Trauma therapy: processing and overcoming trauma

What is trauma?

Psychological trauma is psychological damage that occurs as a result of a traumatising event. The event itself doesn’t necessarily happen in a short moment, but can last over a period of time. Trauma isn't the event itself, but the reaction to the distressing event. Trauma can lead to psychological after-effects known as trauma sequelae.

Where does trauma come from?

Trauma always has a traumatising experience at its root. However, it’s not the event itself that counts, but how we perceive and assess the event. Trauma occurs when the situation is seen as hopeless and unmanageable. This is when the stress or nervous system is overwhelmed and those affected experience tremendous fear, extreme stress, loss of control or powerlessness.

Physical threats as triggers

In many cases, the experience threatens the person’s mental and physical health. Examples of these situations include natural disasters, severe accidents, life-threatening medical conditions, war, and violence in general. But even seemingly less threatening experiences such as bullying or relationship breakdowns lead to trauma. The circumstances as well as the condition and previous history of the person are what count.

Risk factors for trauma sequelae

• Lack of social support
  
• Stressful living conditions after the traumatic experience
  
• Prior mental illness or stress
  
• Previous trauma, especially in childhood
  

Reactions to trauma

Reactions to the traumatic event occur immediately during and after the event – a natural consequence of the excessive pressure on the stress system. Common symptoms are fright and anxiety, numbness, the urge to flee, aggressiveness, and nightmares or flashbacks. During a flashback, the person relives the traumatising event or emotional state. The symptoms sometimes lead to an acute stress reaction – colloquially known as a nervous breakdown.

Lasting symptoms of a trauma

Sometimes reactions to the traumatic event last for an extended period and a traumatic memory develops. Since the nervous system is completely overwhelmed during the event itself, some reactions are stored unprocessed. Later, certain stimuli can trigger the traumatic memory, and the victims relive the raw emotions of the trauma – including their physical reactions.

Memory lapses due to psychological overload

Being stretched to our psychological limits can impair memory function. Memories of the traumatising experience are then partially or completely missing. If the traumatisation repeats itself or lasts several years, memory loss often extends over a longer period of time. This is particularly common when the traumatisation occurs in childhood. The psyche represses memories in order to protect itself from a renewed threat – this is what’s known as a repressed trauma.

How can I process a trauma?

In order to overcome a trauma, one thing is needed at the outset: a feeling of security and trust. In the same way that a trauma develops, the way it’s processed differs from person to person too. For example, overcoming a childhood trauma is different from overcoming a birth trauma.

When to go to trauma therapy?

Trauma can’t always be processed without help. If your trauma affects your everyday life and well-being over a long period, then it's advisable to get help. Trauma therapists have different possibilities and methods to help patients better process an experience.

Trauma therapy methods

Trauma therapy – whether as an inpatient or outpatient – proceeds in different phases. The most important elements of the treatment are: creating a safe framework and reliving the trauma. Treatment approaches often used include cognitive behavioural therapy and other body-oriented trauma therapies, gentle trauma therapy, or EMDR (eye movement desensitisation and reprocessing ), an approach developed specifically for treating trauma sequelae.

What kinds of trauma are there?

Traumatology makes a basic distinction between violence-related trauma and relationship trauma.

1. Violence-related trauma results from a massive threat to a person’s own existence.
2. Relationship trauma is the result of destructive relationship experiences.

Often the types of trauma overlap in practice: for example, severe childhood neglect is usually a mixture of violence-related and relationship trauma. Different forms of trauma, such as childhood trauma, birth trauma, or refugee trauma are specific variants of these types of trauma.

Trauma sequelae

Most people learn to cope with a traumatic experience after a certain time and the symptoms gradually disappear. In some cases, however, there are severe long-term effects. Professionals refer to this as the development of trauma sequelae. The most well known is what many people call post-traumatic stress disorder (PTSD), but it’s far from the only one.

Other trauma sequelae include:

• Anxiety and obsessive-compulsive disorders
  
• Addiction
  
• Depression
• Emotionally unstable personality disorder
• Sexual dysfunction
  

Lower life expectancy

Trauma-related disorders diminish the person’s quality of life and result in lower life expectancy. People with six or more childhood traumas, for example, have a 20-year lower life expectancy than those unaffected.

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