Tag Archive for: Trauma

Unconventional Grieving: Grieving someone Alive

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Grieving someone alive is not a conventional form of grief that is often talked about, but is a real issue that is faced by the living. Death is often viewed as the base requirement for grief but mourning the deceased is only one facet of death. If you have never experienced this, you likely do not understand what we’re talking about. How can you grieve for someone that you haven’t lost? If you have experience this sort of grief, you probably are cheering inside your head that someone has finally put to words what you’re feeling.

Grieving for someone alive, is not the same as anticipatory grief. Anticipatory grief is the type of grief that comes about when you know that you will soon be experiencing a loss, such as when a loved one is dying or in the hospital. If you are experiencing anticipatory grief or looking for resources on it, please visit the following link: http://www.whatsyourgrief.com/anticipatory-grief/.

WHY UNCONVENTIONAL GRIEF HAPPENS

If you’re not familiar with this form of grief, you may be unsure how this is possible or what often triggers this form of grief in people. Often, this form of grief is caused by a loved one becoming someone that you no longer know or recognize.

COMMON CAUSES OF UNCONVENTIONAL GRIEF

• Mental Illness
• Drug or Substance Addiction
• Dementia or Alzheimer’s
• Brain Injury
• Family Trauma

The unfortunate truth of grieving someone alive is that they are still there as the person you once knew but psychologically are a different person than they were before. Also, many of these factors are outside of the control of the person experiencing them or the person who is watching their loved one suffer. It can be hard for either party to recognize because the person does not always look like they are sick.

Don’t look at these causes and think that they mean that you love this person any less though. This form of grief, just like grieving someone who is deceased, does not change the level of attachment to the person. Simply, this person is no longer acting how they were before and have had a dramatic shift in personality. If your brother is suffering from a drug addiction, his behavior may become erratic and he might start stealing from yourself or other family members. Some will grieve the life that he is not living as he focuses living for his addiction. If someone is dealing with a mental illness, they may now be dealing with depression so badly that they are unable to go on living their life or they may be experiencing delusions or hallucinations.

A person will experience many emotions while grieving someone alive. These emotions may be more powerful and more confusing than the grieving process for someone who has recently passed. Anger is a prominent emotion that shows up. The grieving individual could feel anger towards their loved one for the issues they are dealing with and have a hard time understanding that they may not be able to change, such as in the case of mental illness. While experiencing anger, you may feel guilty as well that you are experiencing anger or guilty that you cannot control or change the situation.

Unlike when someone dies, you are unlikely to experience positive emotions while grieving someone alive. When someone passes, you are surrounded by the comfort of their loved ones and are often able to look at the joy of their life. This rarely happens with unconventional or ambiguous grief. Just like when someone dies, you are likely to be overcome with sadness. However, the reminder of your sadness is constant every time you think of this person or hear about them.

How to Grieve Someone Alive

• Let yourself grieve. Don’t attempt to hide or suppress your grief for this situation just because society or your loved ones don’t understand or acknowledge what you’re going through. Be open to sharing how your feeling to close family and friends and don’t push yourself to be someone you’re not at this time.
• Find other people in the same situation. Connecting with other people who are experiencing the same kind of personal loss as you is an invaluable resource. This can come in the form of a support group or finding an individual to speak with. Having someone understand what it is like to be grieving someone  alive will help to put your situation in perspective and help you to gain insight on the validity of your feelings.
• Don’t forget your memories or the past. When you are experiencing ambiguous or unconventional grief, it is easy to forget why and how you previously loved someone in the midst of their hurtful behavior. Remind yourself of the good times that you had and why you originally loved them. It is okay to cherish old moments and mourn that they are gone. Remember that that person is still here though, just not at the moment.
• Open yourself up to change. One of the hardest parts of grieving someone alive is that you are forced to accept a changed relationship that you do not want. It may be difficult for you to look on a loved one in a different life, but you may be able to experience a rewarding relationship with them in new ways than before. Focusing on finding joy in your new relationship will help keep your mental state positive rather than gloomy.
• Always remember that the illness is not the person. For many people, this is the hardest mental hurdle to overcome while grieving someone alive. Stop yourself from thinking of your loved one as the disease they’re dealing with, whether it be addiction, Alzheimer’s, or depression. You will still likely feel angry towards the person but understanding what they’re actually dealing with can help you process some of those feeling.

Unconventional Grief, Ambiguous Grief, or grieving someone alive are all very real and pertinent forms of grief that need to be treated, understood and addressed. Become a member of The American Academy of Bereavement today to find more resources on grief.

