Psychological trauma is a personal response to adversity—the word itself means shock, wound, or injury. The word originates from Greek and relates to the root “tere-,” meaning twisting, piercing, etc. In psychology, trauma refers to an “emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” This definition of trauma reveals that various external events can trigger specific emotional responses, typically following the initial shock and denial.
It is critical to emphasize the human experience of the traumatic event. Trauma is characterized by the subjective response to the event or what occurred rather than the objective event itself. Not everyone who experiences terrible events will experience trauma or severe emotional pain. The concept of trauma is particularly significant in the field of mental health. Starting from a traumatized individual’s unique life story, we can gain insights into their coping mechanisms, the subjective universe they inhabit daily, and their reliving of the past in the present.
Types of traumas
Traumas come in a variety of forms and fall into the following categories:
Acute trauma is a type of trauma where individuals can experience significant levels of distress immediately following a single event. The crucial characteristic of this type of trauma is its length. It is a short-term response to events such as car crashes, physical assaults, earthquakes, drownings, etc.
A series of events rather than a single incident, such as living in a war zone or high-crime neighborhood, defines chronic trauma, unlike acute trauma. Usually interpersonal in nature, this type of trauma involves relationships with people and can be characterized by abuse of power, emotions of betrayal, and constant stress.
Complex trauma is usually associated with multiple traumatic events. People found themselves trapped in situations such as repeated child abuse, domestic violence, and institutional abuse, with no way to escape. Further, this type of trauma can especially impact emotional development and attachment, undermining sense of safety and facilitating hypervigilance. Complex trauma can lead to the development of PTSD and borderline personality disorders.
Secondary (vicarious) trauma is often found in helping professions, such as physicians, first responders, psychologists, social workers, and law enforcement. Compassion fatigue may be the primary mechanism underlying this type of trauma. People who are vulnerable to compassion fatigue can experience acute symptoms, making them wary of caring and giving. As a result, they may experience changes in their worldview, mental health status, and sense of self.
Effects on mental health
The effects on mental health can manifest in numerous ways. Trauma impacts the amygdala, the brain’s structure responsible for identifying threats. Extremely sensitive to dangers, this area of the brain puts much effort into identifying dangers in the environment. Furthermore, it is true that the amygdala retains emotional memories associated with traumatic events, which is the key to our deep understanding of the inner dynamics of trauma—that is, the repeated reliving of the past in the present moment. Stated differently, occurrences of today could set off panic reactions in the absence of actual threat. We then link hypervigilance, excessive reactions (behavior), and emotional dysregulation to the hyperreactivity of the amygdala.
This hyperreactivity may lead individuals to maintain a high level of alertness, even when they perceive no threats. Their emotional reactions may develop out of proportion to the real circumstances, thereby affecting their ability to navigate everyday life.
Overactivation of the amygdala can trigger fear and anxiety in some individuals, even in safe environments. Then it may lead to intrusive memories, flashbacks, intrusive thoughts, and, in some cases, dissociation or avoidance behaviors.
The amygdala may also activate the sympathetic nervous system, a component of the autonomic nervous system. As cortisol and adrenaline levels rise, the SNS plays a crucial role in preparing the body for combat or escape. Short-term it is an excellent survival mechanism and normal response to trauma, but long-term it keeps the body in the state of hyperarousal. As we can observe, trauma survivors are constantly vigilant, constantly scanning their environment for potential threats. This constant state of alertness often results in physical and emotional exhaustion, depleted energy reserves, and physical symptoms such as headaches, pain, tension, and gastrointestinal issues.
Elevated levels of anxiety, anger, and sadness; survivor’s guilt; and inability to feel pleasure—along with a diminished sense of self, guilt, and consistent self-loathing—are common everyday experiences of trauma survivors.
Admitting problems and potential trauma transforms people’s lives, transforming them into survivors capable of regaining agency. The first steps in doing this are building resilience, developing effective coping skills, and developing a sense of self-efficacy. These interventions aim to promote post-traumatic growth. Growth allows individuals to reframe their experiences, finding meaning in their struggles and fostering connections with others who have faced similar challenges. This new perspective helps them recover and inspires others to heal.
Therapeutic interventions and post-traumatic growth
Today we have many interventions for clients with different problems and needs.
