By Carrie Jones, LCSW
Director of Counseling, Community Center Shanghai
This Spring, Lorraine Li of INWARD and CCS Director of Counseling Carrie Jones, presented a workshop entitled Understanding Trauma to help community members better recognize and understand trauma, how it impacts us, and how to support those who have experienced trauma. This article is Part 1 of a two-part series summarizing the information covered in the workshop.
What is Trauma?
At some point in our lives, almost all of us experience a traumatic event – perhaps a car accident, natural disaster, unhealthy or abusive relationship, loss of a loved one, health or medical scare, or being the victim of an assault or other crime. When such events occur, they shatter our sense of security and can result in us feeling helpless in a dangerous world. This emotional distress can be described as trauma.
There is no one clear cut precise definition of psychological trauma, but it generally refers to a person’s emotional response to a distressing experience. As physician Dr. Gabor Mate explains, “Trauma is not what happens to you. Trauma is what happens inside you, as a result of what happened to you.”
We often tend to think of events that cause trauma as those that involve a serious threat to our life. While such events that threaten our physical safety certainly can be traumatic, so too can many other events, including those that threaten our emotional and psychological wellbeing and security. Often, but not always, events that cause trauma are sudden, unpredictable, and feel beyond our control. It is important to recognize though that it is not the objective circumstances that determine whether an event is traumatic or not, but rather the individual’s subjective experience of the event. What is traumatic to one individual may or may not be to another individual.
Types of Trauma
Psychological trauma can be divided into several categories. It should be noted though
that these categories are not mutually exclusive; there is some overlap between the various categories.
Acute trauma: Intense distress in the immediate aftermath of a one-time event (car crash, assault, sudden death of a loved one, etc).
Chronic trauma: Arises from distressing events that are repeated or prolonged (living in a warzone or politically unstable region, etc).
Complex trauma: Exposure to multiple, often interrelated forms of traumatic experiences and the difficulties that arise as a result of these experiences. The adverse experiences that cause complex trauma often begin in childhood, are longstanding or recurrent, and are inflicted by others, often by someone within the individual’s formative attachment relationships (child abuse, intimate partner violence, etc).
Secondary or vicarious trauma: Arises from exposure to other people’s trauma and can be common among those in professions that are called upon to respond to crises and injury (medical professionals, mental health professionals, first responders, law enforcement, etc).
Adverse Childhood Experiences (ACE): A broad range of situations children face that may disrupt the normal course of development and can have long-term impact lasting into adulthood (abuse, neglect, loss of a parent, divorce, living in a household with an individual who suffers from alcohol or drug abuse, where domestic violence occurs, etc).
Collective Trauma: Affects an entire group or community after a wide-scale traumatic event such as 9/11 or the COVID pandemic.
The Effects of Trauma
When a traumatic event occurs, the brain sends out a message of alarm to various body systems to prepare for defense. The sympathetic nervous system stimulates the release of adrenaline, noradrenaline, and stress hormones that prepare the body for a flight-fight-or freeze response. In the short-term, shock, denial, fear, anxiety, and anger are all common responses to trauma. Following some instances of trauma, the brain may become hypervigilant to potential future traumatic events, leading to the production and release of stress hormones even when no immediate threat is present. This leaves the individual living in a state of hyperarousal and in a defense mode that can negatively impact daily functioning and relationships.
Trauma impacts each person differently and how any individual responds to a traumatic event and experiences trauma varies vastly, depending on a number of factors including personality makeup, exposure to previous traumatic events, degree of support and connectedness, availably of resources for help, etc. Responses to trauma may include severe emotional disturbances (depression, anxiety, emotional numbness, etc), nightmares, flashbacks, dissociation, variations in consciousness, survivor’s guilt, suicidal thoughts, and post-traumatic stress disorder (PTSD). Some survivors of trauma experience changes in self-perception, such as a chronic and pervasive sense of helplessness, guilt, shame, stigma, and being completely different from other people. They may also experience changes in their perception of the perpetrator, such as attributing total power to him/her or becoming preoccupied with him/her. Trauma also can result in physical symptoms such as headaches, racing heart, edginess and startling easily, muscle tension, aches and pains, digestive issues, insomnia, and fatigue.
Some individuals may experience intense distress early on, but then seem to bounce back and recover fairly quickly and smoothly, while others may experience more prolonged distress that impacts them in many ways over time. Some survivors of trauma try to avoid thinking about the trauma and some may turn to drugs, alcohol, self-harm, disordered eating, and other unhealthy coping mechanisms to try to alleviate the emotional pain and suffering.
Both the trauma symptoms and attempts to cope with these symptoms can lead to further physical and mental problems and also can have negative impacts on the survivor’s relationship with others. Because of the hurt they have experienced, survivors may withdraw from others, become passive due to learned helplessness, have trouble trusting others, or struggle to protect themselves in future unhealthy or abusive relationships. These various struggles may in turn result in struggles in school/education and/or the workplace.
Although the very nature of trauma does involve distress and suffering, not all the effects of trauma are purely negative. If individuals acknowledge what they have experienced and receive adequate support, positive psychological change such as the development of resilience, effective coping strategies, and increased self-efficacy can occur. Surviving trauma prompts some individuals to foster stronger relationships and to find deeper meaning and purpose in life.
Stay tuned for Part 2 of Understanding Trauma for more information on treatment for trauma, how to support a loved one who has experienced trauma, and how we can work together to create a trauma-informed community.
If you have experienced trauma, you do not have to suffer alone. Here in Shanghai, you can find help and support by calling Lifeline (400 821 1215) for free, confidential, anonymous support or by arranging to see a professional counselor through CCS or other organizations. Reach out for help – there is hope and healing.