 

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Past Trauma May Haunt Your Future Health

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Adverse childhood experiences, in particular, are linked to chronic health conditions.

A rocky childhood. A violent assault. A car accident. If these are in your past, they could be affecting your present health.

These are all examples of traumatic events — which, in psychological terms, are incidents that make you believe you are in danger of being seriously injured or losing your life, says Andrea Roberts, a research scientist with the Harvard T.H. Chan School of Public Health. Research shows that these events can trigger emotional and even physical reactions that can make you more prone to a number of different health conditions, including heart attack, stroke, obesity, diabetes, and cancer.

Understanding trauma

Traumatic events encompass anything from a sexual assault or childhood abuse to a cancer diagnosis. Child abuse is particularly likely to affect your adult life because it occurs at a time when your brain is vulnerable — and it often occurs at the hands of people who are supposed to be your protectors, says Roberts. “By abuse, we often mean things that are a lot milder than things people typically think of as abuse. It might include being hit with a hard object, like a whip, a belt, or a paddle,” says Roberts. “The behavior doesn’t necessarily need to be illegal to induce a traumatic response.”

A child’s perception of events is as important as what actually occurred. “While a child’s life may not have actually been in danger, the child may have seen it as life-threatening,” says Dr. Kerry Ressler, a psychiatry professor at Harvard Medical School.

People who experience traumatic events sometimes develop post-traumatic stress disorder (PTSD), a psychiatric condition that affects 5% to 10% of the general population, says Dr. Ressler. It’s more common in women, affecting twice as many women as men. And it also occurs more frequently in people who have certain risk factors, including those living in poverty, soldiers in active combat, and first responders, he says. PTSD can develop after a person experiences violence or the threat of violence, including sexual violence. It may affect people who have a close relative who experienced those things as well, says Dr. Ressler. These traumatic events are generally incidents that are considered outside the ordinary and are exceptional in their intensity.

Exposure and risk

Your risk for mental and physical health problems from a past trauma goes up with the number of these events you’ve experienced. For example, your risk for problems is much higher if you’ve had three or more negative experiences, called adverse childhood experiences (ACEs), says Roberts.

These include

  • physical abuse
  • sexual abuse
  • emotional abuse
  • physical neglect
  • emotional neglect
  • witnessing domestic violence
  • substance misuse within the household
  • mental illness within the household
  • parental separation or divorce
  • incarceration of a household member.

Another kind of trauma

While severely traumatic events are believed to have the greatest effect on long-term health, other stressful events that don’t necessarily meet the psychological definition of trauma can still cause problems. This might include a sudden death in the family, a stressful divorce, or caring for someone with a chronic or debilitating illness, says Roberts. These milder events might lead to a mental health disorder, such as anxiety or depression. “Trauma pushes your ability to cope, so if you have a predisposition toward anxiety, for example, it may push you over the edge,” says Roberts.

In addition, incidents like these can also produce PTSD-like symptoms in certain people. “When people go through traumatic or complicated grief, they can experience pretty similar symptoms to those they might experience with trauma, such as intrusive thoughts,” says Dr. Ressler.

Medical conditions resulting from trauma

Most of the research related to trauma and chronic disease risk has focused on childhood trauma, says Dr. Ressler. Early childhood trauma is a risk factor for almost everything, from adult depression to PTSD and most psychiatric disorders, as well as a host of medical problems, including cardiovascular problems such as heart attack and stroke, cancer, and obesity.

These effects likely reflect two factors:

Behavioral changes resulting from trauma. People who are suffering from traumatic memories may try to escape them by participating in risky behaviors such as drinking, smoking, drug use, or even overeating for comfort. “Those can all be used as a coping mechanism, a way of dealing with emotional dysregulation that occurs when someone has been traumatized,” says Roberts. These habits, in turn, lead to health problems.

Physical effects related to trauma. The problem goes beyond unhealthy habits. Experts believe that there is actually a direct biological effect that occurs when your body undergoes extreme stress. When you experience something anxiety-provoking, your stress response activates. Your body produces more adrenaline, your heart races, and your body primes itself to react, says Roberts. Someone who has experienced trauma may have stronger surges of adrenaline and experience them more often than someone who has not had the same history. This causes wear and tear on the body — just as it would in a car where the engine was constantly revving and racing, she says. Stress responses have also been demonstrated in people who have experienced discrimination throughout their lives. “It ages your system faster,” says Roberts.

