The Dynamic of Trauma

 

Intrusions, Avoidance, Arousal, and Dissociation. Abuse, neglect, serious accidents and injuries, naturaldisasters, combat, and "wear and tear" stress can cause subtle or pronounced traumatic reactions. Trauma causes the brain to go into crisis. Frightening or threatening situations -- real or perceived -- are processed quickly, but at the cost of accuracy and closure. The part of the brain that controls language, time, sequencing, and advanced problem solving is compromised, while the part that defends against danger is highly engaged. As a result, events tend to be remembered in the form of images, emotions, and bodily sensations. Details essential to understanding and putting events into perspective are diminished or lost. 

Still, the brain continues to try to put things together long after the events are over. As the brain and nervous system keep working, the affected person may experience intrusions in the form of:

 

• emotional "hijacking," manifested by sudden or violent anger, or sobbing

• nightmares and night terrors

• uncontrollable and unidentifiable waves of sadness and loss

• an inexplicable sense of dread or doom

• disturbing images

• in children, repetitive play with themes such as victimization and rescue

 

Simultaneously,  survivors may make heroic efforts o  avoid reminders of the original event(s) by staying away from places, people, objects, locations, and activities that are reminiscent of any aspect of disturbing or traumatic events. A common avoidance response is to decline or refuse to talk about topics that may trigger unwanted thoughts or feelings. Other examples include a rape victim who avoids using perfumes or shampoos that are associated with the attacker; a resident who wants to move out of the neighborhood after a home invasion; and a parent who shuns holiday festivities and other celebrations that remind her of the loss of a child.

 

Against this backdrop of intrusions and avoidance are arousal symptoms, characterized by:

 

• hyper-vigilance

• generalized anxiety and chronic nervousness

• hyper-startle response

• problems with impulse control

• problems with attention and concentration

• difficulty falling or staying asleep

• high-risk behavior

 

Dissociation is a spontaneous, unconscious attempt to protect oneself from distressing experiences. It results from an instinctual response to severely distressful events. Dissociation frequently is manifested by a  feeling that things in one's environment are odd or dreamlike, or that one's body is unreal and unfamiliar. Some of the symptoms that are consistent with dissociation include:

 

• people and things look like cartoon characters

• things look larger or smaller than they are

• language seems louder or softer than it is

• time slows down or speeds up

• over- or under-awareness about one's body

• somatic complaints, such as panic attacks, unexplained pain, chronic illnesses, and odd or painful body sensations

• heightened or dulled sense of pain

• hearing and feeling one's own breathe or heart beat

• difficulty finding words for feelings, combined with a tendency to act

• problems with attention and concentration

• loss of memory for time; i.e. "losing time," or "spacing out" for prolonged periods        

 

Other things that people with dissociative traits report include:

 

• an inability to trust others or maintain mutual, satisfying relationships

• "chatter" or internal dialogues that create "noise" in one's head

• chronic "daydreaming"; getting lost in television or other activities

• unpredictable alterations in self confidence and sense of identity

• marked changes in personality and temperament

• feelings of abandonment, and a sense of being alone and isolate

• routinely forgetting what has and has not been done

• finding unrecognized objects amongst one's belongings

• feeling as if "I'm not myself," or  "I have distinctly different parts of myself"

• unconscious re-enactments of parts of traumatic events (e.g. mistreating oneself or loves ones without knowing why)

• depression, loss of hope, and an oppressive fear that things cannot get better