June 23rd, 2021
Written By: Marialaina Bucci, LCPC, NCC, CDVP, CCTP
Brene Brown, a research professor, and storyteller has centered her research on topics of shame, courage, empathy, and vulnerability. Why is this important you ask? Hold tight.
June is PTSD Awareness Month. PTSD is the acronym for Post-Traumatic Stress Disorder. Why is this also important you ask? Keep reading.
These two points are important and interrelated for a few reasons. Post-Traumatic Stress Disorder, or PTSD, can occur after experiencing a traumatic event or events. The symptoms of trauma can be distressing, even greatly debilitating, and can cause significant challenges in the lives of those survivors. Trauma is not something you ‘just get over'.
The difficult part about trauma is that it feeds feelings of shame. Shame is the concept of, ‘I am bad’, ‘I am unworthy’, and ‘I am undeserving’. And yet, when we are able to dig deep within ourselves, allow ourselves to be vulnerable, and tap into our courage while being met with empathy and compassion, we are able to extinguish those feelings of shame and begin to heal.
By further breaking the silence on trauma and how it impacts so many of us, we can continue to push towards greater healing through a connection that is derived from empathy, compassion, and holding space for one another to own our stories and our bodies.
“Shame cannot survive being spoken. It cannot survive empathy.” -Brene Brown
According to the American Psychological Association, trauma is defined as an emotional and physiological response to any event(s) that is deemed stressful, threatening, or harmful. Events such as combat and sexual assault are oftentimes linked to the word ‘trauma’. However, it should be noted that the presence of physical danger or threat does not necessarily need to be present in order to be coined as ‘traumatic’. Situations that an individual may deem as emotionally threatening or harmful can also be classified as trauma.
At the heart of this issue is not specifying which exact situations or examples are labeled as traumatic but rather the way the mind and body receive and respond to the threat within the environment. In other words, trauma can be any situation that occurs too much, too fast, and ultimately floods the body and mind’s ability to cope with the situation (also known as the ‘Window of Tolerance’) and results in feelings of terror, fear, and helplessness.
There are several categories used to more clearly understand the nature of traumatic experiences and their implications on behavioral, emotional, psychological, and physiological functioning. There are 4 different categories:
Additionally, there are adverse childhood experiences (ACEs) that occur and lead to negative changes in coping, functioning, and ultimately physical health. Those experiences can be classified as either chronic or complex trauma. Please see here for more information on Kaiser Permanente’s study on ACEs.
In terms of further categorizing types of traumatic events/trauma for the sake of better understanding, this concept and its implications is the idea of ‘little t’ and ‘Big T’ trauma. This is more of an informal categorization of traumatic events rather than something formally diagnosable.
‘Little t’ trauma refers to painful experiences that ‘exceed our ability to cope leading to disruptions in emotional functioning’ and subsequent behavioral responses. It is important to note that these events are not inherently life-threatening or ‘bodily-integrity threatening’ but are distressing nonetheless leading to feelings of helplessness and emotional dysregulation. Examples include: ‘infidelity, interpersonal conflict, divorce, legal troubles, financial issues, or abrupt and/or extended relocation’.
These situations are seen as ‘common’ but still include an emotional intensity that can overwhelm an individual’s ability to cope if chronic and/or acute for substantial periods of time. This is because ‘little t’ traumatic events add up over time and can exceed our window of tolerance leading to a breakdown in coping abilities and dysregulation.
Conversely, ‘Big T’ traumas are larger, more acute situations such as combat, sexual assault, or school shooting. Furthermore, these types of incidents include greater feelings of fear, powerlessness, and helplessness exacerbating the severity of trauma symptoms. ‘Big T’ traumas include acuity that goes beyond the ‘little t’ traumatic experiences and is oftentimes more easily recognizable as ‘trauma’ to the individual.
It should be emphasized that both ‘little t’ and ‘Big T’ events qualify as distressing, traumatic, and valid. Your experience is not ‘less than’ simply because you have experienced ‘little t’ traumatic experiences.
There are many forms of trauma that occur on a micro (individual), meso (community), and macro (systemic/institutional) level. Below you will find a preliminary listing of various examples of trauma. Please know that this list is not exhaustive.
Equally important to remember is that not everyone responds to these situations in the same way. One person may experience significant distress and trauma symptoms while another person may not. Neither is right nor wrong.
Remember, we are all different and have our own unique experiences that factor into our ability to cope with distressing situations. Your reactions to abnormal circumstances/situations are normal and valid nonetheless.
In regards to the succession of PTSD and its corresponding symptoms after experiencing a traumatic event, there are several phases that typically occur.
“Traumatized people chronically feel unsafe in their bodies. The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing what is played out inside. They learn to hide from themselves.” -Bessel van der Kolk
The Diagnostic and Statistical Manual of Mental Disorders 5, or the DSM-5, reports there are 4 clusters of symptoms experienced with PTSD.
Healing from trauma is possible, thanks to this concept of brain plasticity, also known as neuroplasticity, and the resilience of the human psyche. Brain plasticity loosely means that our brain’s wiring can change over time based on consistent and repeated behavioral responses.
Neuroplasticity is technically defined as the brain’s ability to create new neural connections over time in order to ‘adapt, master new skills, store memories, and information’, and incorporate new methods of coping in response to positive changes (10). In other words, in the same way, that we learn to adapt and survive our trauma, we can learn new ways of ‘being’ in order to ‘re-wire’ or ‘unlearn’ the effects of trauma.
In order to elicit healthy changes in behavior, emotional regulation, and cognition it is important to receive the proper care and support from professionals that are well-versed and experienced in working with trauma. If you find yourself struggling with the lingering and distressing symptoms of PTSD, please seek help. There is no shame in admitting to and healing from our past painful experiences. Below, please find a list of therapy modalities that are proven successful in the treatment of trauma and PTSD.
Note that if you choose to begin psychotherapy with a professional, first and foremost, you must feel a connection with them. It is important to feel safe, heard, and seen in therapy, especially when working through trauma. Therapeutic relationships are just like any other- they take time to build trust by showing up, putting in the work, being transparent, and having open communication.
Furthermore, you are well within your rights to ask what types of interventions they use in order to get a better understanding of how they approach trauma treatment. Ask questions if you do not understand something!
Finally, know that it is important to remember that this process of unlearning and ‘re-wiring’ takes time and consistent effort. Trauma recovery does not happen overnight. Be patient with yourself!
“Trauma is a fact of life. It does not, however, have to be a life sentence.” - Peter Levine
“Loving ourselves through the process of owning our story is the bravest thing we will ever do.” -Brene Brown
At Clarity Clinic, we have highly trained staff who specialize in psychotherapy and psychiatry services for those experiencing symptoms of PTSD. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.
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