Chronic stress can increase inflammation in the body, and inflammation has been associated with a broad range of illness, including cardiovascular disease and autoimmune diseases, says Roberts. Early trauma disrupts the inflammatory system. This can lead to long-term aberrations in this system and chronic health problems triggered by constant inflammation. Typically, the more trauma you’ve experienced, the worse your health is.

Barriers to getting help

People who have experienced trauma may also struggle with getting help. “One of the most common outcomes of trauma is avoidance,” says Dr. Ressler. “It makes sense. If you experience something traumatic, you want to avoid thinking about it and going to places that remind you of it.” Unfortunately, health settings — with their doctors, therapists, and counselors — are triggers for many people because when someone experiences a traumatic event, he or she often ends up in the health care system.

In addition, if you’ve experienced trauma, you may believe that health care providers will want you to talk about it and dredge up feelings from the past. For these reasons, people who have experienced trauma may avoid medical care.

Some people may be in denial about the role past trauma is playing in their life. “I would say that a lot of people are unaware of how trauma is affecting them,” says Roberts. One of the hallmarks of trauma is the fact that people often use defense mechanisms to protect themselves from stress. Denial is one of those, as is trying to normalize past problems. “People may say things like, ‘oh, everybody I know got hit as a child,'” says Roberts.

Seek out resources

To get more information about trauma and PTSD or to find treatment resources, here are three very good, well-vetted websites from leading professional organizations:

Getting help

If you suspect that past trauma is affecting your life, there is help. This is a treatable problem. “You don’t have to be stuck,” says Dr. Ressler. “There is a good chance that you can move past this.”

Taking steps to address the problem may also help others in your life. Very often people who have experienced trauma pass problems on to others in their family through a process called observational learning, he says. So, helping yourself may help those around you. Consider these steps.

Work with a therapist. A trained therapist can help you reframe what happened to you and help you move past it. “One of the most successful treatments is exposure therapy, where the idea is to expose yourself in small doses to the thing that was most traumatizing, with someone there to support you,” says Roberts. Treatment may also include medication to address any mental health disorders you are experiencing.

Take care of yourself. There are numerous lifestyle measures that can help you reduce stress and anxiety. These include yoga, tai chi, and meditation. Regular exercise can also help you manage stress and other symptoms.

Reach out to others. Research has shown that maintaining strong social ties with friends and family members is crucial to good mental health.

“Unfortunately, all of these things are hard to do when in depressive states,” says Roberts.

That’s why many people may need to start with therapy, and then add other strategies later on.

 

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The Healing Power of Telling Your Trauma Story

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When we’ve survived an extremely upsetting event, it can be painful to revisit the memory. Many of us would prefer not to talk about it, whether it was a car accident, fire, assault, medical emergency, or something else.

However, our trauma memories can continue to haunt us, even — or especially — if we try to avoid them. The more we push away the memory, the more the thoughts tend to intrude on our minds, as many research studies have shown.

If and how we decide to share our trauma memories is a very personal choice, and we have to choose carefully those we entrust with this part of ourselves. When we do choose to tell our story to someone we trust, the following benefits may await. (Please note that additional considerations are often necessary for those with severe and prolonged experiences of trauma or abuse, as noted below.)

1. Feelings of shame subside. 

Keeping trauma a secret can reinforce the feeling that there’s something shameful about what happened — or even about oneself on a more fundamental level. We might believe that others will think less of us if we tell them about our traumatic experience.

When we tell our story and find support instead of shame or criticism, we discover we have nothing to hide. You might even notice a shift in your posture over time — that thinking about or describing your trauma no longer makes you feel like cowering physically and emotionally. Instead, you can hold your head high, both literally and figuratively.

2. Unhelpful beliefs about the event are corrected.

Many people experience shifts in their beliefs about themselves, other people, and the world following a traumatic event. For example, a person might think they’re weak because of what happened, or that other people can never be trusted. When we keep the story inside, we tend to focus on the parts that are most frightening or that make us feel self-critical.

I’ve often been struck during my work with trauma survivors by the power of simply telling one’s story to shift these unhelpful beliefs. These shifts typically don’t require heavy lifting by the therapist to help the trauma survivor recognize the distorted beliefs. Instead, there’s something about opening the book of one’s trauma memory and reading it aloud, “from cover to cover,” that exposes false beliefs.

For example, a person who was assaulted might believe they were targeted, because they look like easy prey; through recounting what actually happened, they may come to see that it was due to situational factors (“wrong place, wrong time”), rather than something personal and enduring about themselves.

