Trauma Archives - Khiron Clinics

What is Trauma Bonding?

Samuel Edgecox — Fri, 04 Aug 2023 08:00:52 +0000

Trauma bonding refers to a strong emotional attachment that develops between a person who is or has been abused and their abuser. This connection is based on the abusive experiences the victim has endured, whether it’s emotional or physical abuse. Despite being mistreated, the victim forms a bond with the abuser, often due to the cycle of abuse, which includes moments of reconciliation and calm after the abuse. These moments of peace create a false sense of safety and attachment, causing the victim to cling to the abuser even when the abuse resurfaces.

Trauma bonding has become an increasingly common term used in discussions about abuse, yet many misunderstand the whole meaning and experience that it describes. Understanding trauma bonding is crucial for helping those who have experienced abuse, as it explains why they may have complex and mixed feelings about their abusive relationships. Breaking free from trauma bonding and healing from the effects of abuse means recognising the signs and seeking professional support from abuse experts and therapists.

The Cycle

The psychological phenomenon known as Stockholm syndrome or trauma bonding has been observed in various situations like intimate partner violence, child abuse, hostage scenarios, human trafficking, and cults. It involves victims developing emotional attachments to their abusers or captors as a result of interpersonal trauma 1. This develops through a cycle of abuse. The cycle of abuse has been widely researched and critiqued, some agree with the four stages, and others do not, with many abuse survivors highlighting that this does not mirror their experience. The 4 stages are as follows:

Tensions Build

Abusive partners react to external stressors, leading to mounting tension and feelings of powerlessness, anger, and paranoia. You may try to placate them to avoid abuse, becoming hyper alert to their needs while feeling anxious and on guard.

Incident of Abuse or Violence

The abuser seeks to regain control by releasing tension on others. This abuse can manifest as insults, threats, attempts to control, physical violence, or emotional manipulation. The abuser may blame you for the abuse, but remember, they are responsible for their actions.

Reconciliation

Following the abuse, the abuser enters a “honeymoon” stage, trying to move past the incident with kindness and loving gestures. These actions trigger bonding hormones, leading you to believe the relationship is back on track.

Calm

Both parties seek to maintain peace, often justifying or denying the abuse. The abuser might apologise while blaming others or point to external factors to excuse their behaviour. You may begin to accept their excuses and doubt the severity of the abuse.

This cycle repeats over time, with the length between repetitions varying and often shortening as the abuse escalates. The calm period may diminish or disappear entirely as the abuse intensifies over time. Recognizing this cycle is crucial for those experiencing abuse to break free and seek help for a healthier, safer future.’

A Closer Look

There are, however, a number of problems with the way this cycle depicts abuse and it may not be appropriate for all cases. The model was designed following anecdotal research on women who experienced domestic abuse 2, and as such it centres on women abused by men. This makes it difficult to recognize the experiences of individuals who don’t fit this traditional gendered model. This can lead to doubt and dismissal when survivors seek support from professionals and loved ones who are limited in their understanding of abuse.

Additionally, the cycle of abuse model can foster victim-blaming, as it suggests that abuse always follows a predictable pattern. This can place blame on the survivor, leading them to doubt their experiences and feel responsible for the abuser’s actions. In reality, responsibility for abuse lies solely with the abuser, regardless of the survivor’s actions or attempts to placate the abuser.

The model has also been described as outdated as it primarily focuses on physical violence, while abuse can also involve other nonphysical tactics such as financial control, emotional manipulation, and verbal degradation. These nonphysical forms of abuse can be equally damaging and impactful, and often harder to recognise.

Finally, the model suggests that abuse can be predicted, but in reality, abuse often occurs without warning. Many people may not recognize the early signs of abuse, and abusers may begin their harmful behaviour gradually and subtly. Limiting awareness to specific steps, gender, community, or background can also overlook other abusive situations.

While the cycle of abuse model may offer some helpful insights, it is essential to approach abuse with a broader and more inclusive perspective, acknowledging the diverse manifestations of abuse and focusing on holding abusers accountable for their actions.

Seeking Support

Seeking professional support for trauma bonding is a crucial step towards healing and breaking free from the cycle of abusive relationships. Trauma bonding can be highly complex and challenging to overcome, making professional guidance essential for addressing its effects on emotional well-being and behaviour.

Trauma-Informed Therapy: Individual therapy with a licensed mental health professional can provide a safe and confidential space to explore your experiences, feelings, and thoughts related to trauma bonding. Therapy can help you gain insight into the dynamics of the abusive relationship, identify patterns of behaviour, and develop healthier coping strategies. Consider finding a therapist who specialises in trauma-informed therapy. They are trained to work with individuals who have experienced trauma and can help you process and work through the emotional impact of trauma bonding. Trauma-focused modalities such as Eye Movement Desensitization and Reprocessing (EMDR) can help to address and process the deep-rooted effects of trauma bonding.

Support Groups: Participating in support groups for survivors of abuse or trauma bonding can be beneficial. Being part of a supportive community can help you feel understood and less alone, providing an opportunity to share experiences and learn from others who have faced similar challenges.

Safety Planning: If you are still in an abusive relationship or concerned about your safety, a professional can help you create a safety plan. This plan can include steps to protect yourself and establish boundaries, such as seeking legal assistance or accessing local resources for survivors of abuse.

Educational Resources: Therapists can provide educational resources on codependency, trauma bonding, and healthy relationship dynamics. Understanding the psychological aspects of trauma bonding can aid in breaking free.

Self-Care Strategies: A mental health professional can help you develop self-care strategies to rebuild your sense of self-worth and self-compassion. Self-care practices can support your emotional healing journey.

Long-Term Healing: Recognize that healing from trauma bonding is a gradual process. It may require ongoing support and patience as you work towards breaking free from the cycle and rebuilding your life.

Remember that seeking professional help is a courageous and essential step towards regaining control of your life and well-being. A skilled and compassionate therapist can provide the support, guidance, and tools needed to heal from trauma bonding and create a healthier future.

End Notes

Casassa, Knight, L., & Mengo, C. (2022). Trauma Bonding Perspectives From Service Providers and Survivors of Sex Trafficking: A Scoping Review. Trauma, Violence, & Abuse, 23(3), 969–984. https://doi.org/10.1177/1524838020985542
Walker. (2009). The battered woman syndrome (3rd ed.). Springer Pub. Co.

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What Is Relational Trauma?

Samuel Edgecox — Thu, 27 Jul 2023 08:00:00 +0000

Relationships are a fundamental part of human life; we exist as part of communities, relying on and contributing to them to survive. While not all relationships we have throughout our lives will be good and healthy, experiencing positive relationships gives us something to aspire to and work towards. They can be a force for good, driving personal development, providing love, care, and joy, and even healing past wounds. Conversely, abusive or toxic relationships can be a source of trauma and pain that lasts years, even decades, beyond the relationship.

Relational trauma can stem from abuse, abandonment, and neglect in all kinds of relationships, from those between parents and children to adult relationships. Relational trauma can affect how we relate to and form relationships with people in the future.

Causes of Relational Trauma

As with any kind of trauma, relational trauma can be caused by a range of situations and factors. It is most often associated with abusive relationships, domestic abuse, and childhood neglect, violence or abuse.

