Preventing and Healing Stress Related Depression, Anxiety and Childhood Behavior
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Emotional and Psychological Trauma: Causes and Effects, Symptoms and Treatment
Psychological or Emotional Trauma is Much Broader Than Current Definitions of PTSD; it has many faces.

On this page: What is psychological or emotional trauma? | What causes emotional or psychological trauma? | What is the difference between stress and emotional or psychological trauma? | What causes psychological trauma? | Why can an event cause an emotionally traumatic response in one person and not in another? | What are the symptoms of emotional trauma? | What are the possible effects of emotional trauma? | What if symptoms don't go away, or appear at a later time? | How is emotional trauma treated? | Online Resources for Emotional or Psychological Trauma

What is psychological or emotional trauma?

The ability to recognize emotional trauma has changed radically over the course of history. Until recently psychological trauma was noted only in men after catastrophic wars. The women's movement in the sixties broadened the definition of emotional trauma to include physically and sexually abused women and children. Now, because of the discoveries made in the nineties - known as the decade of the brain - psychological trauma has further broadened its definition.

Recent research has revealed that emotional trauma can result from such common occurrences as an auto accident, the breakup of a significant relationship, a humiliating or deeply disappointing experience, the discovery of a life-threatening illness or disabling condition, or other similar situations. Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.

Regardless of its source, an emotional trauma contains three common elements:

• it was unexpected;
• the person was unprepared; and
• there was nothing the person could do to prevent it from happening.

It is not the event that determines whether something is traumatic to someone, but the individual's experience of the event. And it is not predictable how a given person will react to a particular event. For someone who is used to being in control of emotions and events, it may be surprising - even embarrassing - to discover that something like an accident or job loss can be so debilitating.

What causes emotional or psychological trauma?

Our brains are structured into three main parts, long observed in autopsies:

• the cortex (the outer surface, where higher thinking skills arise; includes the frontal cortex, the most recently evolved portion of the brain)
• the limbic system (the center of the brain, where emotions evolve)
• the brain stem (the reptilian brain that controls basic survival functions)

Because of the development of brain scan technology, scientists can now observe the brain in action, without waiting for an autopsy. These scans reveal that trauma actually changes the structure and function of the brain, at the point where the frontal cortex, the emotional brain and the survival brain converge. A significant finding is that brain scans of people with relationship or developmental problems, learning problems, and social problems related to emotional intelligence reveal similar structural and functional irregularities as is the case resulting from PTSD.

What is the difference between stress and emotional or psychological trauma?

Trauma is stress run amuck. Stress dis-regulates our nervous systems - but for only a relatively short period of time. Within a few days or weeks, our nervous systems calm down and we revert to a normal state of equilibrium. This return to normalcy is not the case when we have been traumatized. One way to tell the difference between stress and emotional trauma is by looking at the outcome - how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing the following:

• how quickly upset is triggered
• how frequently upset is triggered
• how intensely threatening the source of upset is
• how long upset lasts
• how long it takes to calm down

If we can communicate our distress to people who care about us and can respond adequately, and if we return to a state of equilibrium following a stressful event, we are in the realm of stress. If we become frozen in a state of active emotional intensity, we are experiencing an emotional trauma - even though sometimes we may not be consciously aware of the level of distress we are experiencing

What causes psychological trauma?

Psychological trauma can result from events we have long recognized as traumatic, including:

• natural disasters (earthquakes, fires, floods, hurricanes, etc.)
• physical assault, including rape, incest, molestation, domestic abuse
• serious bodily harm
• serious accidents such as automobile or other high-impact scenarios
• experiencing or witnessing horrific injury, carnage or fatalities

Other potential sources of psychological trauma are often overlooked including:

• falls or sports injuries
• surgery, particularly emergency, and especially in first 3 years of life
• serious illness, especially when accompanied by very high fever
• birth trauma
• hearing about violence to or sudden death of someone close

In addition, traumatic stress in childhood that influences the brain is caused by poor or inadequate relationship with a primary caretaker. Sources of this developmental or relational trauma include the following:

• orced separation very early in life from primary caregiver;
• chronic mis-attunement of caregiver to child's attachment signals ("mal-attachment") or reasons such as physical or mental illness, depression or grief.

It is acknowledged that early life trauma creates a vulnerability for experiencing future traumatic responses.

For a fuller insights on the causes of psychological/emotional trauma see our adult trauma history questionnaire.

Why can an event cause an emotionally traumatic response in one person and not in another?

There is no clear answer to this question, but it is likely that one or more of these factors are involved:

• the severity of the event;
• the individual's personal history (which may not even be recalled);
• the larger meaning the event represents for the individual (which may not be immediately evident);
• coping skills, values and beliefs held by the individual (some of which may have never been identified); and
• the reactions and support from family, friends, and/or professionals.

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop symptoms of "vicarious" or "secondary" traumatization. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

What are the symptoms of emotional trauma?

