Before I begin to touch on this area of mental health, and its available treatments, you may have arrived at this page feeling overwhelmed by the amount of information in the media, and online, about trauma and also PTSD. These terms are used often, and not always appropriately, but I am glad that there is more of a spotlight on the whole area of trauma, which is so much at the heart of many of the conditions that clients bring to the therapy room, including depression, anxiety, eating disorders and addiction. This is why, especially over the last five years in particular, I have increased my training, skills and practical use of trauma treatments, including EMDR, which I will explain in more detail when you read further. As an experienced therapist it is also vital to stress that most people who suffer from a traumatic experience, on any level, feel shame around it. It is really important to know that there is very little that will shock a well practised therapist, and that therapy is a secure space for you to communicate, with no judgement, in an environment which is provided to enhance your sense of personal safety.
Trauma isn’t a one-size-fits-all experience. While we traditionally often thought of trauma as occurring after one, major significant life event, in reality it can be far more nuanced.
‘Little t’ trauma can be defined as an incident, or a series of incidents, which threaten a person’s safety, create discomfort, reduce self esteem and a feeling of having little or no control over one’s life.
‘Big T’ trauma is a reaction to a deeply disturbing, life-threatening situation or event.
A lot of clients who present with trauma have first experienced some form of trauma in childhood. This occurs when a child’s sense of safety and being loved and accepted within the family system is inconsistent. If a child’s physical or emotional needs are not met, and are also neglected, a child feels a sense of abandonment or fear. This can happen when a child suffers serious abuse, and it’s also important to know that it can also result in a parent being preoccupied with their own needs. On the other hand, a parent who is too involved in their child’s life, and wishes to control their existence, without respecting proper boundaries, or if the parent relies on the child to be their caregiver, then this can also lead to a child being hyper-vigilant.
The result of traumatic experiences can lead to mental health issues and disorders which the sufferer often tries to hide, mask or ‘treat’ using their own coping mechanisms, often leading to substance abuse. A person’s sense of self is difficult to develop positively and can lead to relationship issues, difficulties at work and an inability to manage and regulate emotions. It is important to stress that trauma can result from a physical threat, or a mental one, and also a combination of both.
What is trauma?
When a person experiences any initial trauma, the body prepares itself to try and survive, whether it be to confront the threat, or to attempt to escape it. The brain will initially freeze in order to measure the level of threat, and try to prepare its response. The body then will prepare itself to flee: this is called flight. The body’s reactions then ramp up in order or to deal with the threat: the heart will race, and the muscles tense in response – it is preparing to fight if necessary. If there is no sense of escape, then the body, and mind, will often begin to shut down in order to endure the threat.
After the initial trauma is over, and survival has at least been established, events and reactions are then held as what we callsomatic memories in the body. If the person encounters any situation or feeling which in any way triggers reactions experienced during that first traumatic event, the brain will begin to react as if that trauma is happening again, even if there is no actual danger present. A sense of hyper arousal can also occur, so that the person is constantly trying to protect themselves from perceived danger. The body has not yet found a way to process the traumatic experience.
The aftermath of trauma can leave the sufferer encountering a range of both physical and mental issues. Flashbacks can occur, where moments from the experience are replayed. Sleep can be a problem, leading to insomnia, poor quality sleep and even night terrors. People can feel a sense of grief for the life they had before trauma, and can often feel a sense of shame around situations which are not their fault. Panic attacks are common, as is a sense of feeling overwhelmed by everyday life. Sufferers often adopt coping strategies to manage their well being, including avoiding any person or situation which makes them feel unsafe, and in the long run mental health problems such as depression, anxiety, compulsive behaviours and substance abuse arise. A trauma sufferer often can feel a sense of numbness, which is a place which again removes them perceived threats. Again, a combination of any of these outcomes leads to an individual who feels isolated and will struggle in any type of relationship, whether it be personal or professional. For loved ones who wish to help, they feel frustrated that attempts to reassure and provide a safe, home environment feel, in their eyes, unappreciated or of little assistance.
PTSD (Post Traumatic Stress Disorder) can develop as a result of exposure to a traumatic event.
Complex PTSD can occur after a repeated pattern of traumatic events.
What is EMDR and how can it help?
EMDR is a truly integrative approach to treating trauma, using a standardised set of protocols which also incorporate elements from established therapeutic processes. It has a phased approach, and allows the traumatised person to be connected to emotions, thoughts and physical sensations associated with their trauma, in a way which then allows the individual’s own brain to then be guided towards healing.
In simpler terms, when we suffer from trauma, and relive its after affects, even if we send ourselves ‘messages’ that we are safe, whether it be positive self-talk or reassurance from another person, our mind and body struggle to receive that information. It is as if we have an email server which is down: our brain is unable to process the original trauma, and how it is stored in the memory. EMDR helps restore that server, so that those positive messages sent to the person affected by trauma can be received, so that they feel secure in the present.
As EMDR is a treatment delivered in stages, it goes at a pace to suit the client, and safety is paramount during each stage. All therapy starts with history taking, and then a client will be thoroughly prepared for the next stages. At the end of each session, time will be sent to ensure the person feels stable, and ready to go about their day. What you reveal about your trauma is up to you. As a therapist, I am most interested in how it makes you feel physically and mentally. EMDR works by using bi-lateral stimulation, which is a specific movement of the therapist, typically by moving two fingers across the eye line of the client. Tapping and sounds can also be used. Studies have shown this allows the brain to reprocess the memory, so that the client will then be able to know that an external trigger is not a sign of danger, where no threat is present.
I have been training and attending workshops and courses with some of the world’s leading trauma therapists, and truly believe it is the way forward for trauma treatment. It has especially been encouraging for me to witness clients who have never been able to talk about their trauma before know they don’t have to describe it in detail in therapy. You are free to be in our safe space, but the choice remains yours.
I am seeing a lot of online services and courses from businesses which are not based in psychotherapy, psychology or psychiatry offering treatments relating to retraining the brain and tapping techniques. My advice? If you are a trauma sufferer, you both need and deserve professional treatment by a trained practitioner. As so many mental health conditions are rooted in trauma, EMDR is also suitable for many clients presenting with depression, anxiety, eating disorders and addictive behaviours, too.
If you are still reading, have experienced trauma, and its lasting after effects, and feel that there is no way forward, please be reassured that there really is one. It is not about erasing the past from your memory, but it really is about how your mind can re-frame traumatic experiences, no matter how damaging they have been, so that you can live with more freedom and ease in your own life, and in the world around you. In the words of Peter. A Levine, ‘Trauma is a fact of life. It does not, however, have to be a life sentence.’