Relational trauma is also sometimes referred to as complex trauma or developmental trauma. It is generally caused by prolonged adverse experiences in interpersonal relationships, particularly during critical developmental periods. Some of the most common causes of relational trauma include:

Abuse and Neglect: Physical, emotional, or sexual abuse, as well as neglect and abandonment by parents, caregivers, or significant others, is a particularly common cause of developmental or relational trauma.

Dysfunctional Family Dynamics: People raised in families or close communities with unstable relationships, high conflict, mental health issues, or substance abuse can create a traumatic environment for a child. Growing up in this environment can cause a wide range of physical and mental health issues throughout life. Research into Adverse Childhood Experiences (ACE’s) has explored the association between childhood adversity, trauma, and adverse health outcomes. Over the last two decades, ACE research has been extensively developed and replicated globally, detailing the relationship between childhood experiences and health outcomes.1

Caregiver Instability: Inconsistent and unpredictable parenting, such as frequent changes in primary caregivers or a lack of emotional attunement, can lead to relational trauma. There are a wide range of reasons that this can happen. Postpartum depression in mothers, incarceration of parents, foster care or adoption, homelessness, and mental illness or parental trauma can all constitute caregiver instability and result in relational trauma.

Loss and Separation: Experiencing the loss of a loved one can disrupt attachment bonds, sometimes resulting in relational trauma. This could be the loss of a parent or other close relative, as well as a close friend or a non-blood-related guardian.

Intergenerational Trauma: Trauma experienced by previous generations can impact the family environment and perpetuate relational trauma through generational patterns. Intergenerational trauma is the transmission of psychological and emotional effects of traumatic experiences from one generation to the next. It is thought that this happens through the transmission of genetic information as well as environmental factors.

Betrayal and Rejection: Being betrayed, rejected, or abandoned by someone trusted or important in one’s life can cause profound relational trauma. Betrayal and rejection can take many forms; they could be caused by neglect or abandonment by a parent or caregiver and not being believed by a parent when disclosing.

Chronic Stress and Adversity: Living in an environment of ongoing stress, poverty, or other adverse conditions can lead to relational trauma, especially in childhood. ACE research has shown that chronic stress also impacts physical and mental well-being throughout life.

Insecure Attachment: Early experiences of insecure attachment, where caregivers were inconsistent or unavailable, can cause relational trauma in later life.

It’s important to recognise that each individual’s experience of relational trauma is unique, and its effects can be long-lasting, impacting emotional, psychological, and relational well-being. Knowing the signs of relational trauma can help with identifying where mental health challenges may step from and what kind of support to seek.

Short-Term Effects of Relational Trauma

Trauma can affect people differently, with some people experiencing the effects immediately and others having a delayed onset of symptoms for months or even years after the traumatic experience. Short-term effects of relational trauma may include:

Emotional Distress: Anxiety, fear, guilt, shame, and sadness due to traumatic experiences and disrupted or broken relationships.

Physical Symptoms: Headaches, digestive issues and stomach pain, muscle tension, chronic pain, and sleep disturbances such as insomnia and nightmares can arise from stress and emotional turmoil, intensified by the release of stress hormones.

Impaired Coping: Difficulty managing emotions and engaging in healthy coping mechanisms, becoming startled easily, and experiencing difficulty concentrating can all happen as a result of relational trauma.

Relationship Difficulties: As relational trauma stems from relationships; it can cause struggles with forming and maintaining trusting and secure relationships with others. It can also disrupt relationships that have already been formed. For example, a child who experiences relational trauma as a result of parental incarceration or death might experience difficulty in their relationship with other family members or guardians.

Emotional Numbing: Feeling emotionally detached or disconnected from oneself and others is common. Trauma is often so overwhelming that it causes people to experience a sense of ‘emotional numbness’, as if feeling nothing at all is safer than feeling the complexity of emotions that are caused by the trauma. This is not a conscious decision a person makes but rather a defence mechanism.

Long-Term Effects of Relational Trauma

Complex PTSD: Relational trauma can result in Complex Post-Traumatic Stress Disorder (C-PTSD) due to prolonged exposure to trauma in close relationships. Childhood abuse and domestic violence are common causes of C-PTSD.

Attachment Issues: Relational trauma can make it difficult for people to form and maintain healthy intimate relationships as a result of insecure attachment. People may find it difficult to trust others, express vulnerability, and maintain stable relationships when they have experienced relational trauma due to attachment issues. Experienced in early childhood can last into late adulthood if unaddressed.

Mental Health Disorders: People who have experienced relational trauma are at a higher risk of developing anxiety, depression, and other mental health conditions. It is common for teenagers to have co-occurring disorders, as trauma can cause depression, anxiety, obsessive-compulsive disorder (OCD), and PTSD.

Substance Abuse: Research shows that those who experience relational trauma have increased vulnerability to substance abuse and addiction as a coping mechanism. Individuals may use substances to ‘self-medicate’ or cope with the post-traumatic effects of relational trauma.

Physical Health Problems: Research has shown that childhood trauma can cause chronic health issues related to stress, such as cardiovascular problems and weakened immune system functioning.2 It is essential to provide healthy coping mechanisms to regulate their nervous systems and early trauma interventions for young people who experience relational trauma.

While these signs may help to identify relational trauma, individual experiences may vary, and some individuals may demonstrate resilience and coping strategies that mitigate the long-term effects of relational trauma. Seeking professional help and support can significantly aid in healing and managing the impact of relational trauma on one’s life.

Endnotes

Herzog, J. I., & Schmahl, C. (2018). Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Frontiers in psychiatry, 9, 420. https://doi.org/10.3389/fpsyt.2018.00420
Danese, A., & J Lewis, S. (2017). Psychoneuroimmunology of Early-Life Stress: The Hidden Wounds of Childhood Trauma?. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 42(1), 99–114. https://doi.org/10.1038/npp.2016.198

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Understanding Types of Boundaries and Why They’re So Important in Trauma Recovery

Samuel Edgecox — Fri, 14 Jul 2023 08:00:03 +0000

In the realm of mental health, there are certain “buzzwords” that have gained popularity but are not always properly understood. Terms like self-care, regulation, mindfulness, grounding, and boundaries have become widely used, yet their therapeutic significance may not be fully appreciated by everyone.

Personal boundaries encompass the limits and guidelines we establish within relationships, outlining what is deemed acceptable and unacceptable. Boundaries are crucial because they protect our well-being, help us to stay physically, emotionally, and psychologically safe, and promote healthy relationships. They establish a sense of personal autonomy, ensuring that our needs and values are respected. Boundaries enable us to communicate our preferences and maintain and establish mutual respect. They play a vital role in maintaining balance, fostering self-care, and creating healthier interactions with others.

Types of Boundaries

Typically, people possess a blend of boundary types, as boundaries can vary depending on the nature of the relationship. For instance, someone might exhibit healthy boundaries within their family dynamics, porous boundaries in a professional setting, and rigid boundaries when it comes to romantic relationships.

Each boundary type is characterised by distinct traits, and it can be beneficial to identify the specific type that applies to your relationships.

Individuals with rigid boundaries:

Keep others at arm’s length.
Struggle with emotional closeness.
Experience difficulty in seeking assistance.
Tend to be sceptical or mistrustful of others.
Frequently detach themselves from others’ issues or challenges.

