mental health month: trauma

Welcome back! Let’s talk about Truama and Stressor related disorders. Read more for a great book recommendation for emotional trauma and CPTSD.

What is Trauma?

This can be any event or events which leave lasting psychological distress. This ranges from emotional abuse influencing your world view to the vicious physical flashbacks veterans face after war. A car crash can be a trauma that makes you anxious or avoidant about cars. Divorce is a trauma. Children of alcoholics, such as yours truly, have a specific set of common trauma responses. Sexual abuse, the death of a loved one, a gun to your head are all specific traumas that can cause specific perspectives and responses from people.

Sometimes trauma can cause a person to lash out suddenly, aggressively, or present the opposite characteristics; some will shut down, avoid, and become stagnant or submissive. There’s research supporting the hypothesis that traumatic events can heavily influence the wiring in our brain. This has a lot of implications in all mental health conditions, not just Post Traumatic Stress Disorder. But for the sake of honoring Trauma today, we will talk about that only in the context of trauma.

What Are Trauma Disorders?

I had a similar question. The DSM-5 has somewhat of an answer. Here are the diagnoses they list:

1. Reactive attachment disorder: This is in early childhood or infancy where the child does not look toward their caregiver for “comfort, support, protection, and nurturance.” If you’re anything like me, psychopathy might pop into your head. There isn’t a lot of research supporting Reactive attachment disorder as a precursor to psychopathy. But if you’re interested, here’s a random presentation I found on the subject.
2. Disinhibited Social Engagement Disorder: This is basically the opposite of the above disorder. These children will approach strangers and act overly familiar with them, also breaking cultural boundaries. Often they have experienced some kind of pattern of severe neglect from their caregivers. They must be at least 9 months of age to receive this diagnosis. Don’t ask me how that works.
3. Posttraumatic Stress Disorder: This has some of the longest criteria to meet and is often diagnosed very quickly. Major symptoms can be obvious. However, for those of us who have struggled with emotional abuse, it takes a keen eye to recognize the signs. PTSD is an emotional response to one or more traumatic events. This includes “fear-based re-experiencing, emotional and behavioral symptoms. Experiences range from explosive “reactive-externalizing”, to dissociation.
4. Acute Stress Disorder: This would be caused by a gun to your head, or anything else that threatens death, serious injury, or sexual violation. This also applies if you witness one of these events, such as someone being shot in the head, threatened to be shot in the head, someone being raped or beaten. If you had a conscience and were the person filming Ahmaud Arbery‘s death, you may develop this disorder. Evidently that person has not. This can happen to police officers or detectives, or any emergency responders who are repeatedly exposed to violent/disturbing/fatal cases. Keep our COVID front-line medical staff in mind.
5. Adjustment disorders: This is marked by emotional or behavioral symptoms that appear within three months of a stressor. For example, the changes a person may experience after the death of a loved one or sudden death of a close friend.
6. Other-specified Trauma and Stressor-Related Disorder and Unspecified Trauma and Stressor Related Disorder: These both carry criteria of a person exhibiting trauma like responses that cause significant distress but don’t fit in the categories of the other disorders.

How do People Manage?

Writing this hasn’t been easy. My chest is tight, my hands are shaking, and I keep having to remind myself to breath. My senses are become more sensitive by the minute and I’ve had to change my music to something softer and easy to ignore. My stomach is in knots. I’m not thinking about any incident in particular, but the body has an amazing memory. It encodes emotions, sensations, feelings. That’s why dissociation is such a common respond to trauma: escape your body and the feelings are void. It’s a mistake to think only the mind holds the capacity for feeling.

Therapy is a common go-to for trauma. EMDR has stormed popular psychology but according to my research professor last year, it’s unclear whether the lights/wands used in EMDR are causing an effect or if it’s the CBT you’re doing during the session. After all, CBT is the leading therapeutic treatment for trauma. There are no studies with participants using CBT, EMDR (that includes CBT), EMDR without CBT (which would basically be flickering lights or waving wands with you sitting there awkwardly staring at them) and no treatment which would put you on a “waiting list”, you unknowingly part of the control group.

