Often we hear words or terms used and we have a vague idea of what they mean, but we don’t really have a full understanding of what they encompass. For this article I decided to uncover the meaning of the terms trauma and Post Traumatic Stress Disorder, also known as PTSD. While I knew that they refer to mental health problems that affect people in different ways, I had very little understanding of how they applied to everyday life. I am lucky enough to have a son, Shlomo Schor, who is a psychotherapist specializing in treating people who suffer from traumatic experiences that lead to PTSD. He took the time to explain to me what trauma is, how it leads to PTSD, and how it can be treated.
The phenomenon of PTSD, Shlomo explains, is as old as life itself. It has always been known that some people experience something overwhelmingly terrible and aren’t the same afterwards. A common expression is, “He can’t let it go.” This is what Post Traumatic Stress Disorder is. A person experienced something traumatic – a threat to his life or safety – and he can’t let it go. Meaning, he is still living the experience of what happened in the past.
“PTSD was added to Diagnostic Statistical Manual of Mental Disorders in 1980,” Shlomo says. “The diagnosis of PTSD was first intended for combat veterans. Some of these soldiers came back from fighting and just could not function in everyday life. They were unable to find employment, were often homeless, and could not maintain relationships. The diagnosis of PTSD served to identify and describe their symptoms.”
But let’s back up a minute and understand what trauma is. A trauma is an experience that feels like a threat to life from which the person cannot escape. In the case of PTSD, the experience does not get processed like other life experiences. Instead, the fragmented memory is replayed over and over again whenever there is a trigger, an internal or external stimulus that reminds the person of the past trauma. At the time the trigger occurs, the person goes into a flashback. It’s important to note that an individual may not even be aware that he is reliving a previous trauma; sometimes all he experiences is increased anxiety, muscle tension, and the strong desire to avoid the trigger in the future.
All mammals and even reptiles have three possible responses to danger. They are fight, flight, and freeze (hiding or playing dead). Humans have a fourth possible response, called fawning, which means trying to please the attacker in order to avoid being hurt. An individual with PTSD will relive his trauma by going into any of these four states as a way to protect themselves from the imagined trauma that is reoccurring in their minds.
To make this more concrete: Every time our hypothetical war veteran hears a loud noise that reminds him of a gunshot, shouting, or a smoky room, he is brought back in his mind to the terrible situation he was in 20 or 30 years ago when he was in the middle of a battle and afraid he would be killed. This makes him unable to function in the regular world, since he is constantly reliving the past.
Although the diagnosis of PTSD was originally a set of criteria for combat veterans or victims of torture, in reality, there are many situations that can cause a person to experience trauma. Any situation or circumstance in which a person experiences a belief that his or her physical or emotional life is at risk and feels powerless to stop it can be traumatic.
Here is a real-life example: Imagine a person who was in a car accident. Now every time he gets into a car he begins to relive the accident. Several months after the accident, he is still having panic attacks at the thought of driving. Why? Because he hasn’t been able to process the feelings that he felt at the time of the accident, the fear that he was about to die.
In the following true example, a woman had a C-section and the doctors did not administer enough anesthetic. Although she tried to tell the doctor that she could feel the incision, she wasn’t able to talk. Two months later, she was having a terrible time taking care of her baby. Every time she looked at the baby, she had a flashback to the fear and powerlessness she felt during the operation.
Attachment Wounds
Another common experience that relates to trauma but may not be exactly a trauma is an attachment wound. What is an attachment wound? The most important relationship every person has is with his parents. If he does not attach securely to his parents, meaning that he doesn’t learn to trust them fully, then he will go out into the world and replay that experience of not being able to trust again and again in all his future contacts.
Attachment wounds are very common and can occur in many families, sometimes with just one of many children. For whatever reason, something about the relationship with that particular child doesn’t gel properly. (It is not indicative of a bad parent.)
Attachment wounds can show up in different ways. The child can act out either as a victim or by victimizing others. He is in essence playing out the attachment wound that he himself experienced. It is so important to notice and get help when attachment wounds occur because children with attachment wounds become magnets for perpetrators and other situations where victimization is possible. The important thing is to get help ASAP without judging or shaming the parents but instead supporting them and understanding that life happens.
It is very common for traumas of some degree to be experienced in childhood because childhood is such a vulnerable time. Parents often unknowingly inflict traumatic situations on their children, even though they very much wish not to. Sometimes a trauma can occur that a parent has no way to prevent.
Getting stuck in some degree of trauma can be inevitable as life unfolds. The more quickly a person is able to process the trauma, the quicker and easier he/she can heal. There is hope even for people suffering for many years, but early intervention is always preferred.
Is Trauma the Same for Everyone?
Experiencing trauma is subjective. People with a genetic predisposition to anxiety or highly sensitive natures will be more affected by trauma than others. Two people can experience the same situation together, and one will have PTSD from the trauma while the other may be unaffected. For example, a person who was able to help others during a terrorist attack, to hide, or to run away may be less affected than a person who experienced the same attack but could not do anything at all.
It is important to understand that experiencing some trauma is commonplace for most people. Life is serious business and sometimes scary things happen that remain unprocessed. The degree to which the untreated trauma affects an individual’s life may depend on whether or not a person can make life choices that avoid triggering the unresolved trauma. In other words, it depends on how pervasive the triggers are in a person’s life. For example, a person may have experienced a trauma in school, but if he never goes back to school as an adult, he may not have to deal with the effects until he has children and is faced with that trigger through seeing his children go to school. In general, it is common for people to get triggered as parents because parenting often brings up vulnerable experiences from their own childhoods.
A person can be fully functional in some relationships but find specific relationships to be triggering and cause him to regress due to some trauma that hasn’t been deal with. Dealing with and understanding what it is about the situation that is triggering and reminding a person that the threat no longer applies can help to calm him down. If you have unprocessed trauma that is getting in the way of your life functioning, you may want to seek out trauma therapy.
What Is Trauma Therapy?
Many times, people come to a mental health counselor because they are feeling depressed or anxious. Perhaps they are having panic attacks or they are not able to get along with a family member. When the counselor listens to the client’s story, he may discover that the presenting problem is trauma based.
There are many approaches to treating trauma, but the first step in any effective trauma treatment is assessing the individual’s window of tolerance. Essentially, the therapist must assess whether the individual is able to go back to the traumatic incident without becoming overwhelmed and emotionally shutting down. If not, the counselor will work with the client using relaxation or self-calming strategies to expand his window of tolerance so that he can think about the traumatic incident without emotionally shutting down. Once the individual has expanded his window of tolerance, the trauma can be correctly processed so that the individual can recover.
There are many effective techniques for treating PTSD, including cognitive behavioral based therapies, EMDR (Eye Movement Desensitization and Reprocessing), and Somatic Experiencing Therapy. Many therapists, including Shlomo, use modalities such as psychodrama, art therapy, and sandplay therapy to process trauma. When looking for a competent trauma therapist, it is important to make sure that the individual has adequate training, since extensive training for treating trauma is not usually provided in graduate school.
This article is an attempt to explain in simple laymen’s terms one aspect of mental health treatment. I hope it has given readers a clearer idea of the terms trauma and PTSD. Obviously, this is just an overview, and much training and learning is involved to be able to use these techniques to help a person who is suffering.
I would like to thank my son, Shlomo Schor, for taking the time to teach me the information necessary to write this article. It is truly a wonderful feeling to have an adult child who knows more than you do and who has learned a skill that allows him to help others.