Individuals with porous boundaries:

Often feel taken advantage of.
Share personal information excessively or extend themselves beyond reasonable limits.
Rely heavily on the opinions of others.
Place excessive trust in others.
Encounter difficulties in saying no and asserting their own needs.

Individuals with healthy boundaries:

Feel comfortable setting boundaries and saying no when necessary.
Uphold their values and principles without compromising them to please others.
Effectively express their desires and needs through communication.
Offer support to others while maintaining a healthy level of involvement and personal impact.
Acknowledge conflicts as a natural aspect of life and handle them constructively.

Understanding the various types of boundaries can help individuals recognize their own patterns and make informed adjustments in their relationships. It allows for greater self-awareness and the development of healthier and more fulfilling connections with others.

Significance of Boundaries in Trauma Recovery

Experiencing trauma can profoundly affect our ability to establish and maintain healthy boundaries in relationships. Trauma often undermines people’s capacity to be vulnerable, as it may not feel safe. This can cause people to suppress or ignore their needs and feelings for self-protection. Asserting ourselves and saying “no” can become difficult due to a range of factors that depend on the trauma. It may be a result of distorted agency, fear of conflict, or intense guilt. Survivors can often prioritise others’ needs over their own, leading to the feeling that they are trapped in patterns of people-pleasing behaviour.

Having a loss of trust in people – particularly if a survivor was betrayed by a trusted person during childhood – further erodes the belief that setting boundaries is possible or helpful. Some people may have learned that no matter what they do, people always step over their boundaries and that setting them is pointless. Overcoming these challenges requires letting go of defence mechanisms, recognising our needs, and seeking support to heal and regain control.

Boundaries are essential in trauma recovery, helping to build feelings of trust in yourself, and a sense of self worth – that you are deserving of a safe and comfortable environment. They are also an essential part of avoiding triggers that you are not yet ready to face. Particularly in the months following a traumatic event, although for some people this can last years, sounds, smells, sights, feelings and places that remind you of the trauma in some way can cause an uncontrolled reaction. This might range from serious discomfort, fear and sadness, to intense flashbacks, where you feel as if you are re-living the trauma again. Giving yourself permission to set certain parameters that keep you safe is a normal and justified part of recovery. Whether it means meeting people in different places, taking different routes or modes of transport, or setting more interpersonal boundaries with people in your life, these changes could help you maintain a much-needed sense of control while you receive treatment for PTSD or the reactions from the acute phase of trauma recovery become desensitised.

How to Set Boundaries

Finding out what kind of boundaries you have in different situations is a helpful way to begin the process of learning to set more helpful and impactful boundaries. Here are some other helpful

Define Your Boundaries: Take time to identify and define your personal boundaries. Some people choose to do this through self reflection and journaling, while others prefer the support of a therapist. Reflect on your values, needs, and limits in different areas of your life, such as relationships, work, personal space, hobbies, socialising, and anything related to the traumatic experience.

Communicate Clearly: Learning to articulate your boundaries to others in a clear and assertive manner is key to ensuring you maintain a sense of control and respect. This means being direct and specific about what is safe and acceptable to you and what is not. One method for doing this is to state how something makes you feel using an “I” statement, such as: “I feel uncomfortable when touch my shoulder”, and then follow with what you would like to happen, for example: “Please check before touching me in the future”. This ensures that people understand your needs clearly, and makes it less that they will feel personally attacked for doing something wrong.

Enforce Boundaries: Once you have set your boundaries, it is crucial to enforce them consistently. Be firm and assertive when others try to push or disregard your boundaries. Stand your ground and do not compromise on what you have defined as important to you. You can use the same method as before, reminding the person of how something makes you feel, and what you would like to happen.

Practice Self-Care: Setting boundaries also involves having compassion and taking care of yourself. Prioritise self-care activities that promote your physical, emotional, and mental well-being. Actively reflect on what your needs are and what situations or stimulus might be causing you stress or discomfort. This will strengthen your ability to maintain boundaries and communicate them effectively to others.

Remember, setting boundaries is an ongoing process. It requires self-awareness, self-advocacy, and the willingness to prioritise your own needs. By setting and maintaining healthy boundaries, you can foster healthier relationships, protect your overall well-being and lessen the burden of the trauma recovery process.

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Polyvagal Theory: Understanding the Nervous System and Trauma

Samuel Edgecox — Fri, 07 Jul 2023 07:30:08 +0000

Polyvagal Theory, founded by Dr. Stephen Porges, Ph.D., provides a groundbreaking understanding of the relationship between the autonomic nervous system (ANS) and behavioural responses, as well as the impact of chronic stress on physical health. Before the development of this theory, the nervous system was oversimplified, seen as a binary system that was either “on” or “off” in response to stress. However, Porges revealed a more complex picture, introducing a three-part hierarchical model and highlighting the crucial role of the vagus nerve in the autonomic system’s communication and connection.1

What Is Polyvagal Theory? Sympathetic and Parasympathetic Activation

To understand the polyvagal theory, it is important to have a basic understanding of the sympathetic and parasympathetic nervous systems and the vagus nerve. The vagus nerve belongs to the parasympathetic nervous system, often referred to as the rest-and-digest system, which promotes a state of calmness in the body. Porges identified a hierarchy of responses within the autonomic nervous system, including ventral vagal social engagement, sympathetic nervous system activation, and dorsal vagal shutdown.

The ventral vagal social engagement is the state in which humans can connect and relate to others. It is characterised by openness, compassion, joy, mindfulness, and curiosity. This state enhances various bodily processes such as digestion, immunity, circulation to the extremities, and the ability to form relationships while reducing defensive responses.

Sympathetic nervous system activation, which evolved approximately 400 million years ago, triggers a state of mobilisation known as fight-or-flight. In this state, the body prepares to confront a threat by increasing arousal and activating various physiological responses. Heart rate, blood pressure, adrenaline levels, and blood circulation all increase, while digestion, immunity, relational ability, and fuel storage decrease.

However, sympathetic activation cannot be sustained indefinitely, as it would be detrimental to health. The body self-regulates and eventually adopts dorsal vagal shutdown, a more primal state characterised by freezing, lethargy, hopelessness, and reduced basic bodily functions. This shutdown state decreases heart rate, blood pressure, temperature regulation, and immune response, and it also affects social functioning, such as eye contact, facial expressions, and intonation.

According to Polyvagal Theory, the ANS forms the foundation for all human experiences. It explains how individuals engage with the world through various states of activation, including connection, disconnection, and attunement. However, some people may experience a mismatch, perceiving the environment as dangerous even when it is safe.

Polyvagal Theory helps us understand how stress is stored and processed in the body. Chronic stress can alter the brain’s perception of stimuli, leading to increased sensitivity to threats and the interpretation of non-threatening input as dangerous. This heightened perception of danger can be emotionally and physically exhausting, affecting various aspects of life, including work, relationships, hobbies, and studies. It can also impact social interactions, causing individuals to perceive benign stimuli as threatening, which can strain relationships. Recognising the different states of activation and understanding individuals’ needs in each state is crucial for supporting their well-being.2

Polyvagal Theory and Trauma

Polyvagal Theory is particularly relevant in trauma recovery. Trauma, whether experienced in early childhood or later in life, disrupts the autonomic nervous system’s regulation and can lead to hypersensitivity to perceived threats. Dysregulation of the autonomic nervous system can result in a range of physical and psychological symptoms, such as chronic pain, digestive issues, depression, anxiety, PTSD, and substance use disorders. Traumatic experiences can also impact future relationships, as individuals may develop a fear of intimacy and connection due to past experiences of danger or uncertainty with primary caregivers or trusted individuals.