Much of my own trauma is rooted in emotional events. Being threatened, bad mouthed (an eleven year old being called a bold little motherfucker for expressing distress about something is kind of how that went constantly), and intimated taught me to be suspicious, distrusting, and defensively aggressive. Being homeless created a lot of insecurity, confusion, and depression; the first day I wanted to kill myself I was eleven, sitting outside of the house we stayed in where the owner drank a bottle of Jack Daniels each night followed by a plate of Xanax. Her daughter had sex orgies loud enough to permeate the street and the other went to work and school. I have many more stories about many wild people I’ve encountered. Maybe I’ll tell it sometime.

But the alcoholism and drugs in my own house, coupled with our 3 year homelessness, and my terror of school I’d experienced since I was five in day care, made me closed, submissive, and withdrawn. When I hear certain words today–for example, in a team meeting at work, if I hear the word “activity”, my body flashes cold, my heart races more than it already was, my hands shake, my muscles twitch. This is an example of an encoded emotion from my days in school. There are studies going into this.

I didn’t ever talk. I fainted if I was asked in front of the class, and was so nervous to raise my hand that I often peed on myself in elementary; I couldn’t ask to use the bathroom. By middle school I’d developed a ritualistic routine to avoid asking for anything in class: use the bathroom before school, five minutes before the bell ended break, five minutes before the bell ended lunch. That’s continued through college; I’ve never got up and walked out of a class before the class ended. By high school, my dissociation got so severe I experienced fugue states (only lasting at most a day), one that caused me to walk into four lanes of traffic against the light, with my friends apparently screaming. They eventually caught up to me but I only remember walking through my door at home. I don’t remember the rest of the day or what made me so terribly distressed that I left my body.

There are some medications offered, usually SSRIs but sometimes heavier medications like Seroquel for a knock-out sleep. Sleeping can be hard with trauma. Your body is constantly in high alert.

Meditation helps some. This can be any activity that helps you focus on your breath and rooting your thoughts in your body. We get so used to ignoring, avoiding, or giving in completely to the distress our body and mind feels that we lose sight of reconnecting our system, which is so essential to wellness.

Support groups and other outlets to express the physical and emotional experiences are key. Just typing my physical experiences above helped relieve a lot of the tension; it’s important to acknowledge what your body feels, and get specific about it–write it down, call a friend or support force, schedule a therapy appointment. Resort to emergency medication if the experience doesn’t abate after trying everything, including sitting with yourself. I’ve had panic attacks related to body-trauma flashbacks push through Seroquel, Ativan, Klonopin, Valium.

Drugs aren’t always what you need. Sometimes it’s just your body screaming for you to offer understanding, consolation, and acknowledgment of its distress; it’s been through the same things you have, on a cellular level.

Complex PTSD: From Surviving to Thriving has been on my read list for a while. It covers “Complex-PTSD” which is not a DSM diagnosis no matter how many psychologists push for it, but references the emotional markers left over from childhood trauma.

Today, we are greatful to hear from Caz again, over at mentalhealthfromtheotherside.com. Read about her experiences with childhood sexual abuse here.

Thank you to everyone who has been messaging me on Instagram. Sharing your story is difficult and I appreciate those of you just reaching out with words of encouragement, thankfulness, and those of you asking about my own experience with psychosis. We will continue with Mental Health Month NEXT WEEK.

Thursday May 14th: Schizophrenia

Friday May 15h: Bipolar

Saturday May 16th: Dissociative disorders.

These posts may be a little later than usual as I am on a hiring panel at my job on Thursday and Friday. Finals are also coming up. I will keep everyone updated. If you would like to submit a paragraph, quote, or personal story with any of those listed experiences, please reach out through my CONTACT PAGE, or message me on:

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