There are common effects or conditions that may occur following a traumatic event. Sometimes these responses can be delayed, for months or even years after the event. Often, people do not even initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from a more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

Physical
• Eating disturbances (more or less than usual)
• Sleep disturbances (more or less than usual)
• Sexual dysfunction
• Low energy
• Chronic, unexplained pain

Emotional
• Depression, spontaneous crying, despair and hopelessness
• Anxiety
• Panic attacks
• Fearfulness
• Compulsive and obsessive behaviors
• Feeling out of control
• Irritability, angry and resentment
• Emotional numbness
• Withdrawal from normal routine and relationships

Cognitive
• Memory lapses, especially about the trauma
• Difficulty making decisions
• Decreased ability to concentrate
• Feeling distracted
• ADHD symptoms

The following additional symptoms of emotional trauma are commonly associated with a severe precipitating event, such as a natural disaster, exposure to war, rape, assault, violent crime, major car or airplane crashes, or child abuse. Extreme symptoms can also occur as a delayed reaction to the traumatic event.

Re-experiencing the Trauma
• intrusive thoughts
• flashbacks or nightmares
• sudden floods of emotions or images related to the traumatic event

Emotional Numbing and Avoidance
• amnesia
• avoidance of situations that resemble the initial event
• detachment
• depression
• guilt feelings
• grief reactions
• an altered sense of time Increased Arousal
• hyper-vigilance, jumpiness, an extreme sense of being "on guard"
• overreactions, including sudden unprovoked anger
• general anxiety
• insomnia
• obsessions with death

What are the possible effects of emotional trauma?

Even when unrecognized, emotional trauma can create lasting difficulties in an individual's life. One way to determine whether an emotional or psychological trauma has occurred, perhaps even early in life before language or conscious awareness were in place, is to look at the kinds of recurring problems one might be experiencing. These can serve as clues to an earlier situation that caused a dysregulation in the structure or function of the brain.

Common personal and behavioral effects of emotional trauma:
• substance abuse
• compulsive behavior patterns
• self-destructive and impulsive behavior
• uncontrollable reactive thoughts
• inability to make healthy professional or lifestyle choices
• dissociative symptoms ("splitting off" parts of the self)
• feelings of ineffectiveness, shame, despair, hopelessness
• feeling permanently damaged
• a loss of previously sustained beliefs

Common effects of emotional trauma on interpersonal relationships:
• inability to maintain close relationships or choose appropriate friends and mates
• sexual problems
• hostility
• arguments with family members, employers or co-workers
• social withdrawal
• feeling constantly threatened

What if symptoms don't go away, or appear at a later time?

Over time, even without professional treatment, symptoms of an emotional trauma generally subside, and normal daily functioning gradually returns. However, even after time has passed, sometimes the symptoms don't go away. Or they may appear to be gone, but surface again in another stressful situation. When a person's daily life functioning or life choices continue to be affected, a post-traumatic stress disorder may be the problem, requiring professional assistance.

How is emotional trauma treated?

Traditional approaches to treating emotional trauma include talk therapies, Cognitive-Behavioral Therapy (CBT) - intentionally changing one's thoughts and actions - and systematic desensitization to reduce reactivity to a traumatic stressor. These approaches to healing trauma were developed without brain science information, and therefore have varying degrees of success.

Recent developments in the treatment of emotional trauma include new, effective forms of psychotherapy and somatic (body) therapies that were developed with new brain science information in mind. Although often intensely interpersonal, these therapies are also psychological and neurological in their focus and application. This group of therapies relies on innate instinctual resources, rather than medications, to bring about healing. They differ in some ways, but the one thing they have in common is combining talk therapy with a focus on the body. As with any therapy, but especially due to the intensity of the emotions involved, it is important to find a therapist with whom one feels trust and a strong bond. They include:

Eye Movement Desensitization/Reprocessing (EMDR) was developed by psychologist, Francine Shapiro, after she noticed her own stress reactions diminishing when her eyes swept back and forth as she walked through a park. It is conducted by licensed mental health professionals who have taken specific training in this complex approach. It combines elements of a range of therapeutic approaches with eye movements or other forms of rhythmical stimulation, such as hand taps or sounds. Theories as to why EMDR is effective are still evolving. Some speculate that the rapid unique therapeutic element of EMDR - the eye movements or other rhythmical stimulation - might help the brain access and process traumatic material.

EMDR has been most effective with single-incident trauma, but its uses continue to evolve in addressing longer histories of emotional or physical trauma, and in balancing other aspects of a person's life.