By understanding the dysregulation of the autonomic nervous system (ANS) caused by trauma, we can better comprehend the physical and emotional consequences individuals may experience.

Trauma and chronic stress, particularly in early childhood, can lead to ANS dysregulation. A dysregulated ANS may overreact to perceived threats or dangers that do not actually exist. Living in a constant state of mobilisation or immobilisation can be debilitating, leading to chronic pain, digestion issues, and difficulties in connecting and socialising. Maladaptive coping mechanisms like substance use, gambling, and unhealthy eating habits may develop as a result.

Trauma, which is understood as an experience rather than an event, can arise from various causes such as childhood neglect, abuse, parental drug use or incarceration, and adverse childhood experiences (ACEs) like living in dangerous or impoverished neighbourhoods. These traumatic experiences can lead to relational or developmental trauma. Research shows that individuals who experience three or more ACEs are at increased risk of asthma, heart disease, depression, anxiety, and obesity.3 The compounded stress and trauma affect the central nervous system, disrupting ANS functioning and communication through the vagus nerve, which connects the brain to the digestive system and heart. This chronic dysregulation of the ANS results in physical and emotional symptoms as the system continuously searches for threats. Digestive disorders, autoimmune diseases, chronic fatigue, depression, anxiety, PTSD, and substance use disorders are among the common health issues associated with trauma or chronic stress.

Furthermore, early childhood experiences significantly impact future relationships, as the ANS becomes overprotective in adulthood due to chronic feelings of danger or uncertainty around primary caregivers. Adults who experienced violence, neglect, or inconsistent and inattentive parenting may reject intimacy and connection, viewing them as dangerous despite their deep desire for love and connection. The need for connection is often replaced by a need for protection.

Although adverse childhood experiences have profound effects on development and health, trauma at any stage of life can disrupt the autonomic nervous system. Accidents, assaults, natural disasters, and chronic stress are some examples of events that can cause ANS dysregulation. For individuals with a history of trauma, the ANS reacts not only to the perceived safety or danger in their immediate environment but also to the internal interaction between the present environment and the fear or stress triggered by past life events.4

The Polyvagal Theory provides valuable insights into therapy and community support. By recognising the importance of safety, understanding defence mechanisms, and adapting interventions based on the individual’s autonomic responses, therapists can effectively assist clients in their healing journey. Additionally, by incorporating the principles of the Polyvagal Theory into community practices, we can foster a more supportive and empathetic society better equipped to assist individuals dealing with stress and trauma.

Endnotes

Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W.W. Norton.
Herzog, J. I., & Schmahl, C. (2018). Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Frontiers in psychiatry, 9, 420. https://doi.org/10.3389/fpsyt.2018.00420
Steimer T. (2002). The biology of fear- and anxiety-related behaviours. Dialogues in clinical neuroscience, 4(3), 231–249. https://doi.org/10.31887/DCNS.2002.4.3/tsteimer

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Trauma and The Non-Linear Process of Change

Araminta — Thu, 29 Jun 2023 10:00:35 +0000

Trauma is caused by an event or experience that is so threatening or overwhelming that a person cannot cope. In response to perceived danger and stress, the body triggers an involuntary reaction called the stress response. This is often referred to as the fight-flight-or-freeze response and has been an essential part of human survival for hundreds of thousands of years.

When the stress response is triggered, the body is flooded with a variety of hormones, blood distribution to large muscle groups changes and core functions such as heart rate decrease or increase, depending on the response. While this reaction may keep us safe in the moment of danger, possibly giving us the extra speed to get away, enhanced reaction times to respond to attacks, or desensitised pain reactions, it can cause a range of adverse consequences in the long term.

While it is incredibly difficult to produce an accurate statistic, it is thought that around 20% of people who experience trauma may go on to develop Post Traumatic Stress Disorder (PTSD). The prevalence of trauma varies widely among individuals who experience a traumatic event, and not everyone who experiences a traumatic event develops PTSD or other trauma-related conditions. They might live with certain consequences that make relationships, employment, or anything related to the traumatic experience difficult but not meet the diagnostic criteria for PTSD. The impact of a traumatic event differs based on various factors, such as the nature of the event, genetics, individual resilience, available support systems, and personal coping mechanisms.

Trauma and Change

Trauma can be life-changing, profoundly impacting those who experience it in various ways. When someone experiences a traumatic event, it can shatter their sense of safety, trust, and stability. The emotional and psychological effects of trauma can be long-lasting and pervasive, often extending well beyond the initial event itself.

Trauma can have a life-changing influence on beliefs and perspectives. Traumatic experiences can challenge deeply held beliefs about oneself, others, and the world, leading people to question their own vulnerability, the reliability of others, and the fairness of life. The experience and change it evokes in a person can lead to a significant shift in core values, priorities, the things they enjoy, and general outlook on life.

Trauma can also catalyse personal growth and resilience. Many people who have experienced trauma embark on a journey of healing and self-discovery. Through therapy and support networks, as well as drawing on innate strength and self-reflection, they develop coping mechanisms, gain insights into their own resilience, and find new meaning and purpose in life. This can often lead trauma survivors to develop a heightened appreciation for life, greater empathy, and a renewed sense of purpose, which can shape their future choices and actions. However, this happens through a process of change that can be deeply challenging and confusing, with elated highs and demoralising lows.

The Non-Linear Process of Change

Recovering from trauma is a unique and personal experience. It does not follow a predictable path or timetable. While some may experience immediate relief and progress, others may face ongoing challenges and setbacks that impede recovery and interrupt daily life. With trauma, in particular, healing occurs in layers, as individuals gradually confront and process different aspects of their traumatic experiences. Peeling off one layer can bring profound realisation and acceptance but also cause a wave of renewed pain, sensitivity, vulnerability and fear that makes it feel as if healing might be going backwards and the capacity to cope has greatly diminished.

The non-linear and complex process of change involves fluctuations in emotions, memories, and behaviours. One day, a survivor may feel empowered and hopeful, while the next, they may be overwhelmed by triggers and emotional turmoil. This unpredictability can be frustrating and discouraging, both for the individual and their support system.

The change process is often understood in therapy as a wheel with six stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination. The stages represent the progression individuals go through when making behaviour changes; however, the process is not always cyclical, with individuals often oscillating between two or three stages, particularly preparation and maintenance. Each stage requires different support strategies and actions to empower movement to the next stage and ultimately reach the maintenance stage, where the behaviour change becomes a long-term habit.

In the pre-contemplation stage, individuals may not recognise the need for change. In the contemplation stage, they start considering the possibility of change but may still feel ambivalent or hesitant. The preparation stage signifies readiness to take action and involves small steps toward behaviour change.

Once individuals enter the action stage, they have made a change and are committed to continuing the process. The maintenance stage follows, where individuals have sustained their behaviour change for an extended period and focus on preventing relapse.

