Therapy for Psychological Trauma
What is Psychological Trauma? Types of Trauma
Trauma therapy refers to an integrative therapeutic approach used to treat various psychological conditions induced by traumatic experiences. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), trauma is the consequence of experiencing or witnessing an event that is or is perceived to be a danger to own or others’ life or safety. Psychological trauma is a highly subjective negative experience in a person’s life. Its perception varies from person to person. It means that what may be traumatic to one individual, may not be so for another. There are no suggested hierarchies of traumatic events. Yet, some studies indicate that interpersonal trauma is the most damaging form of psychological trauma.
Interpersonal trauma exposure includes sexual assault, physical assault, sexual abuse, physical neglect, physical abuse, emotional neglect, emotional abuse and child abuse.
Furthermore, psychological trauma can result from interpersonal betrayal. Research has shown that betrayal is a more potent risk factor for post-traumatic stress disorder (PTSD) than a life-threatening situation. Betrayal traumas often occur in relationships that involve trust, dependency and care.
Psychological trauma is a rather prevalent phenomenon in people’s life. Research into trauma reveals that as many as 70% of the population recollect having had at least one highly traumatic experience, such as a life-threatening accident, a severe offence or a natural catastrophe.
Systemic trauma is another kind of trauma. It refers to discrimination, oppression or postcolonial trauma, which results in traumatic alterations to cultures and systems. It is known as a type of intergenerational trauma, where a progeny of the traumatised person experiences the consequences of trauma.
When various forms of trauma, such as systemic trauma of tyranny, interpersonal and betrayal trauma, trauma of microaggression and other life-threatening traumatic events are taken into account, the ubiquitous nature of trauma becomes more evident.
Trauma and Post-Traumatic Stress Disorder (PTSD)
Because the extent to which an event is deemed traumatic varies based on individual perception, it’s impossible to compile an exhaustive and unbiased list of traumatic events Various forms of trauma may lead to PTSD. Kessler and colleagues (2014) identified the following types of trauma and their corresponding prevalence among PTSD:
The survey, conducted across 24 countries on a large and diverse community-based sample, estimated the probability of developing PTSD for 29 distinct types of trauma.
Consequences of Trauma
In addition to post-traumatic stress disorder, exposure to trauma is a potent risk factor for dissociative and somatoform disorders.
Traumatic experiences may also contribute to
- chronic pain,
- severe anxiety,
- OCD,
- depression,
- dependencies
- eating disorders.
Trauma often causes problems with emotion regulation and trust. Therefore, in people presenting with the symptoms of mental health or personality disorders, it is reasonable to presume a history of traumatic experiences. For example, (childhood) abuse and neglect are the pronounced risk factors for borderline personality disorder. In trauma psychology, borderline personality disorder is equal to complex traumatic stress.
The list of trauma-induced problems points out two things. First, post-traumatic issues often lead to a wide range of psychological complications. Second, there is no one treatment for post-traumatic problems because of this broad spectrum. Nonetheless, practitioners employ several evidence-based trauma treatments to help trauma survivors.
Trauma Therapy
Therapeutic strategies for post-traumatic difficulties fall into several categories, including stabilisation and containment interventions, eye movement desensitisation and reprocessing (EMDR), cognitive techniques and exposure interventions.
Exposure
Exposure therapies for trauma emphasise the fear and anxiety elements of trauma response. Prolonged exposure is one of the most effective evidence-based trauma interventions for survivors of adult-onset trauma. Exposure therapy for psychological trauma must be conducted only by an experienced psychotherapist.
Cognitive Interventions
Cognitive techniques for trauma treatment highlight identifying and challenging problematic interpretations of self, others and the world to which trauma survivors are prone. Trauma-informed cognitive-behavioural therapy (T-CBT) is among the cognitive treatments with the most potent evidence base for efficacy.
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR rests on the assumption that our psychological problems are the consequences of traumatic life experiences our memory could not process and save properly. They are said to be blocked or unprocessed traumatic memories. These traumatic recollections need some aid in becoming processed, and EMDR is one of the most effective approaches to do this. However, it is necessary to identify which form of bilateral stimulation you are comfortable with.
EMDR is a trauma treatment that involves having a person recollect an image of the trauma and relate it to present troubled thoughts and physical experiences of distress. Subsequently, an EMDR therapist instructs a client to complete recurrent sets of bilateral stimulation (e.g. side-to-side eye movements) to improve memory processing. EMDR is a therapeutic approach initially designed by American psychologist F. Shapiro for working with traumatic and painful memories, which later was adapted to the treatment of many other psychological conditions, including depression, panic disorder, eating disorders, dependencies and more.
Phases of Trauma Treatment
No matter, what specific therapy a trauma therapist employs. The best trauma treatment outcomes reflect a three-phase treatment model. Patients will not necessarily complete these phases linearly.
The first phase of treatment targets the stabilisation and containment of trauma survivors to make them feel safe and secure.
The second phase is the resolution or processing of trauma. The traumatic experiences are remembered, grieved about, and absorbed and trauma-specific symptoms (e.g. flashbacks, nightmares, hypervigilance, avoidant behaviours, disturbing images, dysfunctional beliefs) are addressed.
The final stage of trauma treatment involves self‐esteem and identity enhancement. Concurrently, it aims to improve interpersonal skills and relationships. We usually address the critical issues of life choices, sexuality, and intimacy at this stage. Individuals at this phase often face an existential crisis related to a freshly established sense of self.
Post-traumatic growth (PTG) is one of the ultimate goals of this stage. We aim to achieve post-traumatic growth in the process of transformation following trauma. A theory of PTG maintains that enduring psychological struggles following traumatic experiences can often lead to positive trends in personality development afterwards.
The duration and path of trauma treatment can vary markedly, and a therapist might employ different therapeutic approaches across the phases of trauma therapy. Some patients might stay in therapy longer (especially those with a history of complex trauma). Others move through the treatment much faster. And still, others only present for treatment irregularly as needed.
Therapy for Psychological Trauma: Conclusion
In summary, psychological trauma is a deeply subjective experience, with no clear hierarchy of traumatic events. Research indicates that trauma is pervasive, affecting up to 70% of individuals with highly distressing incidents in their lives. Trauma encompasses various forms, including interpersonal betrayal and systemic trauma, highlighting its widespread nature.
Trauma can lead to mental health issues, such as acute stress disorder, PTSD and dissociative disorders, as well as chronic pain, anxiety, depression and more. Trust, interpersonal skills and emotional regulation can also be compromised.
Treatment approaches include stabilisation, EMDR, cognitive techniques and exposure therapy. Trauma therapy typically follows a three-phase model, aiming for post-traumatic growth, although the duration and path of treatment may vary based on individual needs.
Bibliography:
- https://doi.org/10.7812/TPP/13-098
- https://doi.org/10.1093/med:psych/9780199674718.003.0003
- https://doi.org/10.3402/ejpt.v4i0.19985