I’ve Heard about trauma…

Trauma is gaining more and more media attention these days. It entails witnessing or experiencing a terrifying event. You can find yourself having intrusive memories (flashbacks), avoiding certain situations, having mood disruptions or changes (such as heightened anxiety), and nightmares.

Most people associate trauma with war veterans or people who have suffered from severe physical or sexual abuse. But the reality is that trauma is actually a more expansive experience. In the trauma training I’ve completed, we studied concepts called big T and little t trauma. These concepts speak to research that looks at trauma’s impact on neurobiology demonstrating that trauma is more of a spectrum that can include little t traumatic experiences and big T traumatic experiences. For some people, getting a shot from the doctor can be traumatic, while for others being consistently bullied in school can be traumatic. Defining what deserves a big T or little t designation for your life experiences is part of the process of therapy.

Not all people are comfortable with this expansive definition of trauma—does this broad definition of trauma belittle my experience of physical abuse compared to someone who is afraid of shots?—or perhaps—I’m not comfortable with seeing my critical or neglectful parent as “traumatic”. That’s exaggerating and cliche; all therapists do is help you blame the parents.— All of these responses are welcome and normal in the therapy process. It’s very important to bring these questions and reactions in to the room in our work together. We can explore what definitions and terms mean to you along with your understanding of your life experiences. Perhaps we decide they fall under the trauma category, perhaps we don’t.

Fight Flight Freeze Fawn

When we are experiencing a trauma, our brain goes to the amygdala functions to keep us alive by engaging in one of four responses: fight, flight, freeze, or fawn (The 4 F’s—there is some debate in the community if this is more a freeze response, but I like to distinguish it as it can be helpful).

In the fight response, we fight—literally. You may find yourself being punched, so you throw a punch back. Or you get called a name, so you throw another name right back. This is the fight response that is telling you “in order to survive, you have to physically or verbally fight back”.

In the flight response, you flee or, often times, run. Your body has learned that it is better to run away from a situation in order to survive. In relationships, you may find yourself being the first to leave at the hint of vulnerability or you feel the impulse to sprint when you notice something menacing while out in public.

In the freeze response, you experience a kind of paralysis so that you won’t be seen or heard. It is a response similar to a deer in the wild when they first hear someone else unexpected in their presence. Their body goes rigid and they freeze to better be able to hear if they need to continue to freeze while danger passes or switch to fighting or flighting (fleeing).

In the fawn response, you find yourself being very very agreeable. Say someone is acting bizarrely around you, all the while playing with a knife in their hand. You may find yourself saying “sure. sure.” as they rant about whatever it is that it agitating. And you continue to appease so you can continue to find a way out of the situation.

Complex Trauma

Complex trauma involves repeated traumatic experiences that deeply affect our sense of self worth. For example, having consistent abuse from someone over the course of years will be very impactful on the psyche. It’s no longer one single traumatic event, but trauma extended out for long periods of time. Normally, there are significant (and appropriate) fears of trusting people or even yourself when you have experienced complex trauma. The work of therapy is to be able to unpack the difference between what is innate vs learned in our sense of self and find ways to trust ourselves and others again.

Common Symptoms of Complex-PTSD:

● Self-harm and suicidal ideation, plans, or attempts

● Addictions, self-destructive behaviors, and excessive risk taking

● Emotional eating, eating disorders, and body image concerns

● Social anxiety and relationship difficulties

● Chronic difficulties concentrating and impulsivity

● Toxic shame and guilt

Treatment

My approach includes a holistic approach to treating trauma and centers around the therapeutic relationship between us along with incorporating treatment protocols from EMDR, Dynamic Attachment Repaterning Experiece (DARE), Psychodynamic-Practices, and Trauma Focused Cognitive Behavioral Therapy. Often times, trauma takes time to heal and healing can only start to happen in a long term healing relationship. Though friendships and loved ones are essential to this healing at points, for many people the relationship with the therapist is the starting point for finding and having a safe relationship to begin to explore, understand, trust, and heal from the relational trauma that you experienced before. If relationships have been unsafe, in order to learn how to have safe ones we often times need to experience it first hand with a therapist to then be able to manifest it in ourselves and with other people. Please read more about my nuanced approach to therapy to see more of what that may entail.

Resources:

• Complex PTSD: From Surviving to Thriving (Pete Walker)

• What my Bones Know (Stephanie Foo)

• Educated (novel Tara Westover)

• Healing Developmental Trauma (Laurence Heller, Alline LaPierre)

• Codependent No More (Melody Beattie)