Change can be difficult for everyone, but for trauma survivors, it can feel like giving up something that makes them feel safe. Trauma creates deep-rooted habits and behaviours that serve as defences against fear and terror. These habits are difficult to untangle from the trauma itself, making change a challenging process. Trauma survivors benefit from smaller and more structured changes, with better support systems in place. It is important to respect the survivor’s pace of change, allowing time for preparation and discussing the pros and cons. Change should be approached in small increments, finding the smallest achievable steps while being mindful of overwhelming emotions, while understanding and respecting the role that the habit played in the survivor’s life, gradually finding alternative ways to meet those needs.

Dealing with Change

It is essential to approach trauma recovery with patience, empathy, and flexibility. Healing requires creating a safe and supportive environment that allows for self-expression and exploration of emotions. Professional help, such as therapy or counselling, can provide valuable guidance and tools for navigating the complexities of trauma.

The non-linear process of change reminds us that healing is not a linear destination but a personal journey. It requires self-compassion and understanding, as well as a recognition that progress can be measured in small steps. By acknowledging the non-linear nature of trauma recovery, we can offer the necessary support and validation, fostering resilience and growth in those who have experienced trauma.

Endnotes

Schein, J. PTSD STATS, PTSD UK |. Available at: https://www.ptsduk.org/ptsd-stats/ (Accessed: 25 June 2023).
Cherestal, & Herts, K. L. (2021). Trauma―Focused Treatment for PTSD With Comorbid Psychosis: A Case Report. Clinical Case Studies, 20(3), 201–216. https://doi.org/10.1177/1534650120980069
St Cyr, Liu, J. J. W., Cramm, H., Nazarov, A., Hunt, R., Forchuk, C., Deda, E., & Richardson, J. D. (2022). “You can’t un-ring the bell”: a mixed methods approach to understanding veteran and family perspectives of recovery from military-related posttraumatic stress disorder. BMC Psychiatry, 22(1), 37–37. https://doi.org/10.1186/s12888-021-03622-3

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Untangling the Knots: The Intricate Connection Between Trauma and OCD

Samuel Edgecox — Fri, 02 Jun 2023 07:51:14 +0000

Posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are complex mental health conditions. What is less well-known is the common co-occurrence of these disorders in people who have survived traumatic experiences.

OCD and PTSD Co-occurrence

Current research shows that the chance of an individual diagnosed with PTSD developing OCD within one year is around 30% 1. Obsessive-compulsive disorder has received extensive study and conceptualisation, yet it persists as one of the most incapacitating, prevalent, and costly disorders individuals can experience, as is often misunderstood by society.

In line with estimates for the general population, more than 50% of individuals diagnosed with OCD have encountered at least one potentially traumatic event. However, among those with treatment-resistant OCD, a significant 82% report a history of extensive trauma 2.

Understanding the Intricacies of OCD

OCD is widely mislabeled and misunderstood, often thought of by people as a personality trait instead of a medical condition with complex underlying factors for which people can receive treatment and other professional support. OCD is more than a desire for order and cleanliness. While these can be symptoms present, OCD encompasses a much broader range of obsessions and compulsions. Intrusive thoughts, irrational fears, and repetitive behaviours can manifest in various ways, impacting multiple areas of an individual’s life.

Genetic predisposition, neurobiological abnormalities, and environmental influences all play significant roles in the development of OCD. It is not a choice or a character trait but a genuine disorder that necessitates understanding and support. A common misconception is that individuals with OCD can simply overcome their obsessions and compulsions through sheer willpower or self-control. However, OCD is a neurobiological condition that surpasses personal determination. The intense anxiety and distress caused by OCD make it particularly challenging for individuals to resist compulsions without proper treatment and support. While many of us experience repetitive thoughts or behaviours, those with OCD face persistent and disruptive patterns that significantly affect their daily lives.

Addressing these misconceptions surrounding OCD is crucial. By promoting awareness, education, and empathy, we can foster a better understanding of the disorder and create a more compassionate and inclusive society for individuals living with OCD.

Obsessions

Obsessions refer to recurring and intrusive thoughts, impulses, or images viewed as inappropriate and unwelcome. These obsessions trigger immense distress and anxiety for individuals with OCD. For those with OCD, these obsessions are more than concerns about life issues. Despite being aware of their irrationality, individuals with OCD struggle to suppress or disregard these obsessions.

Individuals who have experienced trauma may develop obsessions directly related to the traumatic event they experienced or witnessed. These obsessions can involve distressing and intrusive thoughts, images, or memories of the traumatic experience. This can vary widely, from people who have lost a parent to an illness developing obsessive behaviours related to health and cleanliness to a person who has been in a car accident developing obsessions related to a fear of being in a car.

Trauma can also contribute to the development or exacerbation of OCD symptoms in general. Traumatic experiences can lead to increased anxiety and a heightened sense of threat and fear, which may trigger or intensify obsessive thoughts and the need to engage in compulsive behaviours to manage or alleviate the anxiety.

Compulsions

Compulsions involve repetitive behaviours or mental rituals that people practice in response to obsessive thoughts. These behaviours may include excessive hand washing, compulsive checking, hoarding, or an overwhelming urge to arrange objects in a certain, often meticulous way. Other compulsions include mental rituals, such as praying, counting internally, or repeating phrases in one’s mind. These actions and behaviours aim to alleviate anxiety, prevent dreaded events, or reduce the likelihood of unfavourable circumstances. Individuals with OCD are well aware of the illogical nature of their compulsions, intensifying their distress.

Trauma can influence the development or manifestation of certain compulsive behaviours in various ways. People who have experienced trauma may engage in compulsions to cope with the distress, anxiety and fear caused by the traumatic event. These compulsions can serve as a way of regaining control, reducing perceived threats, or seeking to prevent the recurrence of similar traumatic experiences. This might include compulsive checking rituals to ensure no harm or danger will occur based on their traumatic experience.

Treating Trauma and OCD

The connection between PTSD and OCD lies in the shared pattern of intrusive thoughts followed by behavioural attempts to alleviate distress. While the specific content of the ideas and behaviours often differs between the two disorders, they are both motivated by the aim of neutralising anxiety, stress or fear. Understanding this connection can be vital for identifying the similarities and differences between PTSD and OCD and helping people find the appropriate treatment approaches.

Endnotes

1. Pinciotti, C. M., Horvath, G., Wetterneck, C. T., & Riemann, B. C. (2022). Does a unique co-occurring OCD and PTSD factor structure exist?: Examination of overlapping OCD and PTSD symptom clusters. Journal of Anxiety Disorders, 85, 102511. https://doi.org/10.1016/j.janxdis.2021.102511

2. Dykshoorn, K. L. (2014). Trauma-related obsessive–compulsive disorder: A Review. Health Psychology and Behavioral Medicine, 2(1), 517–528. https://doi.org/10.1080/21642850.2014.905207

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The Hidden Impact of Trauma on Self-Esteem: Understanding the Connection

Samuel Edgecox — Fri, 12 May 2023 15:49:14 +0000

Who am I?
Where does my value come from?

