Trauma, What is it?

Trauma has been viewed many ways depending on who you talk to. As a therapist that sees things from a trauma informed perspective, my view on this topic is specific. Trauma comes in the form of big “T” traumas and little “t” traumas. You may be thinking, what is Jacob talking about? Before I define what big T and little t traumas are, I want to define trauma first. Trauma as anything that you have experienced in your life that has been distressing and changed the way you see yourself or the world in a negative way. At the end I will also provide symptoms of trauma, so please read until the end. So how does the big T and little t fit into the trauma equation? 

Big T Trauma

A big T trauma is something that was highly impactful on its own and changed the way in which you saw yourself or the world around you. This trauma is impactful in your daily life and may be producing PTSD symptoms. Some examples of this type of trauma are if you are a first responder such as an EMT, police officer, fire fighter, or veteran. Other equally impactful big T traumas could be experiences such as a car crash, sexual assault, physical assault, or domestic violence. These traumas alone are enough to derail the life that you had and wish you could get back to.

Little t Trauma

Little t traumas are just as impactful as big T traumas if collected. Little t traumas are a collection of socially and environmentally based traumas that occur throughout your lifetime. These traumas are responsible for many disorders such as anxiety and depression. Just as big T trauma’s produce symptoms of PTSD, little t traumas produce symptoms of anxiety and depression and many other disorders. This is associated with when we experience something either when we are a child, or a teen, or even young adult that is distressing and changes the way we see ourselves or the world around us. These things can include neglect or abuse (all forms) as a child, lack of attachment with our primary caregiver, consistent relationship patterns in our early teen years, failure to meet goals in the time that was set, and many others. 

A collection of these little t trauma’s produce side effects such as low self-esteem, low confidence in self, feeling threat/fear in relationships, unsavory body sensations such as jitteriness, physical pain, low motivation, lack of pleasure in most things. However, you might wonder, these symptoms just started showing up, how could these other experiences be part of what just started happening to me? 

I want you to imagine a Jenga tower. As you think about this, I want you to start taking pieces out every couple seconds. Every time you take a piece out, you may not notice its effects right away. However, if you begin taking pieces out that hold the foundation together, you may start to notice what happens. This is the way we work as individuals. We have for our whole lives built up positive structures of ourselves and the small distressing things that we experienced, we were able to experience and compensate and keep the structure together. What happens when we get to many of these at once? What happens if something has happened to us enough times? Simply, we start to believe that maybe these negative things that happen in my life tell us who we are.

What do I do now with this information?

This information may be helpful or overwhelming. What is for sure is that experiencing these things are unpleasant. What you can do is start therapy and begin sorting it out! Often when we leave ourselves alone with these experiences, we are the only feedback we have. I have been a therapist long enough to know that when we are our only feedback, things can just get worse. Why sit and suffer when you can take-action and with a therapist that can effectively help.

I work with individuals, families, and couples through many modalities. As a trauma-informed therapist, I use tailored approach for each person. For big T trauma’s, I use Eye Movement Desensitization Reprocessing (EMDR) Therapy. For Little t trauma’s I use a combination of EMDR and talk therapy using CBT and Gestalt therapy.

Please if you or someone else you know is dealing with any of these issues, have them reach out and set up an initial appointment.

Below I will list the symptoms of Post-Traumatic Stress Disorder, Depression, and Anxiety according to the Mayo Clinic (2018)

Post-Traumatic Stress Disorder (PTSD)

A disorder in which a person has difficulty recovering after experiencing or witnessing a terrifying event.

• The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions. Intrusive memories

Symptoms of intrusive memories may include:

• Recurrent, unwanted distressing memories of the traumatic event
• Reliving the traumatic event as if it were happening again (flashbacks)
• Upsetting dreams or nightmares about the traumatic event
• Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Avoidance
Symptoms of avoidance may include:

• Trying to avoid thinking or talking about the traumatic event
• Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:

• Negative thoughts about yourself, other people, or the world
• Hopelessness about the future
• Memory problems, including not remembering important aspects of the traumatic event
• Difficulty maintaining close relationships
• Feeling detached from family and friends
• Lack of interest in activities you once enjoyed
• Difficulty experiencing positive emotions
• Feeling emotionally numb

Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

• Being easily startled or frightened
• Always being on guard for danger
• Self-destructive behavior, such as drinking too much or driving too fast
• Trouble sleeping
• Trouble concentrating
• Irritability, angry outbursts, or aggressive behavior
• Overwhelming guilt or shame

Depression
A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.

• Possible causes include a combination of biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain.

Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

• Feelings of sadness, tearfulness, emptiness, or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation, or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions, and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches

The mainstay of treatment is usually medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

Anxiety

Intense, excessive, and persistent worry and fear about everyday situations. Fast heart rate, rapid breathing, sweating, and feeling tired may occur.

Symptoms

• Feeling nervous, restless, or tense
• Having a sense of impending danger, panic, or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety
• Several types of anxiety disorders exist:

Other Types of Anxiety

• Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless, or embarrassed.
• Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
• Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
• Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work, and social functioning.
• Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
• Social anxiety disorder (social phobia) involves high levels of anxiety, fear, and avoidance of social situations due to feelings of embarrassment, self-consciousness, and concern about being judged or viewed negatively by others.

 

References
Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD) – Symptoms and causes. 
https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967?utm_source=Google&utm_medium=abstract&utm_content=Posttraumatic-stress-disorder&utm_campaign=Knowledge-panel

Mayo Clinic. (2018, May 4). Anxiety disorders – Symptoms and causes.
https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961?utm_source=Google&utm_medium=abstract&utm_content=Anxiety&utm_campaign=Knowledge-panel

Mayo Clinic. (2018, February 3). Depression (major depressive disorder) – Symptoms and causes.
https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007?utm_source=Google&utm_medium=abstract&utm_content=Major-depression&utm_campaign=Knowledge-panel