lives, our sense of meaning and purpose, others – healing is possible.
Focusing in: What can we do about trauma?
How do we heal
There are so many different options and suitable pathways to heal trauma. In a nutshell, the most important part of healing is reconnecting with our self and with others and then with the broader community and world. For complex trauma, we become disconnected relationally and so it stands to reason that reconnection needs to also be relational. This is why building a safe, trusting connection with your trauma informed therapist is key to healing, it’s how we are seen and then can learn to see ourselves again and from there, we heal.
Second to connection in terms of what I believe are priorities in trauma treatment, integration. Another metaphor I like to use here for integration is the image of a bridge, integration is a process of building bridges between all the disconnected fragments of our life story. It is putting together the conflicting parts of our remembered story into one cohesive narrative; it is integrating the part of the brain that understands the trauma (the left brain/logic brain) and the part of the brain that feels the trauma (the right side/feeling brain). I do really believe that the more we can learn about the brain, how it works, what is normal and what is abnormal and how to understand our symptoms in the right context, we are able to remove, the confusion, fear and stigma that surrounds trauma and trauma healing and move away from a pathology lens and move towards a more adaptive, social model of well-being.
Adjusting our lenses – widening our view
In terms of therapy option – my recommendation is always this AND that, rather than a this OR that approach. A crucial part of healing is exploration, it is curiosity, discovery and openness. Sometimes, there might be wisdom in starting with one approach at a time so as not to overload our own nervous systems, however, there is no one size fits all as mentioned. Culturally responsive, trauma informed, and evidence based are some key components of safe trauma practice. Trauma-informed without cultural responsiveness become unsafe for those marginalised by this exclusion. I can speak more on this in future blogs however, my post would be incomplete and inauthentic without this element being mentioned when it comes to treatment planning and treatment options for people from all backgrounds and diversity. Our cultural backgrounds matter, our languages and personal and collective histories matter and our communities’ experiences matter, we need to bring this wholeness into treatment otherwise reconnection can only ever be partial which in and of itself is retraumatising.
Capturing Our Collective approach: Stabalistation, Education, Integration, and Collaboration
How we work with trauma
Some of my most recommended treatment modes for trauma are trauma informed, evidence-based methods of healing that are proven to be effective in helping people reconnect and integrate trauma and create or build a sense of hope for the future.
Rather than a single mode of trauma techniques recommended, our approach is to use a trauma informed stabilisation treatment (TIST) a structured, gradual healing process that focuses on stability first and integration next. This is the slow and safe method. From this foundation, we then branch off into various techniques such as, Internal Family Systems Therapy, Emotion Focused Therapy, Narrative and Narrative Exposure therapy, Jungian Depth Psychotherapy, Trauma informed CBT, Dialectical Behaviour Therapy, Somatic Experiencing and body-based Trauma Releasing techniques and mindfulness-based, stress reduction approaches as well as solution focused psychotherapy.
We also collaborate with many aligned practices that offer what we do not have capacity or resources to offer but that we highly celebrate like, trauma sensitive movement and yoga, expressive art therapy or music therapy as well as assistive animal therapy or even integrated EMDR or Brainspotting. In many cases, medication is required and in other cases body supportive nutritional supplementation is more suitable. Group therapy has also proven really effective in assisting people to form some connections with others and re-engage slowly and learn trust and safety through practice for those practical learners this would be really valuable.
Some finishing thoughts –
“During bad circumstances, which is the human inheritance, you must decide not to be reduced. You have your humanity, and you must not allow anything to reduce that.” – Maya Angelou
In a world that is increasingly disconnected, trauma and trauma healing can feel incredibly isolating – my hope as you read and heal is that you might capture the main message – we are broken down in relationships, but we heal in them too. We need each other in order to grow, to change and to reconnect so let’s build the courage to lean in again, and risk it all
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Author: Vanessa Bendikov
CLINICAL PSYCHOTHERAPIST | SUPERVISOR | DIRECTOR