These are the questions that define self-esteem, and the answers are hugely impacted by trauma. It is estimated that around 85% of people worldwide struggle with low self-esteem 1. Trauma often plays a role in shaping this negative self-perception that encroaches on emotional and physical well-being.

Defining Self-Esteem

Self-esteem starts from within. Similarly, trauma leaves a lasting impact on a person’s internal landscape. Those who have endured traumatic experiences are likely to find themselves struggling with inexplicable feelings of fear, anxiety and sadness. These emotional struggles can lead to self-criticism and pave the way for negative self-image.

When someone does not struggle with low self-esteem, they are more likely to have an accurate perception of themselves. Healthy self-esteem allows people to recognise and accept both their flaws and strengths. This means that they are far less vulnerable to mental health struggles and can hold realistic expectations for both themselves and other people.

Meanwhile, people with low self-esteem can often feel dissatisfied with their place in the world, even when they appear to be successful. They can also feel inferior to others as they tend to focus on their perceived weaknesses 2.

Low Self-Esteem

Low self-esteem is a complex phenomenon that can go unnoticed by many individuals. Although not always overtly expressed, certain behaviours and cognitive patterns serve as indicators of underlying self-esteem struggles. Understanding these signs is crucial in providing meaningful support.

Subtle signs of low self-esteem include:

An inability to handle criticism
Difficulty making friends
A constant need for attention or recognition
Dissatisfaction with appearance
Challenging relationships with food and weight

This is by no means an exhaustive list. After all, it is important to remember that each person is unique, and so too is their sense of self. However, by thinking about negative thoughts and behaviours, it is possible to notice the concealed signs of low self-esteem 3.

The Connection Between Trauma and Self-Esteem

Once low self-esteem has been recognised, it is necessary to seek out the underlying causes behind this negative self-perception. While there are many reasons a person may have self-esteem issues, most contributing factors can be ascribed to trauma or traumatic events. For example:

Bullying
Discrimination
Neglect
Physical health problems
Mental health problems
Financial difficulties

Each of these experiences can have a huge impact on self-esteem. Bullying inflicts both emotional and physical harm, leading to long-lasting feelings of inferiority. Similarly, discrimination can erode self-esteem by instilling a sense of inadequacy based on factors such as race, gender, or sexual orientation.

The lasting impact of trauma cannot be overstated. Therefore, by recognising trauma as a source of low self-esteem, it is possible to empower survivors on their journey of healing.

Developmental Trauma

Knocks to self-esteem can happen at any stage of life. However, those who have developed a strong sense of self from an early age are far less likely to be impacted by perceived failures or setbacks as adults. As a result, it is important to examine the impact of developmental trauma on self-esteem.

From the day they are born, children start to form an understanding of their place and value in the world. Traumatic experiences during this crucial period can disrupt emotional development. This, in turn, fosters negative self-perceptions that persist into adulthood. For example, if children believe that their value comes from grades at school, their physical appearance or other measurable factors, they may believe that their value is conditional. In comparison, those who experience unconditional love will have higher self-esteem as they know that they are valuable regardless of these external factors.

Distortion of self-worth in childhood leads to negative thinking patterns that become fixed emotional processes. Therefore, in order to improve self-esteem, it is important that people unlearn some of the emotional patterns and coping strategies that they developed as children 4.

Improving Self-Esteem

Self-esteem is not fixed, it constantly oscillates between different states. Therefore just as certain factors can negatively impact self-esteem, there are things that have a positive impact on it. In order to improve self-esteem, it is necessary to cultivate self-awareness and engage in evidence-based practices of self-care. This can be through realising that certain activities and behaviours are not conducive to happiness. For example, activities such as excessive social media usage or unhealthy consumption of alcohol or caffeine are likely to negatively impact self-esteem. Meanwhile, taking time for hobbies such as sports, art or reading can hugely improve self-esteem 5.

Improved levels of self-esteem can also be achieved through seeking wider support from friends, family and professionals. The most important thing to be aware of is that everyone is different, and so is their trauma. This means that healing journeys vary from person to person. It is, therefore, imperative to approach both self-esteem and trauma with sensitivity, nuance and constant compassion. This way, it is possible to break free from the vicious cycles of trauma and low self-esteem.

Endnotes

1. Guttman, J. (2019). The relationship with yourself: Notes on self-confidence and authenticity. Retrieved from https://www.psychologytoday.com/us/blog/sustainable-life-satisfaction/201906/the-relationship-yourself
2. Neff, K. D. (2011). Self‐compassion, self‐esteem, and well‐being. Social and personality psychology compass, 5(1), 1-12.
3. Mind. (2022). Retrieved from https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-esteem/about-self-esteem/
4. Cikanavicius, D. (2018). Retrieved from https://psychcentral.com/blog/psychology-self/2018/05/childhood-self-esteem#1
5. Abdel-Khalek, A. M. (2016). Introduction to the psychology of self-esteem. Self-esteem: perspectives, influences, and improvement strategies, 1-23.

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How Trauma Effects Sleep

Araminta — Thu, 04 May 2023 10:47:36 +0000

How Trauma Affects Sleep

Humans have various needs; nutrition, exercise and, of course, rest. Sleep plays a crucial role in the well-being of the body and mind. Without the right amount of sleep, it is common to experience lethargy, inconsistent mood and difficulty with concentration.[i]

Trauma has a profound effect on sleep. The impact of a traumatic event, or series of events, takes a considerable toll on the nervous system. This means there will likely be some disruption to sleep in the aftermath of trauma, which, in turn, can drastically impact physical and mental well-being. To understand trauma, we need to understand how it influences unconscious and conscious states.[ii]

Healthy Sleep

To understand how trauma affects sleep, it is necessary to think about what a healthy sleeping pattern looks like. While ‘healthy’ varies from person to person, some key consistencies indicate a good night’s sleep. Most healthy sleepers can fall asleep in around half an hour of settling into bed, rarely wake up in the middle of the night, and if they do, they can easily fall back asleep.[iii] Most importantly, healthy sleep is characterised by a series of stages, beginning with light sleep and finishing with the most crucial stage, REM.

Why Do Humans Need REM?

REM (rapid eye movement) is a state of sleep characterised by heightened brain activity and vivid dreams. It is an essential part of cognitive functioning and emotional processing. At birth, babies need eight hours in this state; however, only two hours are required as adults. The intensity of REM can be illustrated by horses which can stand up during other sleep stages but must lie down during REM.[iv]

When people have experienced trauma, it becomes harder for them to access this sleeping state. As the final stage of sleep, REM prepares the brain to wake up by activating the central nervous system. At times of trauma, the brain can feel disconnected from the workings of the nervous system. It is, therefore, common that people who have experienced trauma can only sleep lightly, so often they cannot reach REM. These disruptions to the most crucial stage of sleep lead to mood disorders, an inability to consolidate memories and a decrease in overall cognitive performance.

Physiological Impact of Trauma on Sleep

Traumatic events drastically impact the physiological processes that regulate sleep. Those who have experienced trauma will find that their body shifts into a hyperarousal state with increased stress hormone production. Elevated levels of the stress hormone cortisol disrupt sleeping patterns, making it difficult for individuals to fall asleep or stay asleep for meaningful periods of time.

