Trauma and PTSD

Post-Traumatic Stress Disorder (PTSD)

PTSD results from exposure to an overwhelmingly stressful event.

For diagnosis purposes, the definition of PTSD is restricted to involvement in or witnessing of incidents relating to threats or experiences of serious injury, or sexual violence or near-death experiences.

However, in relation to treatment, it is more useful to view trauma as “any event that leaves a long term negative impact on the psyche”. This definition of trauma was put forward in the Adverse Childhood Experiences study by Felitti and others (1998) and has been adopted as very useful by many clinicians.

This means one person may witness or experience an event and not be traumatised by it while another individual is traumatised by the same event and therefore needs treatment in order to clear the impact of that experience. It also acknowledges the impact of early and cumulative events in one’s life.

Some of these “adverse life events” may not meet the criteria for the traditional definition of PTSD, but they have been shown to potentially have an equal or greater effect on the individual as a one-off event that would meet the criteria.

This definition removes judgment towards the individual in terms of whether their response is justified in relation to the particular event. Instead, the symptoms are simply acknowledged as being a traumatic response and are treated as such.

The World Health Organization has stated that the two frontline therapies for PTSD are trauma-focused Cognitive Behaviour Therapy (CBT) and EMDR Therapy.

Complex PTSD

Some people suffer from what is termed Complex PTSD, sometimes also referred to as Complex Trauma or Childhood Developmental Trauma.

Complex PTSD generally applies to PTSD and related symptoms which commonly include depression and dissociation that originate in childhood from multiple and severe traumas and/or from a breakdown in attachment.

Sufferers of Complex PTSD may experience levels of dissociation or numbness which serves as a way to cope with threatening situations or situations that are perceived to be threatening. Dissociation is in fact something that we all use or experience to a greater or lesser extent from time to time.

We all have different parts or aspects of ourselves. For example, when we are angry at someone we love, we may say that one part of us feels so angry at the person but another part loves them just the same. Or if we are breaking up with someone then one part may feel sad but another part may feel some relief.

However, sometimes peoples’ levels of dissociation can seem like both a help and a hindrance at the same time.  Being numb or distant or taking your mind elsewhere can protect you from re-experiencing the trauma and that is a good thing, but in the long term and with Complex PTSD left untreated, it can get in the way of leading a fully functional life.

Sometimes, people can live fully functional lives for many years, not thinking about traumatic events that occurred earlier in their life. Then, almost suddenly and perhaps many years later, memories of these earlier events begin to bother them and cause problems. This is often when adults come to seek help for Complex PTSD.

For children with PTSD or Complex PTSD, early intervention is highly recommended and can make all the difference. Children can also suffer from dissociative symptoms and there are therapies designed especially for treating children with these difficulties.

Specialised skills are required to work with dissociation. Therapies include Ego State Therapy and Internal Family Systems therapy. These therapies are often used in combination with EMDR Therapy in order to allow the individual to feel safe to process the traumatic memories that are stored in a way that continues to cause the disturbance that brings someone into therapy.