Telling the trauma story to a supportive therapist is one of the key components of Cognitive Behavioral Therapy (CBT), which is one of the most effective treatments for post-traumatic stress disorder (PTSD). I recently explored the latest findings on PTSD treatment research with psychologist Dr. Mark Powers, Director of Trauma Research at Baylor Scott and White Health. As we discussed, effective CBT typically doesn’t require an intensive examination of the survivor’s beliefs and evidence for those beliefs, as is often done in CBT for other conditions. Instead, insights about the truth of what happened emerge just through talking about what happened and what it means.

3. The memory becomes less triggering. 

Revisiting a trauma memory can be very upsetting, triggering strong emotional and physical reactions and even flashbacks to the event. Those reactions can stay in place for years if we have unprocessed trauma memories, especially when we’re trying to avoid thinking about the trauma.

Through retelling the story of what happened, we find that our distress about it goes down. The first time, it’s likely to be very upsetting, even overwhelming, and we might think we’ll never be able to tolerate the memory. With repeated retelling to people who love and care about us, though, we find the opposite — that the memory no longer grips us. As Dr. Powers noted, we find that the memory no longer controls us. It will never be a pleasant memory, of course, but it won’t have the same raw intensity that it once had.

4. You find a sense of mastery.

As we talk about our trauma, we find that we’re not broken. In fact, as Dr. Powers pointed out, we can come to see that our reactions to trauma actually make sense. For example, it’s understandable that our nervous systems are on high alert, since they’re working to protect us from similar danger in the future.

Many trauma survivors I’ve worked with described the strength they found as they faced their trauma and told their story. They said they felt like they could face anything, as they saw their fear lessen and found greater freedom in their lives. It takes courage to tell your story, and witnessing your own courage shows you that you’re not only strong, but also whole.  

5. The trauma memory becomes more organized.

Trauma memories tends to be somewhat disorganized compared to other types of memories. They’re often stored in fragments, disconnected from a clear narrative and a broader context. Existing research suggests that these differences are detectable in the brain, with unprocessed trauma memories showing less involvement of areas like the hippocampus that provide context to our experience.

Recounting the trauma begins to organize the memory into a story of what happened. We can see that it has a beginning, a middle, and an end, and that it happened at a specific place and a specific time. We can better understand the events that led up to it, and our own reactions at the time and in the aftermath. By putting a narrative frame around it, the memory can become more manageable and less threatening.

6. You begin to make sense of the trauma.

The biggest benefit from sharing our trauma stories may come from starting to make sense of a senseless event. “As humans we gravitate toward processing and trying to make sense of our experience,” Dr. Powers said, and that need is especially pronounced following a trauma. “That’s why treatment is often geared toward finding a sense of meaning.”

While PTSD treatment shares elements with the treatment of anxiety, such as phobias, Dr. Powers pointed out that it focuses more on meaning than does treatment for anxiety. “We don’t see the same type of drive to make sense of one’s fear in panic disorder or spider phobia,” he said. “The person doesn’t tend to say, ‘I really need to understand my fear of spiders.’ But that does seem to happen in PTSD, that our brains need to process what happened.”

Accordingly, effective therapy for PTSD includes not only revisiting the trauma memory, but also exploring its possible meanings. The meaning doesn’t come “off the shelf,” of course, but can only be arrived at by each individual. According to Dr. Powers, “At best we can help guide them through that discovery process.”

Important Considerations

It probably goes without saying that not everyone is the ideal person to share your trauma with. Some people may have a hard time hearing it based on their own trauma history. Others might respond with blame or criticism, or other non-validating responses. Choose carefully so that the person is likely to meet your story with understanding and compassion.

Timing is also important. It may take time before you’re at the point where you’re able to put the trauma into words. Be patient with yourself, recognizing that “not now” doesn’t have to mean “never.” Again, you get to decide when, where, and how you tell your story, which is a crucial part of owning the events of your life.

A Note About Complex PTSD

As noted above, the points raised here are based for the most part on work with discrete types of trauma — for example, a one-time car accident or violent assault. Other considerations may be necessary for those experiencing more complex forms of PTSD, such as those with a history of severe childhood maltreatment. The National Center for PTSD provides additional information on complex PTSD.

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The Wounds of Childhood Can Be Healed

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When many of us think of childhood, we imagine happy, carefree times. Tender feelings of safe, loving relationships with parents and grandparents are often remembered. Those of us who are parents ourselves know there is nothing more precious than the birth of a child and the dreams associated with watching that child grow and thrive into adulthood.

