Friday, February 05, 2016

A recipe for trauma

Most of the literature defines trauma as an event, just look at Criterion A1* in a PTSD (posttraumatic stress disorder) diagnosis.

However, I believe trauma is the experience of an event, not the event itself. You cannot be traumatised without having had a response to an event, it is therefore the response which is important. If fear, (or any intense emotion that overwhelms our resources to cope with it), helplessness and feeling/being trapped are present and an external threat is internalised, there is a good chance of a person being traumatised.  And that includes many so-called "disorders", not just PTSD.

This is especially true in the case of children where a threat can be either real or perceived. For example, a child might live with the fear of being abandoned, they might never be abandoned, at least not physically, and that constant threat depletes their resilience and exhausts their nervous system as they are on continuous high alert. They will adapt their behaviour to not be abandoned and so their true self is lost in the (usually) futile search for acceptance and love. They certainly will not feel safe, another crucial element in the process of being traumatised and healing from trauma.

By not including emotional abuse and neglect, any criteria for comprehensively assessing trauma are incomplete and as a consequence many people don't get the help they need because their bruises aren't as visible as those from physical and sexual abuse.

Comparisons deplete the actuality of the things compared ~ William S. Wilson

* The person was exposed to: death, threatened death, actual or threatened injury, or actual or threatened sexual violence (American Psychiatric Association, 2013).

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