This dysregulation of sleep, when left unchecked, can lead to more serious disorders such as insomnia or sleep apnea. Sleep apnea, a condition characterised by breathing problems during sleep, is exacerbated by trauma-related stress. Similarly, insomnia, which causes people to struggle with falling asleep, is a common side effect of trauma.[v]

Emotional Impact of Trauma on Sleep

In addition to physiological side effects, the emotional labour associated with trauma also greatly impacts sleep. A dysregulated nervous system, unable to discharge trauma from the past, remains in a state of fight or flight. While this leads to physical changes in hormones, images of the traumatic event can also remain in the subconscious, and people will often find that their dreams reflect this.

The brain is wonderfully complicated, so it will attempt to discharge fearful memories and intrusive thoughts, often in the form of nightmares. Nightmares can be hugely anxiety-inducing and cause people to fear sleep. As a result, it is possible that traumatised people not only struggle to get to sleep, they actively avoid it.[vi]

Solutions

As humans, we are programmed to crave nourishment in all its forms, and that includes rest. For people who have experienced trauma, a healthy sleeping pattern can feel inaccessible. However, there is a solution to this problem, and that is through sleep hygiene.

Sleep hygiene, much like any other form of hygiene, requires a conscious effort toward maintaining healthy habits. People with good sleep hygiene typically follow a regular sleeping pattern. They practise mindful approaches to sleep, such as avoiding stimulating activities close to bedtime, limiting caffeine consumption, and establishing a relaxing pre-sleep routine.

In addition to these small changes, it is also important to be mindful of how certain coping mechanisms can affect sleep. Drugs, alcohol, and substance misuse are common in the aftermath of trauma. However, the stimulation and desensitisation they provide drastically reduce sleep quality. Many people will find themselves in cycles of medicating to sleep, getting artificial sleep and therefore needing to continue to use medication to gain any semblance of a ‘normal’ sleeping pattern.[vii]

By prioritising physical and emotional well-being, those who have experienced trauma will find they fall asleep far more easily. Therefore, seeking therapy that actively seeks to resolve a dysregulated nervous system is of the utmost importance. Once individuals start working to alleviate their trauma, it is far more likely that they will achieve restful sleep, which, in turn, will improve cognitive function, mood, and overall health.

References:

^{^[i]} National Institute of Neurological Disorders and Strokes (NINDS). (2019, August 13). Brain basics: Understanding Sleep.

^{^[ii]} Babson, K. A., & Feldner, M. T. (2010). Temporal relations between sleep problems and both traumatic event exposure and PTSD: a critical review of the empirical literature. Journal of anxiety disorders, 24(1), 1–15.

^{^[iii]} Harvey, A. G., Stinson, K., Whitaker, K. L., Moskovitz, D., & Virk, H. (2008). The subjective meaning of sleep quality: a comparison of individuals with and without insomnia. Sleep, 31(3), 383–393.

^{^[iv]} Blumberg, M. S., Lesku, J. A., Libourel, P. A., Schmidt, M. H., & Rattenborg, N. C. (2020). What is REM sleep?. Current Biology, 30(1), R38–R49.

^{^[v]} Chu, B., Marwaha, K., Sanvictores, T., & Ayers, D. (2021). Physiology, stress reaction. In StatPearls [Internet]. StatPearls Publishing.

^{^[vi]} Gieselmann, A., Ait Aoudia, M., Carr, M., Germain, A., Gorzka, R., Holzinger, B., Kleim, B., Krakow, B., Kunze, A. E., Lancee, J., Nadorff, M. R., Nielsen, T., Riemann, D., Sandahl, H., Schlarb, A. A., Schmid, C., Schredl, M., Spoormaker, V. I., Steil, R., van Schagen, A. M., … Pietrowsky, R. (2019). Aetiology and treatment of nightmare disorder: State of the art and future perspectives. Journal of Sleep Research, 28(4), e12820.

^{^[vii]} Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23–36.

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Trauma and Anxiety in Young Adults

Araminta — Sun, 30 Apr 2023 04:57:38 +0000

Trauma and Anxiety in Young Adults

On the surface, trauma and anxiety seem like very different issues. Where trauma stems from experiencing an intensely distressing or life-threatening event, or series of events, anxiety is a mental health condition that young adults can struggle with regardless of whether they have experienced trauma in the past.

However, there is a close connection between trauma and anxiety, and experiencing trauma can contribute to the development of anxiety disorders.

How Trauma Affects the Developing Brain

Children’s brains constantly learn and develop; however, exposure to trauma or adverse childhood experiences (ACEs) can change how it grows.

For example, studies have shown that the amygdala of children who have lived through neglect and abuse matures faster, in what is known as the stress acceleration hypothesis. The amygdala acts like a smoke alarm, alerting people to danger. After trauma, the amygdala can become overactive, causing reactions not proportional to the perceived threat. Alternatively, the threat system can also become underactive, contributing to dissociation.

The brain is programmed to protect people when they encounter dangerous situations. It initiates the fight or flight response, preparing the body to run away or fight off the danger, stimulating the release of cortisol and norepinephrine to help fuel the body. However, even after the event has passed, or if people face ongoing traumatic situations such as abuse, they can struggle to move out of the fight-or-flight state.

When the body is constantly trapped in a state of fight or flight, it continues to release hormones to help the body get away. This can be incredibly damaging to people’s health over time and can contribute to anxiety development.

Research has linked traumatic experiences to significant neurological changes that can affect the brain’s structure. One study found that young adults who experience childhood trauma and neglect had greater activation within the amygdala, the part of the brain which helps with emotional regulation, which could contribute to heightened anxiety in trauma survivors.

Trauma and Anxiety

Anxiety is a common symptom experienced by trauma survivors. Even things they used to do regularly before a traumatic event, such as going for a run, can be incredibly anxiety-inducing and overwhelming. Some people may avoid anything that makes them anxious. Although this provides short-term relief, it can increase anxiety in the future, making it challenging for people to overcome.

There are many types of anxiety that people can experience:

Agoraphobia – Agoraphobia is the fear of being in a situation or place where escape is impossible. People may begin to avoid places where they feel panicked or trapped, which can cause problems in everyday life.
Panic disorder – Panic attacks are intense feelings of terror and apprehension without the presence of danger. They can strike suddenly and cause symptoms from chest pain to nausea and an accelerated heart rate. Panic disorder involves experiencing panic attacks without warning.
Social anxiety – Those who struggle with social anxiety worry excessively about social situations, fearing that people will negatively judge them for their actions. It can lead to avoidance behaviours, and people can isolate themselves and decline invitations to events, leading to a greater sense of isolation.

Hypervigilance

Hypervigilance is associated with both trauma and anxiety. It involves people being highly aware and alert of their surroundings, constantly aware of any potential threats, even if nothing is present.

Hypervigilance can include symptoms such as:

An exaggerated startle response
Struggling to focus
Difficulty regulating emotions
Persistent worry
Difficulty sleeping
Restlessness
Overestimating a threat
Obsessive avoidance of perceived threats

Chronic hypervigilance is the body’s way of protecting people from potentially threatening or dangerous situations, especially if they have experienced trauma in the past. It can be triggered by feeling trapped or experiencing something related to past trauma, such as being in the same area.