Adults also know that growing up can be painful. The wounds of childhood can persist throughout life, embodied in every muscle and organ of our bodies. Children experience trauma in similar ways as adults, including from abuse, poverty, war, injury, or other adverse events. But there is more to trauma than meets the eye.

There are subtle, often invisible, ways children suffer from trauma, the most common being the loss of human connection. Relational trauma can be experienced by children who feel misunderstood, inferior, unaccepted, emotionally neglected, or socially disconnected. These feelings damage children’s emotional health.

Today, college freshmen rate their emotional health compared to others their age at 50.7%, the lowest level ever (Eagan, et al, 2014). Numerous studies have highlighted the declining emotional health of U.S. students, including a steady rise in anxiety, depression, and mental illness (Pryor, et al., 2010; Douce & Keeling, 2014). While these statistics are a cause for concern, the good news is that researchers are beginning to better understand the links between poor mental health, relational trauma, and the brain. As a result, therapies are improving.

In recent years, neuroscientists and psychologists have studied various types of trauma and its effects on children. We know, for example, that when children experience trauma, their growth and development is disrupted. To heal and move forward, research shows that the brain must be stimulated in fresh, creative ways. More than ever, a child needs support from adults who can authentically and respectfully interact with them.

In a groundbreaking new book, Relational and Body-Centered Practices for Healing Trauma: Lifting the Burdens of the Past,psychologist Sharon Stanley, PhD, demonstrates the importance of sharing traumatic experiences in the presence of those who can see, hear, and feel the many ways our bodies communicate truth. Written primarily for helping professionals, this book also reminds us of the significant role parents, teachers, and mentors play in helping children heal from adverse events or relational trauma. In fact, the neuroscienceresearch and practices that Stanley shares should be at the heart of every healthy adult-child relationship. Gleaned from her book are three important ways all adults can become healers for the children in their lives.

3 Ways to Help Children Heal from Traumatic Life Experiences

  1. Promote Embodied AwarenessBe willing to listen and respect the embodied and subjective experience that each child holds to be true. What does this mean? Neuroscience research shows that every traumatic experience is felt in the human body. When children become aware of their bodies, that awareness communicates important information to their brain. The brain, in turn, makes corrective changes and restores healthy functioning.A simple shift in conversation can help children become more aware of their bodies. For example, instead of simply asking, “How do you feel?” you might ask, “How and where do you feel that (fear, anger, sadness) in your body?” When children become accustomed to connecting their feelings with bodily sensations, they achieve embodied awareness. “Aided by embodied awareness,” says Stanley, “we can look more closely, hear more accurately, and feel more actively in the moment, a mindfulness that can shift habitual autonomic fixed patterns from trauma.”
  2. Create Meaningful RitualsThroughout history, humans have recovered from trauma by coming together to honor struggle and the power of transformation. Unfortunately, ritual and ceremony have all but disappeared in many of today’s Western cultures. Based on years of research with indigenous peoples, Stanley points out the powerful brain-body connections that are made through ritual and how those connections are essential to healing trauma.We can help children recover from painful events and hurtful relationships by working with them to create meaningful rituals. Again, body-based activities should be front and center, engaging the right hemisphere of the brain to connect to a child’s subjective way of knowing. Integration of the arts, music, contemplative practices, and dance, says Stanley, can transform the chaos of trauma into relational resources for growth.

    The goal of rituals is to create human connections. When parents and teachers create safe spaces for children to express themselves, explore their feelings, and become aware of the sensations in their bodies, children feel what it means to be human. Stanley suggests that ceremony changes the brain in ways that convert fear to love, facilitating growth and development.

  3. Connect through Somatic EmpathyMuch has been written about the power of empathy. What Stanley does exceedingly well in her book is to differentiate what we often understand as “cognitive empathy,” an attempt to understand what others think, from “somatic empathy,” an ability to feel what others feel. The former is a left-brain activity; the latter is right-brained.According to Stanley, “Somatic empathy communicates to people suffering from trauma that they are seen, felt, and understood just as they are, allowing them to feel felt.” Parents, teachers, and all caring adults have the ability to help children heal through our interactions with them and through our mindful attention to their body-based cues.

    For example, when a child aches in his stomach, feels tension in her jaw, or experiences tight sensations in his chest, we can help that child more consciously connect these sensations to a deeper self-knowing. We do this through authentic listening and a sense of respect for how a child feels and experiences those feelings in his or her body. We are consciously present, helping children reflect and gain embodied self-awareness.

