Where Trauma Comes From
The sad thing about trauma is that it rarely comes alone. It’s one thing to suffer from trauma, but it also typically causes us to feel ashamed or embarrassed additionally.
There remains a stigma around trauma and stress, usually revolving around some sort of perceived weakness. The truth is that trauma is both psychological and biological, and no one should feel ashamed for feeling its effects.
To better explain the mechanisms behind this, KetaView reached out to Ava Mason – UCL Ph.D. student and educational YouTuber. What follows is her breakdown of trauma.
What is our instinct when exposed to stress?
When we are exposed to significant stress, our survival response is described as the defense cascade.1 Firstly, we experience the fawn response (also known as social engagement), where we try to reason our way out of a situation. If this is not effective, we would go into fight or flight, choosing to either confront or escape the situation. Confrontation may be induced from feelings of rage, frustration or irritation, while flight may bring on feelings of fear, worry or panic. If these options are hopeless or the situation remains overwhelming, we would then conduct the freeze response. This is when our body chooses to protect ourselves by shutting down more evolved parts of our brain, such as those involved in memory and pain. All of these responses are evolved to protect us, and which behavior we choose to elicit will depend on the situation and our instinctual reaction.
What is considered a trauma and PTSD?
According to the clinical definition of a traumatic event, (required for a DSM-5 PTSD diagnosis), trauma is an overwhelming event that involves actual or threatened death, serious injury, or violation. While not all stressful events are diagnostically described as ‘traumatic’, many individuals may demonstrate PTSD symptoms through stressful life events that are not under this definition.
PTSD criteria involves experiencing very intrusive symptoms, avoidance behaviour, mood changes and hyperarousal. Intrusive symptoms may involve flashbacks, dreams or intense reactions to trauma reminders, while hyperarousal could vary from irritability, concentration difficulties to sleep disturbance. Exhibiting these symptoms directly after a traumatic event is a normal response, and many of these symptoms will diminish when the trauma has been naturally processed correctly over time.2
What role does memory processing play?
Information from an event is slowly incorporated from short term into long term storage through a process called consolidation3. This consolidation means that we are able to put together all the different aspects of the memory, such as the sensory details of what we specifically felt or saw, and the context of the memory, like how long it lasted and when it occurred.
Research suggests that the hippocampus is involved in this consolidation, helping to form new memories and access them when required. The amygdala (an important region for processing fear) is involved in the strength to which a memory is consolidated. The sensory details of emotionally charged events are usually consolidated stronger into your long-term memory. According to the dual processing theory4, when you go through a stressful event, your memories are processed less in the hippocampus and more in the amygdala. This means that you have enhanced recollection of the sensory details of the memory, lacking the memories context you should have through consolidation. This explains certain symptoms such as ‘flashback’s.
How does our interpretation of the event affect PTSD symptoms?
According to the cognitive model of PTSD5, the way we interpret an event also plays a part in whether we experience PTSD symptoms. How we interpret an event is based on many factors, such as how long an event is, how predictable it was, our own prior experiences and beliefs and how the trauma memory was processed by the brain.
The way we interpret 1) our own initial PTSD symptoms, 2) other people’s reactions after the trauma has occurred and 3) the consequence the event has had on other life domains, will affect our coping strategies. Negative thoughts of the traumatic event could relate to the fact it happened (eg ‘nowhere is safe’), specifically to you (eg ‘I attract disaster’) or how you reacted during the experience (eg ‘I should have done this instead..’). Thoughts of the traumas consequence could relate to the symptoms you experience (eg. ‘I cannot cope with stress’), or other people’s reactions to the trauma ( eg ‘I cannot rely on other people anymore’).
These could also affect how we remember events, such as by selectively remembering the negative aspects that support your negative viewpoint and ignoring some of the positive aspects. One example would be remembering a nurse that was rude to you after a car accident, and not thinking about all the people who tried to help you during the event. Some of these thoughts may cause you to use unhealthy coping strategies, such as constant distraction without talking about what happened and avoidance from reminders, supporting ideas that the world is a dangerous place without being able to challenge these beliefs. Different emotions and the way we process memories will fuel different thoughts and then, different coping strategies. Research has found that having a negative attitude towards emotional expression and a tendency to suppress or withhold negative emotions were linked to the continuing of PTSD symptoms6. Therefore, if you do not feel like you can cope with these overwhelming feelings and thoughts after the event, it is important to talk to someone about your feelings or try to address them so they can be processed.
Also, as part of experiencing trauma could involve involuntarily re-experiencing the trauma, it is important to think about what potential triggers could make you feel the emotions you experienced during the traumatic event. One example from Ehlers & Clark (2000) would be a man who was rescued after being kidnapped. He used to feel anxious and sweaty every time he heard door knocking, as it reminded him of his captors before they used to come into the room. However, when he realized that it was actually the sound of footsteps that spurred his fight or flight response, rather than the knocking sound afterwards, he was able to use his coping strategies more effectively.