Anxious Attachment

Attachment styles develop in early childhood and influence how adults form relationships and perceive the world. Children and teenagers with anxious attachment styles may have had parents who were inconsistent with their responses, such as being sometimes caring but cold and distant at other times. It can also develop due to childhood neglect and abuse or early separation from a caregiver, such as in the case of divorce.

Young adults with an anxious attachment style can struggle with many symptoms of anxiety, as well as:

Trusting others
Being clingy with their partners
Being scared of abandonment by their loved ones
Requiring constant reassurance that people care about them
Difficulty regulating negative emotions

Coping with Trauma-based Anxiety

Anxiety and trauma in all their forms can be safely addressed with a combination of professional interventions and self-care, including:

Breathwork – deep, controlled breaths stimulate the parasympathetic nervous system, also known as the rest and digest system. This helps the body move from fight-or-flight to a sense of safety, helping to relieve anxiety. Practising breathwork and breathing techniques is very simple and can be done anywhere. Taking a few minutes to breathe deeply, engaging the diaphragm, and exhaling slowly, can improve regulation in an anxious moment.
Healthy distractions – anxiety can be all-consuming, and it is only natural that young people do not want to feel that way. However, some may turn to unhealthy coping mechanisms to distract them from their feelings, such as spending excessive amounts of time on social media or abusing alcohol. Instead, explore healthy distractions that give intense anxiety some time to decrease, such as reading a book, journalling, or even doing chores. Distraction is not a solution for anxiety; avoiding it too much can worsen it, but distractions can offer a small reprieve when it feels too intense.
Professional help – addressing the root causes of trauma can improve symptoms in young adults, including trauma-related anxiety. There are a variety of treatments to help young people confront their anxiety and trauma, including neurofeedback and somatic experiencing, all of which can vastly improve their mental health and well-being.

Trauma can be a significant cause of anxiety in young adults, affecting every facet of their daily lives. However, by remaining patient, committed, and proactive in seeking help, young adults can successfully navigate and overcome the challenges of trauma-related anxiety and move towards a future full of hope and healing.

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Exploring the Link Between Trauma and Anxiety

Araminta — Fri, 21 Apr 2023 05:50:37 +0000

Trauma is caused by a distressing experience that is too overwhelming to deal with, causing long-lasting effects on a person’s mental health. The effects of trauma can be wide-ranging and affect everyone differently. In response to the same experience, such as a natural disaster, one person may develop post-traumatic stress disorder (PTSD) while another person experiences no long-lasting negative effects.

Anxiety is a common symptom experienced by those who have gone through a traumatic event, causing a disturbance in the automatic nervous system and the amygdala, which are responsible for identifying threats and regulating the response.

Trauma can include physical or sexual abuse, natural disasters, combat, accidents, or witnessing violence. After a traumatic event, many people experience anxiety symptoms, such as feeling on edge, having trouble sleeping – including insomnia – and feeling irritable or easily startled. These symptoms are a natural response to the stress of the traumatic event and are known as acute stress disorder (ASD). For most people, these symptoms will gradually lessen or stop altogether. However, these symptoms persist for some people and can develop into PTSD or other anxiety disorders and phobias.

Research has shown that individuals who experience trauma are at a higher risk for developing anxiety disorders.^[1]

The Role of the Amygdala

One possible explanation for the link between trauma and anxiety is the role of the amygdala, a structure in the brain that plays a key role in the processing of emotions. The amygdala is known to be involved in the fear response, and research has shown that it is activated during traumatic experiences. In individuals with PTSD, particularly those who have experienced multiple traumas, the amygdala can become overactive. This leads to the body triggering an exaggerated fear response that doesn’t match a situation’s objective severity. The amygdala can cause the fight-or-flight response to be triggered even in non-threatening situations. This can result in the development of anxiety disorders such as generalised anxiety disorder (GAD).

Negative Cognitions

The link between trauma and anxiety can also result from negative cognitions. Negative cognitions are individuals’ beliefs about themselves, others, or the world around them. These negative beliefs can develop due to traumatic experiences and can contribute to the development of anxiety disorders. For example, an individual who has experienced a traumatic event may believe that the world is a dangerous place and that they are not safe, leading to anxiety.

Trauma and the HPA Axis

There is also evidence to suggest that the link between trauma and anxiety may be due to the impact of trauma on the hypothalamic-pituitary-adrenal (HPA) axis. When a person experiences trauma, their nervous system is pushed out of balance, which can significantly affect their overall health. The constant state of stress can disrupt the normal functioning of the hypothalamic-pituitary-adrenal (HPA) axis, a crucial component of the body’s stress response system.

Chronic stress – such as abuse – can cause the HPA axis to become overactive, leading to the excessive release of hormones such as cortisol. This can result in a range of physical and mental health issues, including anxiety, depression, and fatigue.

The HPA axis is a complex system regulating the body’s stress response. Traumatic experiences can disrupt the HPA axis, leading to an overactive stress response and the development of anxiety disorders.

Treatment Options for Trauma and Anxiety

Treatment for trauma-related anxiety disorders often involves therapy, medication, or a combination of both.

Medication

Benzodiazepines are a class of drugs that enhance the activity of a neurotransmitter called gamma-aminobutyric acid (GABA), which has a calming effect on the brain. This can relieve specific symptoms of PTSD and anxiety, allowing people to experience a better level of functioning in daily tasks, such as work or study.

SSRIs are antidepressants that work by increasing the levels of serotonin in the brain. There are various SSRI drugs, with sertraline being the most common in the UK.

SSRIs are considered a first-line therapy for PTSD, and research suggests that they are associated with an average response rate of about 60% among patients. However, a smaller proportion of patients – between 20% to 30% – achieve complete remission of their symptoms through the use of SSRIs.^[2]

Other therapies or interventions are seen as necessary to achieve full recovery from PTSD, addressing the root cause of the issue, providing effective coping mechanisms, and exploring thought patterns that may interrupt a person’s recovery or ability to function.

Therapy

Cognitive behavioural therapy (CBT) is one of the most common therapies for PTSD and anxiety. It is grounded in the theory that a person’s thoughts, feelings, and behaviours are interconnected and changing the negative ones can improve mental health.

Exposure therapy is a form of CBT that involves gradually exposing a person to situations or memories that trigger their anxiety or PTSD symptoms, helping them to develop coping mechanisms.

Eye movement desensitisation and reprocessing (EMDR) is a newer form of therapy that has shown effectiveness in treating PTSD. EMDR involves a series of guided repetitive eye movements or tapping while a person recalls traumatic memories, and associated thoughts and feelings, helping to reduce the emotional impact of the memory.

Finding the right therapy for PTSD and anxiety is a personal journey, and it may take time to find the most effective treatment plan. In addition to therapy and medication, several self-care strategies can help manage trauma-related anxiety, including exercise, mindfulness meditation, yoga, and relaxation techniques.

If you have a client or know of someone struggling with anything you have read in this blog, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] Kascakova, N., Furstova, J., Hasto, J., Madarasova Geckova, A., & Tavel, P. (2020). The Unholy Trinity: Childhood Trauma, Adulthood Anxiety, and Long-Term Pain. International journal of environmental research and public health, 17(2), 414. https://doi.org/10.3390/ijerph17020414

^[2] Alexander W. (2012). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. P & T : a peer-reviewed journal for formulary management, 37(1), 32–38.

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