TRIGGER WARNING: This episode/blog contains information about (gun) violence which may be triggering to survivors.
We have all experienced some level of primary or secondary trauma over the past few years. The pandemic, the war in Ukraine, and school shootings among other events have brought the topic of trauma front and center in our public discourse.
In this episode, I’m breaking down the definition of trauma so you can have a better understanding of what it is and can make the distinction between normal trauma responses and post-traumatic stress disorder (PTSD).
(Trigger Warning: I’m going to be sharing my own traumatic experience in the video and in the blog below.)
“Trauma is what happens inside of you as a result of what happened to you.”
-Dr. Garbor Maté
When I was a young therapist at the beginning of my relationship with my husband, I had a very traumatic experience. Prior to this, I had what I considered a pretty healthy relationship to fear. I was bold and extroverted in my young life. And then Vic and I were held up at gunpoint at our home.
We were heading out for a date night in NYC. The car was running and Vic was outside waiting for me to jump in and get our evening started. I walked out to see a huge shadow of a person with a stocking over their face standing over Vic’s prone body with a knee on his back and a gun to the back of his head.
Part of what creates deep trauma is the threat of bodily harm or death to you or someone you love. After that night, at first, I naively thought I would just be able to get back to my life, talk to my therapist, and it would all be fine.
We weren’t shot or physically harmed, but that terrifying vision haunted me. Intrusive memories could be sparked by sensory information in the present- like the sound of a car pulling out of the driveway because I heard that sound the night of the incident after the perpetrator robbed us and was getting away. The entire experience would come back into my mind as if I was walking toward the scene all over again.
In that traumatic moment, I disassociated, meaning in my mind’s eye and view, I floated above the scene. I could see the top of my own head. It is a very odd but relatively common experience for trauma survivors because our minds try to protect us in moments of extreme stress and this is a way of distancing ourselves from the bad thing that is happening.
I began to have pronounced symptoms of trauma in the aftermath. I was afraid to be alone in my house. I kept a knife next to my bed. Vic had the house completely redone with a high-tech security system including a panic button behind our bed that upon activation would directly notify our local police precinct. None of those measures touched the fear I was experiencing because the fear was ever-present in my mind.
I developed a heightened startle response. No matter where I was, I felt like people were sneaking up on me, to the point where Vic started to announce his presence from 3 flights away to avoid startling me. The beginning of this healing process was extremely stressful for all of us.
I also experienced recurring nightmares of the attack. I would dream about the experience, but instead of it ending as it did in real life (with the individual robbing us and leaving), it would end with Vic getting shot. It was just awful.
I had spent my whole adult life thinking I was never going to have the kind of partnership and love relationship I finally found with Vic and at that point, it was still almost too good to be true. And in one violent, visceral, moment I realized all of that could have been taken away in one split second.
It was incredibly painful and disturbing, and as difficult as my symptoms post-trauma were, they were a normal response to my experience.
So let’s get into the distinctions between trauma and PTSD. It is normal to have strong reactions following a distressing, frightening event. The most important thing to understand is that trauma response has a timeline.
My trauma symptoms were the most acute in the first month following the incident. With therapy and EMDR (Eye Movement Desensitization and Reprocessing), I noticed I was improving incrementally as time went on.
Everyone is going to have a different experience of traumatic response, and there is a range of physical, mental, emotional, and behavioral reactions to trauma. No matter what you have been through, if you think you are experiencing trauma symptoms, it is my hope you would seek therapeutic support right away.
According to the DSM-5 (Diagnostic Statistical Manual of Mental Disorders) here are the criteria for PTSD¹:
- Exposure to death, threatened death, actual or threatened serious injury, actual or threatened sexual violence by one or more of the following ways:
- Direct experience of the trauma
- Witnessing the traumatic event as it occurred to another
- Indirect exposure by learning of the trauma experienced by someone close to you
- Experiencing exposure to aversive details of trauma (first responders, police officers in the line of duty, or other work-related exposure)
- Intrusive symptoms:
- Intrusive memories
- Disturbing dreams related to the traumatic experience
- Dissociative reactions like flashbacks in which you relive the trauma
- Prolonged psychological distress at exposure to external or internal cues that remind you of the event (like the sound of a car pulling out of the driveway for me)
- Physiological reactions to external or internal cues that remind you of the event (like rapid heartbeat, sweating, headaches, insomnia, etc)
- Avoidance of trauma-related stimuli after the event. Avoidance of thoughts, feelings, or external reminders.
- Alterations in cognitions and mood:
- Memory issues
- Negative beliefs or expectations about self or others (like self-blame)
- Depression, anxiety, apathy
- Marked alterations in arousal and reactivity:
- Irritable behavior and angry outbursts with little or no provocation
- Reckless, risky, or self-destructive behavior
- Exaggerated startle response
- Problems with concentration
- Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
- Duration and intensity of the symptoms above for more than 1 month.
The biggest distinction between post-traumatic stress disorder (or syndrome) and normal trauma response is the timeframe. If symptoms don’t begin to get better as time goes on but remain at the same level of intensity for more than a month or so, you might be experiencing PTSD, where essentially the trauma gets stuck, so to speak.
While trauma can leave an imprint on us for the rest of our lives, with therapy, support, understanding, and inner work, it is possible to process, integrate, and heal.
I have more resources for you inside this week’s downloadable guide, and you can download that right here.
I want to leave you with another quote from Dr. Maté:
Trauma involves a lifelong pushing down, a tremendous expenditure of energy of not feeling the pain. As we heal, that energy is liberated for life in the present.
So the energy of trauma can be transformed into the energy of life…
It is my hope that if you are suffering from the aftermath of a trauma you get the support you need so that eventually, you will be able to transform your pain into the energy of living your life in the present.
I hope this added value to your life and if it did, please share it with anyone in your world you think it could help. Have an amazing week and as always, take care of you.