What is Trauma?


  

Given this is a trauma blog and not, say a turquoise necklace aficionados blog (which I would also be happy to write) I figured a few definitions might be in order. 

What the heck is trauma exactly?  Let’s start there. 

  • Stress, Trauma and PTSD (Post Traumatic Stress Disorder) exist on a continuum

On one end we have stress.  We all have felt stress before.  My recent example:    

Some jerk unkind human stole the cash and debit cards out of my purse a few weeks back.   I had to call the fraud department at the banks, cancel my cards and walk around with cash because I didn’t have access to the checking account cards after cancelling them (of course I totally forgot until writing this blog that I could have just carried my check book with me—duh!).   That was stress.  I didn’t take it (too) personally and didn’t get paranoid after it happened.  I thought of the whole experience as unpleasant, but aside from the sixty bucks in cash they stole I didn’t lose money and felt more annoyance and inconvenience than loss.

  • Stress falls under the umbrella of slightly unusual, annoying situations that take time and energy to resolve but which do resolve over time—
  • Or situations which do not resolve over time but are impersonal.  

Big deadlines at work, a temporary dental or medical problem, miscommunication with a friend or loved one, or working in a job setting with layoffs brewing are all examples of stressful situations. 

While pursuing my clinical licensure I worked for a community based mental health clinic (which shall not be named) with constant turnover, downright kooky administration, exponential caseloads, and such paltry pay that the janitors in the janitors union (???) which we were bizarrely compulsory members of (??!!!) made substantially more than us master’s level therapists (which is not to say that janitors deserve anything less than a living wage).  

Why does it matter that a stressful situation that cannot be solved is not personal

Because then you are not alone with your thoughts and feelings.  When I worked at the Unnamed Community Mental Health Clinic, all of us line staff were in the same boat and we supported and commiserated together.  

Now over ten years later many of us still talk, refer clients to each other, consult cases and get together socially.  From the stress of the situation we created a network of support to survive emotionally, and in time as we all left the original stressor our social support transformed from necessary to life enhancing.   

So how is trauma different than stress

  • Trauma is an overwhelming frightening experience which can range in severity from relatively mild such as being rear ended in a low speed car accident to major individual experience such as being sexually violated, beaten, shot at, etc.. or a collective major traumatic experience such as being in the world trade center on 9-11-01. 
  • The difference between stress and trauma is the level of overwhelm, fear and feelings of helplessness
  • Bessel Van Der Kolk (Grand Pooh-bah in the field of traumatology) says the difference between a stressful normal event and trauma is a feeling of helplessness to change the outcome
    • ie:  Trauma involves that sick sense of watching something terrible happen to ourselves (hello dissociation!)  or someone else and not being able to do a darn thing about it. 

 What is PTSD?

  • PTSD (Post Traumatic Stress Disorder) is a DELAYED psychological reaction to experiencing or witnessing a traumatic event that is outside the realm of normal human experiences. 

Thus, you cannot claim the state of your child’s bedroom is causing you PTSD.  (But go ahead and try and let me know if it works as I have two messy little rug rats of my own and I’m always looking for ways to encourage cleanliness.)

  • Individuals with PTSD demonstrate a range of symptoms including difficulty concentrating, flashbacks, feeling emotionally blunted/numb, being hyperalert/jumpy, feeling as though everything is unreal, experiencing nightmares and sleep disturbances.

I like to use raccoon eyes as a diagnostic tool.  When I meet with a client for the first time if they look like they are being poked from behind with a sharp stick, their speech is rapid and fractured and their eyes look perpetually surprised I can be fairly sure they are in the grips of PTSD. 

A subtle but important difference between stresses versus traumas is our ability to talk about the experience without feeling shame or (much) bitterness.  “This is the worst thing that ever happened to me” and “If only” points to trauma, where as a shrug along with “that sucked” points to stress. 

  • An important choice we can strive for to promote mental health and prevent stress from becoming trauma is not to take difficult situations personally. 

From where I sit typing this blog, in the aggressively air-conditioned place I have come to regard as the World’s Coldest Starbucks with the Loudest Music System Ever, rubbing my hands together to restore circulation and wishing for noise cancelling headset and a downy parka in the middle of July, I’m feeling a wee bit stressed out from the intensity of cold and noise.  Fortunately I know the baristas are trying to turn everyone here equally into deaf human popsicles and not just me. 

 

Safety, Security, Repetition


When my twins were little they liked to be read “Goodnight Moon,” the lovely children’s book by Margaret Wise Brown and illustrated by Clement Hurd. Night after night, after night..after night. One or the other child would toddle across the living room, shove aside a multitude of other children’s books, and emerge with a big smile, holding a book I ultimately could recite in my sleep and felt a strong urge to burn. Trying to feign neutrality, I would encouragingly offer,
“How about a new book tonight?”
“nuh-uh.” Benji would say and shake his head with finality.
“Ohhh! Look at this book! It’s about fire trucks/outer space/dinosaurs/chaos theory/etc. What do you say?” I would hold up an alternate choice, waggling the book slightly to make it look so darned exciting it was ready to jump out of my hands.
“Good night moon.” Jonah would insist. Stubbornly my boys would hold the book and crowd my lap and night after night and with a sigh I would begin,
“In the great green room was a telephone and a red balloon and a picture of…”

As I type this I know that millions of parents across the planet are doing just this, and I encourage you faithful moms and dads to continue reading the same blasted children’s book, over and over. Why? Because young children are already learning so many new things: how to use the toilet, how to button a shirt, how to hurl cheerios at the cat… their mind is filled to the brim with new information. So they need some predictable baselines to return to every day. A stable, loving home with regular routines provides exactly that, and the repetition of a favorite book read on a daily basis reinforces it. This is one small step you can take to lower the trauma load for your child.

How does this relate to you if you are not plagued with children’s book burn out? In the face of large changes such as unemployment, divorce, death of a loved one, or other traumas, you can also give yourself some of this instinctual comfort by reinstating old (healthy) patterns from your childhood, or creating new ones. Creating a ritual can be as simple as taking a bath every evening before bed or going for a walk after dinner and noticing all the flowers coming up.

Rituals and routines have a special place in trauma treatment because they comfort us by their very repetition, and when we are comforted we feel safer and more relaxed.

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