The goal of constructivist therapy is to discover fresh approaches to reinterpret meanings locked in the trauma moment. Every single day, survivors experience the meanings and conclusions of the trauma as core beliefs. For instance, survivors interact with others under the belief that they have low self-worth and feel tremendous shame when they are around other people. Guilt and other intense emotions often exacerbate the embarrassment. The main objectives of this modality could include dealing with these emotions, offering a different context, and providing pragmatic treatment for trauma-related parts of the self. This method encourages people to replace these detrimental concepts with better, more constructive ones. Resilience and self-compassion help survivors progressively restore their sense of self-worth and learn to negotiate social situations with more ease and confidence.
Trauma-focused therapy, as a cognitive-behavioral modality, on the other hand, helps the brain to retrain its responses to trauma triggers. Youth, with their unique problems of post-traumatic stress and mood disorders resulting from sexual and physical abuse, particularly benefit from this approach. This is a short intervention, since it lasts for a limited number of sessions, typically ranging from a few weeks to a few months. Through structured approaches, it aims to empower individuals by developing coping strategies and enhancing their emotional resilience. Most of the work is to modify distorted or unhelpful thinking, along with negative reactions and behavior.
EMDR (Eye Movement Desensitization and Reprocessing) is a treatment that can assist many traumatized individuals in processing and recovering from traumatic experiences and memories. The goal of this modality is to help clients process negative emotions, beliefs, bodily sensations, and images associated with traumatic memories. In that important way, EMDR helps people to ‘unstick’ from traumatic memories and resolve some of their mental health problems. EMDR is especially effective at helping people with PTSD (post-traumatic stress disorder) because it treats mental health conditions associated with traumatic memories from the past.
Somatic experiencing differs significantly from the previously mentioned modalities. It is a somatic approach to healing trauma. This approach primarily aims to release the stored trauma in the body, thereby aiding in the restoration of balance in the central nervous system. Working with bodily energy, SE practitioners strive to integrate trauma-generated energy and elevate it to a new level, preventing it from remaining “stuck” in the traumatized state. Understanding how to allow the body to utilize its inherent resources for energy release is a crucial aspect of this process.
Mindfulness and relaxation techniques can significantly aid individuals in managing unpleasant and overwhelming emotions, research shows. Practices like meditation and yoga can downregulate the central nervous system, reducing hyperarousal and promoting calmness and balance. Research shows that these techniques, when integrated with psychotherapy, might significantly help traumatized populations. Simple mindfulness practices, like mindful breathing, grounding, and body scan, might reduce symptoms of anxiety, depression, and PTSD in diverse populations. Mindfulness-based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT) are specific modalities that integrate mindfulness in their approach to trauma.
Post-traumatic growth is a positive psychological change that some individuals experience after the traumatic event or mental health crisis. This concept does not exclude the presence of elevated levels of distress or even post-traumatic stress disorder. Rather, some trauma survivors find diverse ways to cultivate inner strength, seek new opportunities and avenues of meaning, and boost their resilience—during disturbance or after it passes. Having more appreciation for life itself, these individuals sometimes seek new meanings in the pursuit of religion and spirituality.
A mental health crisis per se might be viewed as the time when all the core beliefs and constructs are shaken to the ground, so the potential for reconstruction of the old system of meanings is much bigger. The individual can see that as an opportunity for growth and personal development. Through the process of making sense of what happened in the past, the traumatized person has a chance to make powerful shifts in her thinking and more readily live in the present moment, thus paving the way for a better future.
Posttraumatic growth-focused mental health interventions typically foster strengths found during traumatic experiences, coping mechanisms, insights, and diverse perspectives on life and self. In addition to psychotherapy, fostering a sense of connection and community, cultivating self-compassion, engaging in mind-body practices like yoga, and promoting spiritual practices could significantly benefit most clients.
Strength-based approaches, which place a strong emphasis on self-reflection, emotional processing, and awareness of bodily sensations and the body, may hold significant promise for the future of trauma treatments and mental health in general. However, while many individuals have benefited from reframing their traumatic experiences as opportunities for posttraumatic growth, not everyone experiences such growth. We should not view the lack of growth as a personal failure. On the contrary, every person has her own path to follow, so social expectations to find meaning in adversity might lead to additional distress for them. This underscores the need for a more idiographic approach to mental health, where the therapist tailors their intervention to each client’s unique needs. By embracing this approach, therapists can create and co-create a safe environment that respects and celebrates the client’s struggles, unique experiences, and challenges. In the end, a personalized approach might empower clients to live their lives with greater confidence, resilience, and understanding.
Vladimir Mušicki, PhD 