No escape: The pervasiveness of trauma and the ease of retraumatization

Over the past 4 years in my psychotherapy practice in a community mental health center, I’ve worked with lots of trauma cases–children and families with histories of neglect, abuse, abandonment, exposure to violence, and a host of other horrific things. When I left the agency 3 weeks ago in hopes of pursuing other interests and diversifying my experiences, I was enthusiastically sent off towards an anticipated less stressful, trauma-free life outside of community mental health. Though I was extremely sad and somewhat regretful about leaving the children and families I’d become so attached to and invested in, I did look forward to new freedom and less stress.

What I didn’t expect was for my exposure to traumatic experience to drastically increase or to almost immediately experience a direct trauma myself. I was quickly reminded that trauma is not exclusive to community mental health or is it a rare or unique occurrence that happens to certain people (though certain demographics are at risk to more exposure to certain types of trauma due to forces such as oppression, history, cultural dynamics. ex. Blacks have higher risk of witnessing domestic violence). Traumatic events are always happening and their presence is sort omnipresent. We’re constantly being exposed to traumatizing things through media and by simply living in this world, whether it’s turning on the T.V. to watch a natural disaster occurring or a war in action, or turning on the computer to see a post of a violent fight or police brutality in your community. In the same way the media and the world gives us pervasive messages that reinforce sexism, racism, classism, homophobia, transphobia, sizeism, etc., it also encourages and repeatedly displays trauma.

Due to the prevalence of exposure to traumatic events, these things have become routine and “normal.” And subsequently, many of us are or have been traumatized and don’t even know. Not all exposure to traumatic events result in a trauma response or diagnosis, but it is difficult to not have some emotional response to something traumatic. There are people moving through the world feeling fearful, distrustful, anxious, hypervigilant, angry, or depressed without knowing why. Others have found a way to cope with these painful things using highly developed defenses like denial, projection, acting out, and dissociation, among others. Both of these responses (reacting and defending) are logical and necessary ways of adapting to living in such an unpredictable and oftentimes cruel and scary world. These are ways we’ve learned to protect ourselves from experiencing emotions associated with being traumatized which can be intrusive and make us feel weak and powerless. However, in the long run these responses are harmful to our personal growth and healing, and to our relationships with the people and world around us.

Trauma is complex and experiences of trauma can vary significantly. Some people may experience one traumatic event in their lifetime like a bad car accident or natural disaster, while others may experience multiple traumas over time like consistent emotional or physical abuse or witnessing frequent community violence.

What is trauma?
Trauma is an emotional response to life threatening event like a rape, abuse, natural disaster, or accident. It can be experienced directly, or by witnessing, or being told about the event. Events like street harassment, neglect, emotional abuse, witnessing domestic violence, sudden death of a loved one, medical complications, bullying, or a humiliating or extremely disempowering experience can also be traumatic.

Types of Trauma:

Acute Trauma: Acute trauma occurs when a person experiences distressing emotional reactions within one month of a traumatic event. The emotional response can include dissociative symptoms (numbing, detachment), re-experiencing the event through dreams, flashbacks, and intrusive thoughts, avoidance of stimuli that remind one of the event, and increased anxiety/arousal.

Complex/comprehensive Trauma: Multiple and/or repeated exposures to trauma over a period of time, like persistent physical and/or sexual abuse and witnessing domestic violence and community violence would be characterized as complex or chronic trauma. Complex trauma can seriously impact a person’s development, especially a child. Early childhood trauma often significantly affects brain development, ability to regulate emotions, ability to form healthy attachments/relationships, impulse control, self-esteem, learning, and the ability to feel safe in the world. The effects of childhood trauma can be incredibly challenging for both the child and the caregivers of the child. Traumatized children often have learned to survive their traumas by using behaviors that can be difficult for others to understand or tolerate. When children are acting out or displaying troubling behavior, it is important to understand what underlies this behavior, as there might be some trauma or other emotional turmoil affecting them.

Generational Trauma: Some of us may not have experienced a direct trauma in our lifetime, but could be holding on to the wounds of trauma’s experienced by our ancestors or older relatives. Often times traumatic experiences are too overwhelming to process and work through, and the learned behavior and emotions associated with these traumatic events end up being passed down through. For example, as a result of longstanding systemic racism starting from slavery, some Black Americans have developed what is called Post Traumatic Slave Syndrome, a term coined by Dr. Joy DeGruy. This is multigenerational trauma that continues to be transmitted through families and communities who have not yet healed from the trauma of violent and complex oppression.

Community or Societal Trauma:As mentioned above, trauma can be experienced not only individually, but collectively through some type of shared experience. On September 11, 2001, the United States was repeatedly shown the collapse of the World Trade Center, which was a terrifying experience. One did not have to be in NYC that day to be traumatized by the event. This is an example of how an entire nation can be acutely traumatized. Similarly, communities that are plagued with violence and poverty can also be traumatized. The collective experience of trauma by a shared group often establishes patterns and ways of being that sometimes become part of that groups “culture.”

Diagnoses that capture Trauma:

Post-traumatic Stress Disorder-Develops after experiencing, witnessing, or hearing about a harmful event. Symptoms last for at least one month and include re-experiencing the trauma through intrusive thoughts, dreams, and flashbacks, avoiding stimuli that triggers memories of the experiencing, and increased anxiety/arousal.

Acute Stress Disorder-Symptoms are the same as PTSD, but duration of emotional distress is less than one month.

Other diagnoses-Experiencing trauma can also lead to depressive disorders, anxiety disorders, attachments disorders, personality disorders, developmental disorders, and adjustment disorders.

Recovering from Trauma

Recovering from trauma can be a long, arduous process. If not dealt with, trauma can have devastating effects on healthy development and living; functioning in relationships, coping with emotions, and the ability to deal with day-to-day tasks will be compromised. To begin healing from trauma and move towards mental health and contentment, a therapeutic practice is recommended. Seeking a therapist can be helpful, but if therapy does not feel right for you, there are many other practices that can help work through trauma.