    Through compassionate relationships based in somatic empathy, a child’s brain changes in ways that repair the effects of trauma.

Seeking Help when Youth Experience Trauma

The three practices listed above are everyday ways all adults can nurture deep connections with children and teenagers and help them heal from trauma. But often, children need the help of experienced psychological professionals to overcome adverse events and relational trauma in their lives. The good news is that neurobiological research with somatic, embodied healing practices is breaking new ground each year.

Stanley has trained hundreds of practitioners for over a decade in what she calls “somatic transformation.” For helping professionals who want to understand the neurobiological underpinnings of trauma and new ways to work with those affected by trauma, I highly recommend Stanley’s book, based on the most recent research and transformative practices available.

As parents and teachers, we must all become more aware of the subtle cues of relational trauma in our children and in ourselves. Through numerous case studies, Stanley demonstrates that it is never too late to heal the wounds of our own childhoods through body-based somatic healing. When we heal ourselves, we have greater capacity to be in authentic empathy-based relationships with our children.

References

Douce, L.A, & Keeling, R.P. (2014) A strategic primer on college student mental health. (Washington DC: American Council on Education).

K. Eagan, et al., (2014) The American Freshman: National Norms Fall 2014(Los Angeles: CA: Higher Education Research Institute, UCLA, 2014)

J.H. Pryor, et al., (2010) The American Freshman: National Norms Fall 2010(Los Angeles, CA: Higher Education Research Institute, UCLA, 2010).

S. Stanley, (2016) Relational and Body-Centered Practices for Healing Trauma: Lifting the Burdens of the Past (New York: Routledge).

Author

Marilyn Price-Mitchell, PhD, is the author of Tomorrow’s Change Makers: Reclaiming the Power of Citizenship for a New Generation. A developmental psychologist and researcher, she works at the intersection of positive youth development and education.

https://www.psychologytoday.com/us/blog/the-moment-youth/201605/the-wounds-childhood-can-be-healed

PTSD And Trauma: Not Just For Veterans

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When we think about posttraumatic stress disorder (PTSD), it’s typically in the context of active duty service members and veterans—for good reason. Dangerous and potentially traumatic situations are common occurrences in the context of military service. However, it’s important to note that PTSD is not exclusive to this type of trauma.

In the U.S., about eight million people experience PTSD. While any traumatic experience can lead to PTSD, there are a few types of trauma that are the most common. Examples include sexual assault/abuse, natural disasters, accidents/injuries to self or other, or being in a life-threatening situation. When you consider these examples, it’s understandable why people would associate PTSD most frequently with military service members. However, this assumption can be problematic.

If people believe that only service members and veterans can develop PTSD, the recognition of symptoms and treatment can be delayed. The fact is: Anyone can develop PTSD when they experience or witness a traumatic event—adult or child, man or woman. Anyone.

How Do You Know If You Have PTSD?

About 50% of all people will go through at least one traumatic experience in their lifetime. But not everyone will develop PTSD. In fact, the majority won’t. However, it can be difficult to distinguish between the typical symptoms that follow a traumatic event and when it has reached the point that a condition like PTSD has developed.

It’s common for people who experience trauma to have nightmares or flashbacks for a few weeks and then gradually improve. It’s when those symptoms don’t improve and begin to interfere with a person’s life that a mental health evaluation should be considered. A person who experiences the following intense symptoms for more than a month may have PTSD:

  • At least one “re-experiencing” symptom (flashbacks, bad dreams, frightening thoughts)
  • At least one avoidance symptom (avoiding thoughts, feeling, places, objects or events related to the traumatic experience)
  • At least two arousal and reactivity symptoms (easily startled, feeling tense, difficulty sleeping, outbursts of anger)
  • At least two cognition and mood symptoms (difficulty remembering details of the traumatic experience, negative thoughts, distorted feelings, loss of interest)

It’s important to note that PTSD-related symptoms may not occur immediately after the traumatic event; they may not surface until weeks or months afterwards. Another major, key difference between typical reactions and PTSD is that while most will remember the fear they felt during trauma, PTSD can cause a person to actually feel as if they are reliving that fear.

What Should You Do After Trauma?

If a person feels supported by friends and family after a traumatic event, it can reduce the risk of developing symptoms of PTSD. It can also be helpful for a person to join a support group, so they can share their thoughts, fears and questions with other people who have also experienced trauma. Using healthy, positive coping strategies—such as exercise, mediation or playing an instrument—can also be helpful.

