February 27, 2020

Understanding Psychological Trauma, Its Impact, and Its Treatment

"Traumatized people chronically feel unsafe inside 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 awareness of what is played out inside." -Bessel A. van der Kolk

Caregiver: Hi, are you accepting new patients? I’d like to schedule an appointment for my child.

Me: Yes, sounds good. Can you tell me what some of the current concerns are or what is prompting you to reach out for help now?

Caregiver: Well, they have not been listening to me lately.Very bad behavior. They get angry very quickly. They stay in their room almost all day long and all they want to do is play video games.  Grades in school are quickly dropping. Lack of motivation overall. Nothing seems to be working anymore and I don’t know what to do.

Me: Thank you for sharing that. Have they experienced any type of trauma in their lives recently or in the past?

Caregiver: I don’t think so. I mean, their dad and I got divorced a while back and he’s in and out of their lives right now. It’s just been mostly me for some time now. But otherwise, no trauma that I know of. They just don’t like talking about what’s going on in their mind.

Me: I see.

This sequence here is what the typical first encounter sounds like over the phone when a caregiver makes that initial phone call to me looking for answers in order to help their child. Frustration is prevalent. Tensions are high. Hope is dim. And clear answers and solutions are seemingly nowhere to be found.

What ensues during our first face-to-face encounter in the office is a sense of clarification, where the concept of “trauma” is placed front and center in everything that we will be doing from here on out. But wait a minute. What exactly is “trauma?” Is that just a word people use to over-dramatize unfortunate events in their life? After all, it rhymes with “drama”, so it has to be related, right?

In the world of psychology, trauma is generally defined as the emotional response the body goes through after someone is exposed to something that is deeply distressing, or overwhelming. When a person’s childhood involves something so negatively impactful that it causes actual emotional dysregulation, there’s an even greater likelihood that the effects of it will be significant, or long-lasting. Oftentimes, when we think of childhood trauma, we think of the more “typical” traumas, such as being physically or sexually abused. However, trauma comes in many different forms and can vary in impact from one person to another. It might even come from something that’s only “moderately” distressing but happens consistently for a long period of time… because living in emergency-response mode for an extended period of time also causes the brain trauma. Our brain is always trying to make sense of experiences and of the world around us. When it is unable to process something so overwhelming that it fails to integrate the experience into a pre-existing mental construct, emotional equilibrium is lost, causing all sorts of emotions to de-compartmentalize and “spill over” into multiple parts of our human self. The brain is now physically altered and the biological processes in the body are affected. The fear center of the brain (the “amygdala”) becomes over-stimulated by the trauma, which causes the brain to think it should be (insert uncomfortable emotion here) all of the time, even when the “threat” is not there. In turn, the pre-frontal cortex of the brain becomes less able to function properly, which shuts down the ability to make logical decisions, control impulses, and organize thoughts. Over time, the part of the brain that controls emotions becomes dysregulated, which means the person might feel emotions too strongly, not strongly enough,too often, not often enough, or at inappropriate times. This is known as “hypo”or “hyper” arousal. With this is mind, it is not very hard to imagine how this can translate into everyday life, in turn causing multiple problems. Problems at school. Problems with relationships. Problems with parents. Problems with self. Problems, problems, problems.

The interesting thing is that all this psychology jargon isn’t just a theory. It’s been proven in study after study of brain imaging done on those who’ve experienced psychological trauma.

What happens in therapy is a re-building process, much liker ebuilding roads. Brain functioning is impacted after having to endure trauma. “Potholes” are created in the neural pathways of the brain, which slows down neurons (chemical messages) and sometimes prevents them from getting from one place to another. Smooth neural pathways are needed in order to transport chemical messages efficiently. When the neural pathway, or “road”, becomes damaged due to trauma, neurons will have a hard time getting to where it needs to go. Alternative routes, or detours, can be constructed over time with Trauma-Focused Therapy.

Trauma-Focused Therapy is a specific approach to therapy that recognizes and emphasizes the understanding of how a traumatic experience, or a set of experiences, impacts a child’s mental, behavioral, emotional, physical, and spiritual well-being. This type of therapy is rooted in understanding the connection between the trauma experience and the person's emotional and behavioral responses.

A trauma-focused approach seeks an awareness of the widespread impact of trauma on life experience and relationships. It recognizes trauma’s role in the outlook, emotions and behavior of a person with a trauma history. A trauma-focused approach also accepts that trauma’s impact is far more prevalent than most people realize. A trauma-focused approach attends to the underlying trauma from any cause.

The purpose of trauma-focused therapy is to offer skills and strategies to assist the person in better understanding, coping with, and processing emotions and memories tied to traumatic experiences, with the end goal of enabling your them to create a healthier and more adaptive meaning of the experience that took their life.

In short, it is crucial to seek a deeper understanding of what we see on the surface, which oftentimes is “bad behavior”. We need to be willing to explore the murky depths, for in doing this, we find many explanations for the things that didn’t make sense. Along the way, we begin to understand ourselves better and why we think the way we do, why we feel the way we do, and why we do the things we do. This is what therapy is for. A process. An enlightenment.

Healing Minds Behavioral Health, PLLC is a private mental health practice with a specialization in trauma-focused services for children, adolescents, and families. You may contact us at 210-418-2546 for additional information.

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