What are the effects of trauma?
Hi I’m Sarah! I’m a Manchester psychotherapist, working worldwide via Zoom.
Who experiences trauma?
A lot of the clients that I work with have experienced some kind of trauma or another. I specialise in working with CPTSD or complex trauma, but people may also identify as having PTSD, having suffered from childhood abuse or trauma, emotional abuse, narcissistic abuse, or CEN (childhood emotional neglect).
If you are struggling with trauma, or think you might be, whatever your diagnosis you might be experiencing any or all of the following
Trauma symptoms
Nightmares
Flashbacks
Emotional flashbacks
Triggers
Hyper vigilance (constantly feeling alert)
Depression
Panic attacks
Anxiety
Feeling of low self worth
Guilt
Shame
Can you heal from trauma?
We can’t undo what happened to you, and it would be dismissive to suggest otherwise.
But it is possible to heal from CPTSD or trauma and you can feel better about yourself. You can get relief from your symptoms and stop blaming yourself for what happened.
Why can’t I concentrate after trauma?
It’s worth noting that people who are traumatised have difficulty concentrating and/or understanding.
They can frequently feel ‘lost’ or dissociate and might be unable to do simple tasks that they know well such as forgetting how to make a cup of tea or being unable to speak. If this is you, please go easy on yourself and go slowly.
This is because when people are traumatised or retriggered, they don’t have access to the thinking parts of their brain. You are not stupid, you are just feeling overwhelmed.
Wait until you feel better and try again or try on a different day, or ask someone to help you.
Why do I keep reliving my trauma?
When you are traumatised, you get stuck. Your brain does not understand that the trauma is finished, it treats it as an ongoing incident and it often replays incidents or snippets of the trauma as flashbacks.
You might also experience emotional flashbacks which are overwhelming feelings that are not proportionate to the present situation or experience.
How does trauma affect memory?
Traumatic memories are far more likely to be stored as implicit memory; these are emotional responses, unconscious awareness and are triggered unintentionally and linked to instinctive responses (described below and available as attempts to protect you). This means that you act out of instinct and not by thinking and making a rational decision and can lead to situations where you say ‘I don’t know what happened’ or ‘I don’t know why I did that’. This can lead to survivors feeling frustrated, ashamed and unwilling to talk about their experiences for fear of being judged.
I can’t remember the traumatic event
Non traumatic memories, such as what you were doing last week, are far more likely to be stored as explicit memory; which is categorised and organised and whereby you have access to parts of your brain that help you think, rationalise and plan. This means they are far more likely to have a beginning, a middle and an end and appear in a logical order. This is why traumatic memories are often fragmented, disorganised and difficult to recall - you simply cannot access them in the same way as you can other memories.
What are flashbacks?
What this means, is that you either don’t feel safe in the present or can easily be triggered to literally re experience the past. The more traumatised you are, the more difficulty you will have with staying in the present and knowing the difference between your past and your present. This can be a symptom of PTSD or CPTSD (complex trauma) which is a subset of PTSD.
What is fight, flight, freeze, fawn, flop?
Fight, flight, freeze, fawn (sometimes also known as friend) and flop are all trauma responses, that is ways that th body responds automatically when it realises it’s in danger. These are not well known and it’s common for people to talk about fight or flight without mentioning the others.
Trauma responses are widely misunderstood; you have probably heard of fight or flight - fighting back against the threat and running away. In reality there is also, friend/fawn- seeking help or presenting as non threatening and freeze (think rabbit in the headlights). Freeze is far more common than people seem to realise and often happens in sexual trauma. Other trauma experts have also added flop; when freeze doesn't work the body literally switches off and goes floppy (or maybe faints).
When children have been traumatised a common response is to blame themselves in some way. Far better for them to continue believing that the world (and adults) is a safe place and that they are at fault, that to believe the world is unsafe and they are blameless. In this way, they are still able to feel in control.
Why do trauma survivors blame themselves?
You will hear this very frequently when talking to people who have suffered trauma ‘I shouldn’t have made him angry’, ‘I did something wrong and that’s why he reacted like that’, ‘if I hadn’t have got in bed with him, it wouldn’t have happened’, ‘I was a difficult child, that’s why my parents weren't very affectionate’.
These are all attempts to have some kind of control. If the victim is at fault, they can change, they can do better! If they had/have no control, they will need to accept that people they trusted failed them (or that sometimes, terrible things happen for no reason such as accidents, natural disasters, death etc.)
This can be a very scary place to be, particularly if you do not have much support. In terms of trauma when something bad is done to you by someone you trusted e.g. parental abuse as a child - they might be the person you were relying on to take care of you.
It can be enormously isolating and lonely and can lead to CPTSD or complex trauma.