If symptoms persist, it’s essential to seek treatment. Those with PTSD typically respond better to structured therapies such as:

  • Cognitive behavioral therapy (CBT) – helps a person replace their negative thoughts and behaviors with positive ones
  • Eye movement desensitization and reprocessing (EDMR) – exposes a person to traumatic memories with varying stimuli, such as eye movements
  • Exposure therapy – helps a person safely face their fears so they can learn to cope with them
  • Imagery rehearsal therapy (IRT) – is a new treatment for reducing the intensity and frequency of nightmares

If you or someone you know is having a difficult time coping with trauma, these interventions can make a huge difference. PTSD is treatable. It’s more effective if treated early, but it’s never too late to get treatment no matter how long ago the trauma occurred.

Trauma is a part of life—it affects most people at some point. But that doesn’t mean it’s a mundane experience that can be ignored or brushed off. The key is to check-in on symptoms and seek care from a mental health professional if they persist.

Whether you’re a military service member, veteran, salesperson or elementary school student, PTSD has the potential to develop in any of us. And if it does, please know that help is available. No one should face PTSD alone.

Laura Greenstein is communications coordinator.

https://www.nami.org/Blogs/NAMI-Blog/November-2017/PTSD-and-Trauma-Not-Just-for-Veterans

Loving a Trauma Survivor: Understanding Childhood Trauma’s Impact On Relationships

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Survivors of childhood trauma deserve all the peace and security that a loving relationship can provide. But a history of abuse or neglect can make trusting another person feel terrifying. Trying to form an intimate relationship may lead to frightening missteps and confusion.

How can we better understand the impact of trauma, and help survivors find the love, friendship and support they and their partner deserve?

How People Cope With Unresolved Trauma

Whether the trauma was physical, sexual, or emotional, the impact can show up in a host of relationship issues. Survivors often believe deep down that no one can really be trusted, that intimacy is dangerous, and for them, a real loving attachment is an impossible dream. Many tell themselves they are flawed, not good enough and unworthy of love. Thoughts like these can wreak havoc in relationships throughout life.

When early childhood relationships are sources of overwhelming fear, or when absent, insecure or disorganized attachment leaves a person feeling helpless and alone, the mind needs some way to cope. A child may latch onto thoughts like

  • Don’t trust, it’s not safe!
  • Don’t reach out, don’t be a burden to anyone!
  • Don’t dwell on how you feel, just move along!

These ideas may help a person cope when they hurt so badly every day and just need to survive. But they do not help the emerging adult make sense of their inner world or learn how to grow and relate to others. Even if the survivor finds a safe, loving partner later in life, the self-limiting scripts stay with them. They cannot just easily toss them and start over. These life lessons are all they have (so far) to survive the best way they know how.

Noticing Trauma’s Impact On Behavior and Mood

Many times, trauma survivors re-live childhood experiences with an unresponsive or abusive partner (an important topic for another article). This often happens without the ability to see the reasons why they feel compelled to pursue unhealthy relationships. Beneath awareness is a drive to revisit unresolved trauma, and finally make things right. Of course, childhood wounds cannot be repaired this way unless there are two willing partners working on changing those cycles. But if these forces remain unnoticed, survivors can get caught in a cycle of abuse.

Even with a safe partner, a trauma survivor may

  • Experience depression
  • Develop compulsive behavior, an eating disorder, or substance dependence to try and regulate their emotions
  • Have flashbacks or panic attacks
  • Feel persistent self-doubt
  • Have suicidal thoughts
  • Seek or carry out the adverse behavior they experienced as a child

Partners of trauma survivors may want desperately to help. But partners need to “be clear that it is not your problem to fix and you don’t have the power to change another human being,” says Lisa Ferentz, LCSW in a post for partners of trauma survivors. Rather, know that both of you deserve to connect with resources to help you find comfort and healing.

Seeing Trauma’s Impact On Relationships

It is important to recognize unhealed trauma as a dynamic force in an intimate relationship. It can super-charge emotions, escalate issues, and make it seem impossible to communicate effectively. Issues become complicated by:

  • Heightened reactions to common relationship issues
  • Emotionally fueled disagreements
  • Withdrawal or distant, unresponsive behavior
  • Aversion to conflict and inability to talk through issues
  • Assumptions that the partner is against them when it is not the case
  • Lingering doubt about a partner’s love and faithfulness
  • Difficulty accepting love, despite repeated reassurance

In a relationship, a history of trauma is not simply one person’s problem to solve. Anything that affects one partner impacts the other and the relationship. With guidance from therapy, partners begin to see how to untangle the issues.

