Being a psychotherapist that specializes in trauma, I have a unique opportunity to study the effects of trauma on the brain, on the body, and on the client’s subjective experience of the world. I think it is very important for the world of medicine and psychology to understand trauma in a deeper way, so that we can properly diagnose it and help our clients heal faster.
We tend to think of trauma as a war, car accident, or sexual abuse. This isn’t entirely true. Trauma is not the actual event that happens to the person. Trauma is the reaction of the brain being overwhelmed by the event. When fear or negative emotions overwhelm the brain, it needs to find a way to protect itself. This is the experience of trauma. The protection of the brain is automatic, not a conscious decision. To handle the experience, the brain will often split the experience up into many different parts and store them in the brain separately. “The traumatizing event results in memories that are stored in a dysfunctional way, that is, stored in isolation, unassimilated into the memory networks of the individual. The lack of adequate assimilation means that the client is still reacting emotionally and behaviorally in ways consistent with the moment of trauma”(Shapiro, 2001, p17).
Trauma, therefore, is a subjective experience. What overwhelms one person’s brain may not overwhelm another person’s brain. Also, what overwhelms a child will, very likely, not overwhelm an adult. A child is more susceptible to trauma because the child is not born with natural defenses to protect itself. As we get older and become adults, we become much more skilled in protecting ourselves, managing emotions, and setting boundaries. We are not as vulnerable to trauma. That is not to say that adults don’t experience trauma, just that adults are not as susceptible to trauma.
In the psychology world we have been talking about “big T” trauma and “little t” trauma for years. We know that having a “big T” trauma like war, car accident, or sexual abuse can create trauma in the brain. However, neuroscientific research has now shown that the “little t” traumas of childhood, often called attachment trauma, are just as harmful to the brain. For example, a child that constantly feels physically threatened, a child that finds themselves alone too much, or feeling like they don’t measure up in their parents eyes, we call this attachment trauma, as it relates to the attachment relationship of the primary caregivers and the feeling of safety and security of the child. The amazing thing about trauma is that the threat doesn’t have to be real to cause harm, just the perception of threat is enough to cause an overwhelming fear reaction in the brain.
Surprisingly in clinical work, “little t” or attachment trauma can be harder to resolve than “Big T” trauma; mostly because of the consistent nature of it. Research shows that this consistent type of trauma affects the brain even more because it is forming the child’s experience of life, safety and love. Some of the symptoms I often see in these patient’s lives are mental, physical, and relational.
Mentally, I see that the client may have abnormal amount of fears and phobias, chronic patterns of anxiety and hyper-vigilance, addiction issues, and a higher dependency on drugs. They suffer more from depression, personality disorders, and thoughts of suicide. Their symptoms may be misdiagnosed as ADD. Physically, I see all kinds of somatic symptoms: stomach issues, auto-immune diseases, poor posture, and chronic pain responses. Relationally, they are often in relationship dynamics that are unhealthy in some way. They may identify as a savior type or needing a savior to rescue them and keep them safe. They may have people-pleasing tendencies or rebel at authority. They may often feel overly helpless, get easily overwhelmed, feel like a victim, or always need to be in control.
We don’t tend to think of these symptoms as symptoms of trauma, but they are. Because trauma doesn’t reside in the thinking part of the brain, we can’t treat trauma by talking about it or taking medication to stop the symptoms. The trauma lives in the middle and lower centers of the brain, where the survival and reactionary parts of the brain are. When these parts of the brain get triggered our emotions get triggered and then our thoughts get triggered. To resolve this dilemma, we need to work from the lower brain up to the higher brain. This means getting to the unconscious and automatic responses that are outside of the individual’s cognitive awareness and working up towards their thoughts and cognitive schemas.
EMDR is a therapy that is very successful in treating trauma and PTSD (post-traumatic stress disorder). It uses eye movements that activate the right and left brain. It also accesses the lower, middle and upper brain. Often a client can see complete resolution of a one-time trauma in 1-3 sessions. A client that was in a life threatening car accident completely resolved her symptoms of PTSD in 6 sessions while a traumatic C-section client resolved her PTSD in one session.
EMDR is a highly effective therapy that heals PTSD. Studies have indicated an elimination of PTSD diagnosis in 77-90% of client participants after three to ten sessions. One study reported an 84% remission of PTSD diagnosis at 15-month follow-up. Other research using participants with PTSD have found significant decreases in a wide range of symptoms after two or three treatment sessions.
There is hope for these clients. We just have to be on the lookout for what trauma actually looks like and diagnose it quicker, so that our clients won’t stay stuck in the negative symptoms of unresolved trauma.
Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd ed.). New York, NY: Guilford Press.