Therapy for trauma survivors
When I work, I go slowly. I tell people not to go into details about trauma so as to avoid retraumatising themselves, particularly at a time when they don’t know me and don’t know if I am reliable or a safe person. Whilst it’s helpful for me to information about why you’re seeking help to check if we’d be a good fit to work together, I don’t need details.
Relational trauma
I work primarily with relational trauma which is trauma that occurs in a relationship particularly in the family. It can look like name calling, lack of support, gaslighting (making you believe you are crazy or questioning your experience), manipulation, the silent treatment, lack of validation (not allowing your feelings or dismissing them). Sometimes it is absence where there are no boundaries, no caretaking or not receiving money, clothes or food that you need. Since relational trauma is not well know you might not know that this is trauma and you may simply believe that you are depressed or anxious or you might suspect you have PTSD.
Therapy for relational trauma
I work relationally, which means that the relationship (or alliance or connection - whatever you want to call it) is very important. Please note that this is a strictly professional relationship, although I care very much about my clients I keep to professional boundaries.
I work with people who have frequently felt like they had no one on their side. This might be their first experience on having someone that will listen, care and be non judgmental.
Why is trauma so misunderstood?
Trauma can be isolating for many reasons. It is so badly misunderstood that you will frequently hear people say ridiculous things.
One of the most common ones I see is ‘if anyone tried to rape me, sexually assault me I’d punch them in the face’ or advice to people who have experience sexual assault as ‘next time someone does that scream and poke their eyes out’.
For this reason, I would caution against listening to people who don’t know what they’re talking about. Feeling misunderstood and invalidated can be retraumatising or trigger previous childhood trauma or emotional abuse.
How do I recover from trauma?
Trauma recovery starts with understanding the process of trauma and how it affects you, this psycho education (education about how trauma works) will help you to understand your body and to stop blaming yourself for what happened and how you reacted.
How long does trauma recovery take?
Trauma recovery often takes a long time. This is probably not what you want to hear but I find it best to be honest.
You may simply be expecting too much too soon.
It takes time, to understand your brain responses, develop strategies to stay in what is called ‘the window of tolerance’ (in a mental space where you feel ok and not overwhelmed).
If you already have a therapist, healing may be possible in ‘regular’ therapy (assuming a good therapist, a good mutual understanding, knowledge of trauma and how it affects you). If you do not get what you need or feel understood, it can be useful to find a trauma expert.
How to find a CPTSD therapist?
When you are looking for a therapist, look for terms like: trauma informed therapist, CPTSD specialist, complex trauma, childhood trauma or CEN (childhood emotional neglect).
These terms are often used interchangeably by trauma specialists but it’s worth checking if the trauma expert you make contact with treats people like you or has had success with similar clients.
If a therapist doesn’t feel like a good fit, don’t be afraid to ask if they can recommend someone. Therapist often have networks of people that they can refer to.
What is the best therapy for childhood trauma?
Relational therapy
I am biased in preferring therapists who work relationally, because that’s how I work (therapists have a tendency to prefer their own styles). I’ve also received other types of therapies in the past and found them too ‘cold’.
Anyone who has experienced relational trauma (difficult family relationships) or has been traumatised by a parent relationship or as a young child may struggle with therapists who don’t offer feedback and allow for questions and discussions about how you experience them.
Feeling confused in therapy or not being sure what you’re allowed to do can leave the client feeling abandoned which can repeat past traumas for them.
Why did I freeze during a traumatic event?
Your trauma responses (whether you subconsciously choose ‘fight, flight, freeze, friend/fawn or flop’) will be influenced by your past experiences and whether they have ‘worked’ or ‘not worked’ for you in the past. And for your body an effective strategy is ‘hey I’m alive’ rather than ‘this was the best choice logically’.
This is why it is so cruel when people suggest that repeat trauma victims fight back. If you tried and failed (for example if the perpetrator was more powerful than you e.g. adult vs. child) to defend yourself you are less likely to be able to defend yourself or attempt an active trauma response (fight/flight).
This is not a conscious decision; you are not choosing to do this. Unfortunately, it is also true that you are more likely to be traumatised if your brain opts for a passive approach (friend, freeze or flop). So now, you are not only traumatised, you are blaming yourself for not having done more (and if you couldn’t do more it is quite likely that you couldn’t because you were previously traumatised).
And to top it off you are surrounded with misinformed people telling you your should have done better. It is a perfect storm.
TRAUMA RESOURCES
I particularly like these flashback management techniques by Pete Walker. He specialises in CPTSD but again these can be relevant for many people. He has written an excellent book called ‘From Surviving to Thriving’ which is a welcome resource for many complex trauma survivors and often offers their first experience of feeling understood and validated.
http://www.pete-walker.com/13StepsManageFlashbacks.htm
You don’t have to manage alone
Find out how I can help you heal from trauma by clicking here and booking a free 15 minute call, without even picking up the phone.