Somatic Psychotherapies The term somatic, coined by Tomas Hanna, means mind/body or more precisely brain/body. The idea is that to change the body, we have to engage the brain and change the brain - not only how we think and feel, but also the neurological connections themselves. The body, its sensations, and direct sensory experience are referenced throughout the therapeutic process. Somatic therapies include:

Somatic Experiencing: developed by Peter Levine, this approach evolved in part from observations of how animals literally "shake off" traumatic experiences, allowing the body to process stress chemicals completely until they return to normal levels. The SE therapist may be a licensed professional or unlicensed but with some mental health training. All SE therapists complete an extensive training program, in which they learn to observe the body, facial expressions and gestures carefully and to help the person "thaw" a response that was "frozen" in a traumatic situation (illustration: the person might be observed to make short gestures that almost appear to be a "pushing" motion, but that stop abruptly - the therapist might have the person complete the gesture in full, and notice how the body's tension level changes).

Hakomi Method: originated by Ron Kurtz, this system is based on five therapeutic principles - Mindfulness, Organicity, Non-Violence, the Mind-Body Connection, and Unity. It is a body-centered approach for which, in part, the therapist helps the client experiment with small changes in gesture or other movements, to see what differences occur in the processing of emotionally charged content (illustration: the person might be observed to always make a certain gesture or have a certain posture when talking about the attacker - the therapist might suggest the gesture or posture be changed to a different one as an experiment, and then to notice the changes in feelings or thoughts).

Somatic Psychology: developed by Pat Ogden, this treatment merges somatic therapies, neuroscience, attachment theory, and cognitive approaches, as well Hakomi Method. The approach often uses physical expression to process the energy stored in the body following a trauma, to reset the neurological system into better balance (illustration: the person might be asked to push the attacker away by forcefully pushing against a wall or against a pillow held by the therapist, to allow the body's neurological and musculature systems to reset themselves to a more normal level).

AEDP (Accelerated Experiential Dynamic Psychotherapy): developed by Diana Fosha, New York based psychoanalyst, this approach brings the elements of secure attachment into her work with adults. The talk therapy she practices focuses on the mutual exchange of all deeply-seated emotions, bodily awareness and joyous playful exchange.


We gratefully acknowledge the role of www.Helpguide.org in providing us with information that has been used on this page.

 

Online Resources for Emotional or Psychological Trauma

General Information

www.sidran.org/whatistrauma.html
This noncommercial site offers a thorough description of the causes and symptoms of trauma.

www.jeannesegal.com/emotional_intelligence
is a non- commercial website that describes the relationship between emotional intelligence and emotional trauma.

www.trauma-pages.com/pg2.htm
This popular non-commercial site by David Baldwin does a thorough job of defining and describing PTSD.

www.tlcinstitute.org/trauma.html
Is an educational institution that focuses on violent traumatic events and fears in children's lives. Especially helpful is the distinction made between trauma and grief.

www.traumainstitute.org/trauma.php
is a noncommercial site that focuses on the societal as well as personal impact of trauma

Trauma Pages - Supportive Information - A comprehensive list of links related to various types of trauma, treatments, support, and related issues.

Managing Traumatic Stress - A factsheet provided by from the American Psychological Association.

 

Trauma information for helping children and adolescents

National Institute of Mental Health - Lists reactions of children and adolescents to traumatic events (which may differ from adult reactions), and ways adults can help young trauma survivors.

Psychological Trauma Center - Cedars-Sinai Medical Center provides information for parents, including tips on helping children and adolescents deal with traumatic events.

National Mental Health Association - Offers ways to help children handle disaster-related anxiety (relevant to any anxiety), listed by age from pre-school through adolescence.

Academy of Cognitive Therapy - Has a section on help for children, which describes children's reactions to trauma and offers guidelines for parents and teachers.

 

Therapeutic approaches for emotional and other trauma
(Note: because many of these therapies are relatively recent in development, much of the information about them appears on sites that offer training or products and thus are designated by * as a commercial site)

EMDR Institute* EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It integrates many of elements of a range of therapeutic approaches in combination with eye movements or other forms of rhythmical stimulation in ways that stimulate the brain's information processing system. This site provides information on related publications as well as referrals to EMDR-trained clinicians

Somatic Therapies

Somatic Psychology* The term somatics has evolved to mean "the experienced body," "experiencing the body from within," and "one's experience of one's own body." This webpage explores some of the meanings behind somatic psychology and the training involved.

Trauma Healing with Somatic Experiencing* Somatic experiencing is a short-term naturalistic approach to the resolution and healing of trauma. It employs the awareness of body sensation to help people renegotiate and heal their traumas rather than relive them. This website also has related articles and a practitioner directory.

Hakomi Method* describes the theory and practice of one of the first body-centered therapies. Includes links to an entire training manual and other readings.

Sensorimotor Psychotherapy Institute* Describes the certification program for trauma work, combining body work and psychotherapy.

Integrative Body Psychotherapy* In Integrative Body Psychotherapy, verbal and cognitive methods are integrated with a somatic body orientation and breath work. This site provides information about this type of psychotherapy, as well as a directory of certified therapists.

 

Reprinted with permission from Helpguide.org. © 2005. For information on over 125 Mental Health and Lifelong Wellness topics visit www.helpguide.org.

 

 

   
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