Many people do not even realize that they have had traumatic experiences. Trauma-informed therapy works by helping couples begin to see how they experienced traumatic abuse or neglect, and how it still affects them, and impacts their current relationships. This approach enables the therapist to provide specific insights to help couples separate past issues from present ones. Progress often comes more readily through a combination of individual sessions and work as a couple.

Trauma-informed therapy helps partners give each other the gift of what I and other therapists call psychoeducation – learning to understand each individual’s story, how it impacts their relationship, and how to process thoughts and emotions in healthier ways.

The Importance of Self-Care For Trauma Survivors and Their Partners

Trauma survivors and their partners have different needs for support. How can one respond when the other is grappling with mental health issues? How do you calm things down when overwhelming emotions get triggered?

It takes therapy for couples to find answers that are most healing for them. But some general tips for trauma survivors and their partners that can help are:

  • Have a really good support system for each of you and the relationship. Make time for family and friends who are positive about your relationship and respect you and your loved one.
  • Find a trauma-informed therapist to guide you as a couple or as individuals in your effort to better understand yourselves and each other.
  • Find resources outside of therapy such as support groups or other similar activities
  • Take time for psychoeducation. Learn about the nature of trauma, self-care and healing techniques like mindfulness. For example, one helpful model is Stan Taktin’s “couple bubble.” This is a visual aid to help partners see how to become a more secure, well-functioning couple. Surrounding yourself and your partner with an imaginary bubble “means that the couple is aware in public and in private they protect each other at all times. They don’t allow either of them to be the third wheel for very long, at least not without repair. In this way, everybody actually fares much better.” See More Helpful Resources below.

Communication Tips for Partners of Trauma Survivors

Building a healthy bond with a trauma survivor means working a lot on communication. Grappling with relationship issues can heighten fear and may trigger flashbacks for someone with a history of trauma.

Learning how to manage communication helps couples restore calm and provide comfort as their understanding of trauma grows. For example, couples can:

  • Use self-observation to recognize when to slow down or step back as feelings escalate
  • Practice mindfulness to raise awareness and recognize triggers for each of you
  • Develop some phrases to help you stay grounded in the present and re-direct your dialog, such as:
    • “I wonder if we can slow this down.
    • “It seems like we’re getting triggered. Can we figure out what’s going on with us?”
    • “I wonder if we are heading into old territory.”
    • “I’m thinking this could be something we should talk about in therapy.”
    • “I wonder if we could try and stay grounded in what is going on for us – is that possible?”

Communication can also help a partner comfort a loved one during a flashback. Techniques include:

  • Reminding the person that he or she is safe.
  • Calling attention to the here and now (referencing the present date, location and other immediate sights and sounds).
  • Offering a glass of water, which can help stop a flashback surprisingly well. (It activates the salivary glands, which in turn stimulates the behavior-regulating prefrontal cortex.)

Healing childhood wounds takes careful, hard work. But it is possible to replace old rules bit by bit. Finding a therapist who can recognize and acknowledge the hurt, which the survivor has carried alone for so long, is key to repairing deep wounds.

Partners may decide to work individually with their own trauma-informed therapist, while working with another as a couple, to provide the resources they need. When a survivor of early trauma can finally find comforting connection with a therapist, and then with their partner, the relationship between the couple can begin to support deep healing as well.

The more we understand about the impact of trauma, the more we can help those touched by it to go beyond surviving, and find the healing security of healthier loving relationships.

More Helpful Resources

Articles and Websites

“Helping a Partner Who Engages in Self-Destructive Behaviors” by Lisa Ferentz, LCSW

“Trauma-Informed Care; Understanding the Many Challenges of Toxic Stress” by Robyn Brickel, M.A., LMFT

Sidran Institute (resources for traumatic stress education and advocacy)

Books

Wired for Love: How Understanding Your Partner’s Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship by Stan Tatkin, PsyD, MFT

Allies in Healing: When the Person You Love Was Sexually Abused As a Child by Laura Davis

Trust After Trauma: A Guide to Relationships for Survivors and Those Who Love Them by Aphrodite Matsakis

Mindsight: The New Science of Personal Transformation by Daniel Siegel

http://brickelandassociates.com/trauma-survivor-relationships/