What is Trauma, PTSD and C-PTSD?
What is Trauma, PTSD and C-PTSD?
Have you been wondering if you have trauma? What are the signs and symptoms of trauma? How does one become traumatized? Read on to get answers to your questions about trauma and PTSD.
Trauma is an event or series of events that is distressing or disturbing, and is experienced by someone as either physically or emotionally harmful or life threatening and has adverse effects on their level of functioning (mental, physical, social, emotional or spiritual). In light of the Covid Pandemic, all of us have been traumatized one way or another due to the life-threatening nature of the virus and the way in which it dramatically altered our lives both physically and emotionally (#ChangeIsHard! amiright?)
Bessel van der Kolk, author of the well-know book on trauma “The Body Keeps the Score” defines trauma in this way:“Trauma is an event that overwhelms the central nervous system, altering the way we process and recall memories …Trauma is not the story of something that happened back then…it’s the current imprint of that pain, horror, and fear living inside people.” The DSM-5 (which is the diagnostic manual for mental health conditions) says the trauma occurs when the following happens:
“Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
directly experiencing the traumatic event(s)
witnessing, in person, the traumatic event(s) as it occurred to others
learning that the traumatic event(s) occurred to a close family member or close friend (in case of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental)or
experiencing repeated or extreme exposure to aversive details of the traumatic event(s).”
(NOTE: #4 does not apply to exposure through electronic media, TV, movies or pictures unless it’s work-related).
Types of Trauma Exposures:
Child Abuse (physical, sexual, psychological, or neglect)
Mass Interpersonal Violence (including school and community violence)
Natural Disasters
Large-Scale Transportation Accidents
Fire and Burns
Motor Vehicle Accidents
Rape or Sexual Assault
Physical Assault
Intimate Partner Violence (aka “Domestic Violence”)
Sex Trafficking (or Commercial Sexual Exploitation)
Labor Trafficking
Torture
War (including military related stressors – injury, loss, POW)
Witnessing or being confronted with the Homicide/Suicide of another person
Life-Threatening Medical Conditions and/or Medical Procedures (such as a cancer diagnosis)
Emergency Worker Exposure to Traumatic incidents
Historical, Collective, or Intergenerational Trauma such as:
Racism
Slavery
Forcible removal from a family or community
Genocide
War
Threats to psychological integrity such as:
extreme emotional abuse
major losses or separations
degradation, humiliation, or bullying and
coercion/psychological manipulation ( eg. coerced but not physically violent sexual experiences, undue influence/brainwashing or mind control)
Betrayal Trauma – i.e. when a partner or parent commits infidelity
Effects of Trauma
Being exposed to traumatic events can lead to the development of many different types of mental health challenges. Some people are more resilient than others. Not everyone develops mental health symptoms in response to a traumatic event. Some people experience brief symptoms that resolve within 1 month of the incident, while others experience stronger, more acute symptoms that may last several months to years. Sometimes, a person may experience a delayed reaction to a traumatic event and may not experience symptoms until months or even years after the exposure occurred.
There is no right or wrong way to respond to a trauma. Everyone is unique in how they respond or react to what they’ve experienced. Many factors contribute to why some people develop Post-Traumatic Stress Disorder (PTSD) while others are able to bounce back more quickly.
What are some common symptoms of trauma or PTSD?
Before we dive into the symptoms, I’d like to point out that while it’s referred to “PTSD” (or post-traumatic stress disorder), I really like to think about it as PTSI - aka “post-traumatic stress injury.” I heard this on a TV show and feel this is more accurate representation of the impact that trauma has on one’s life.
Trauma symptoms are divided into 4 clusters:
Re-experiencing of the traumatic event
Avoidance of trauma-relevant stimuli
Numbing, negative cognitions and mood related to the trauma
Hyperarousal and hyperreactivity in response to trauma-related material
Here is a more specific list of the symptoms one may experience in response to a traumatic event (or series of events):
Intrusion thoughts, memories, or dreams
Avoidance of situations or memories that serve as reminders of the event
Anxiety
Depression
Dissociative symptoms
Hyper-arousal
Hyper-vigilance
Panic
Somatization
Substance misuse or dependence
What is Complex, Developmental Trauma? (aka C-PTSD)
Complex, developmental trauma is “...the experience of multiple, chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (eg, sexual or physical abuse, war, community violence) and early-life onset. These exposures often occur within the child’s caregiving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood.” (Van der Kolk, Bessel)
What are the effects of experiencing chronic trauma?
“Chronic trauma interferes with neurobiological development and the capacity to integrate sensory, emotional and cognitive information into a cohesive whole. Developmental trauma sets the stage for unfocused responses to subsequent stress, leading to dramatic increases in the use of medical, correctional, social and mental health services.” (Van der Kolk, Bessel)
How does C-PTSD differ from PTSD?
People who have been exposed to multiple traumatic events throughout their life, and especially earlier in life, tend to have more significant struggles with their symptoms. It takes more effort to overcome challenges (although it’s not impossible) and it may take longer to recover from the negative effects of the traumatic events.
Examples of C-PTSD Symptoms
Difficulty managing emotions and becoming easily triggered
Somatic symptoms (eg, hyper or hypo arousal within the nervous system, muscle tension/tightness, more prone to becoming sick; self-mutilation - aka “cutting”)
Changes in cognitions (eg, thinking that it is happening again, confusion, dissociation)
Relationship challenges (eg, clinging, oppositional, distrustful, compliant)
Negative self-concept (eg, self-hate, blame)
Difficulty functioning in in work or at school
What are the treatment options for trauma, PTSD and C-PTSD?
There are several therapeutic approaches and modalities that can be effective in treating trauma. The choice of therapy depends on individual preferences, the nature of the trauma, and the client's specific needs. Here are some common therapy options for trauma treatment:
Attachment-Based Therapy
Brainspotting*
Cognitive Behavioral Therapy (CBT)
Eye Movement Desensitization and Reprocessing (EMDR)*
Dialectical Behavioral Therapy (DBT)
Internal Family Systems (IFS)*
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)* - for kids ages 3-18
Narrative Therapy
Psychodynamic Therapy
Mindfulness-Based Stress Reduction (MBSR)
Somatic Experiencing
The ones that are starred are known to be some of the most effective therapy models for trauma and PTSD. For someone who has experienced C-PTSD, are combination of various therapy models may be effective over a period of time to heal the developmental wounds and chronic negative effects of the trauma exposures.
It's essential to note that the effectiveness of a specific therapy can vary from person to person. Many individuals benefit from a combination of therapeutic approaches tailored to their unique needs and circumstances. Seeking guidance from a qualified mental health professional can help determine the most suitable therapy for trauma treatment.
Did this post resonate with you? If you’re suffering from trauma-related symptoms or have recently experienced a traumatic event (or are a survivor of childhood trauma) I would love to support you on your road to recovery. As a trauma-informed therapist, I’m trained in EMDR (Eye Movement Desensitization and Reprocessing) and other trauma-specific therapy models to help support you in your trauma recovery.
Start your trauma therapy in San Diego
Are you ready to start feeling better and take back control of your life? I’d love to talk with you about how I can help. Schedule a free, 15-minute phone consultation to see if I might be a good fit for your needs. I look forward to talking with you!
References:
Van der Kolk, B. “Developmental Trauma Disorder.” Psychiatric Annals. (Month 200 x). Pgs 2-8. Retrieved from: https://traumaticstressinstitute.org/wp-content/files_mf/1276541701VanderKolkDvptTraumaDis.pdf
