Counseling Trauma

What is "Trauma"?

While traditionally trauma is defined by some specific, life-altering event that occurred, it is better understood as how an individual is impacted by that event today. Not everyone experiences events in the same manner, for a variety of reasons. What may have been a disaster for one person may have been a "blessing in disguise" for another; neither is right, or wrong. More importantly, the individual who does experience challenges following a significant event is not "weak" for experiencing difficulties in day-to-day life. There are numerous neurobiological changes that occur in response to significant life events, and a multitude of factors that may predispose one person to have greater difficulty acclimating to a "new" normal compared to another.

Trauma is different from everyday stress in that the trauma typically triggers very high, often long-lasting periods of intense stress. Trauma is stress at a toxic level, and is nearly always harmful to us, while stress can be helpful. Consider this analogy:

Experiencing stress is like going for leg day at the gym - uncomfortable during the workout, and you're a bit sore the next day, yet stronger over time.

Experiencing trauma is going for leg day, the weight machine falling apart on your leg, breaking and/or tearing bones and muscles, and then enduring the numerous medical appointments, insurance bills, pain, discomfort, and frustration in the aftermath.

**the following information is provided for educational purposes only, and should not be used to treat or diagnose**

Changes in the Brain

Single significant traumatic events disrupt the sense of normal in our brains. Typically, the stress hormones cortisol and adrenaline will release, our heartrate will increase, and our body will prepare to fight, flee, or freeze.

In the brain, the hippocampus (the memory center) and prefrontal cortex (where critical thinking skills are) will shrink, allowing the amygdala (the alert center) to "take over" and allow us to react.

Once the danger has ended, the brain and body naturally return to the normal state with the assistance of several neurohormones including oxytocin, allowing a sense of calm to return. However, when experiencing a Trauma response, the brain does not register that the Event has ended, and continues to alert the rest of the body to the threat for days, weeks, months, or even years after the Event.

Infographic showing examples of Fight, Flight, Freeze, and Collapse responses to threats: a small cat fleeing from a lion, a small cat attempting to fight a lion, a small cat pretending to be dead in front of a lion, and a small cat fainting in front of a lion.

Infographic courtesy of NICABM

Predisposition to Trauma-Related Issues

Research increasingly demonstrates that there are significant factors that may predispose some individuals to trauma-related mental health issues at a greater rate than others. Starting in the womb, a fetus may be exposed to greater levels of stress hormones from the stressed-out or traumatized mother, causing potentially life-long changes to the baseline of those same stress hormones in the child. Absent, neglectful, or otherwise inconsistent caregiving as an infant can contribute to dysregulation of important neurobiological processes. This great video provides an overview of some of the lasting impacts that early difficulties in life can have.

Big T Trauma

These are the traumatic events commonly assumed to be life-altering for individuals:

War
Natural disaster
Violent crime
Sudden death of a loved one
Major car/work accident
Fatal or life-threatening incident

Little t trauma

These events are less "obvious" though have persistent, insidious impacts on an individual's sense of the world and how they might engage with it:

Emotional, mental, and/or verbal abuse/neglect
Bullying/harassment
Domestic/dating violence
Financial instability/homelessness
Living with loved one’s addiction/major mental health issues
Chronic health conditions/surgeries

Complex/Compound Trauma

Chronic, repeated, compounded Big T and little t traumas can lead to the development of a corrupted belief system, expectation of loss or abandonment by others, and numerous behavioral, mental, and physical health issues:

Parentification – having to take on the parent role when still a child/caretaking for other children or parent(s)
Sexual abuse and/or incest
Chronic neglect or abandonment emotionally, mentally, and/or physically
Enmeshment/Engulfment Trauma – lack of ability to have own sense of Self/personal identity

Common Symptoms

Below are some common signs and symptoms trauma survivors may experience. This list is not exhaustive, and is provided for information purposes only.

Physical Signs

aches & pains, including headaches and stomach aches
sweats, heart palpitations ("fluttering")
changed sleep and/or appetite
significant changes in libido
gastrointestinal discomfort
decreased immune system/frequently ill

Emotional Signs

shock or disbelief
fear and/or anxiety
disorientation/confusion
hyper-alert and/or hypervigilant
irritable, anger outbursts
rapid mood swings that don't appear to match the present circumstances
nightmares
flashbacks - sense of reliving the trauma(s)
feelings of helplessness, out of control
sense of detachment from self/the world/others
sense of unreality about yourself/the world
deep feelings of guilt & shame, that "I deserved it"
loss of interest in previously enjoyable activities

Behavioral Signs

Difficulty trusting others, and/or self
Avoidance of others, activities that remind you of the trauma(s)
Excessive worrying
Withdrawing or isolating from loved ones
Increased use of mood-altering substances, such as drugs, alcohol, or prescriptions
Hyper- or hypo-sexual behaviors

Resiliency Matters

Challenges in childhood aren't the only things that impact someone's predisposition to developing trauma-related issues later in life - resiliency has an even greater impact. Research shows that having one single adult that believes in and supports a child can change that child's life. If you're reading this right now, you survived. Somewhere along the way, you developed some resiliency to cope with the devastation in which you lived. As in childhood, nurturing resiliency factors supports a whole life recovery process. Some aspects that enhance resiliency include:

Close relationships with competent caregivers or other caring adults
Having a sense of purpose in life
Individual character strengths
Social engagement opportunities
Practical and available support services for parents and families

mother hugging and comforting two young children as they cry

What to expect in trauma therapy

Clinicians affiliated with The Lighthouse provide services through a trauma-informed approach, meaning they are ready and able to address issues related to your history when you are, without your having to feel the need to "fill them in."

First and foremost, our priority is to help you to feel comfortable, empowered, and supported in our space.

Secondly, you are a person worthy of support before you are a survivor of your story. Your own unique needs are what we will plan our course of treatment around.

Initial Sessions

After completing the intake forms and consents, you'll likely spend the first few sessions getting to know the therapist, answering some questions about your life and current challenges, and working together with your therapist to identify what you'd like to achieve in your therapy journey.

Often, life may be a bit hectic when you begin therapy, so your therapist will support you in developing skills to assist you in stabilization. Sometimes this will look like connecting you with local resources, and other times it may be exploring coping skills you can use in and out of the sessions to combat the sense of feeling overwhelmed by your own emotions, thoughts, and memories.

Many clients will say that they begin to feel better within the first few sessions, simply by having the opportunity to experience validation, compassion, and confirmation of their experiences. However, lasting change takes time. The changes that occurred in your brain in response to the trauma(s) aren't going to heal overnight, but when you trust the process you will notice that recovery happens.

Types of Therapy

What makes a therapy style trauma-informed has much more to do with the therapist's training, education, and background than the specific model of therapy. However, there are several therapies that are seen to be much more effective at treating symptoms related to trauma than others - we refer to these as evidence-based practices, as they have been research-driven and/or research-proven to be more effective.

When working with a trauma-informed therapist, you may engage in some of the following therapies:

Cognitive Behavioral Therapy (CBT) // Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Eye Movement Desensitization and Reprocessing (EMDR)

Internal Family Systems (IFS)

Dialectical Behavioral Therapy (DBT)

Solution-Focused Brief Treatment (SFBT)

Emotionally-Focused Individual Therapy (EFIT)

Motivational Interviewing

Mindfulness

Narrative

Cognitive Processing Therapy (CPT)

Somatic Therapy

Polyvagal Therapy

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