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Traumatic Stress
Addressing Your Concerns
Traumatic stress is caused by either experiencing or, in the case of secondary traumatic stress, witnessing intense experiences of pain, feeling unsafe, and or loss of autonomy. Many experiences that trigger an automatic “fight or flight” response in the body can cause traumatic stress. Individuals affected by traumatic stress commonly suffer long-term consequences such as intrusive memories about the incident, an isolating pattern of avoidant behaviors, feelings of anxiety and/or depression, and difficulty with memory and/or attentional tasks.
In such cases where the individual has significant challenges due to these long-term consequences, they might be diagnosed with Post-Traumatic Stress Disorder (PTSD). One in eleven people will be diagnosed with PTSD at some point in their lifetime. Though PTSD is often associated with the work of first responders and combat veterans, we know that it occurs frequently in the general population in response to events such as vehicle collisions, intimate partner violence, violent crime, severe illness, and direct exposure to environmental catastrophe.
There are three building blocks to our approach to recovery from traumatic stress of any type:
- Recovery is guided by the individual according to their goals and capacity for change
- Trauma is as much about the body as it is the mind
- It is often helpful to think about our thoughts and feelings as parts of us rather than giving ourselves over to them as if they are our identity.
Trauma recovery starts with your desire to grow, and the first task of trauma therapy is ensuring that you have a space where you feel safe so you can begin to grow that feeling of safety into other parts of your life. All of this is done at your pace, when you are ready.
A significant amount of research over the past 30 years has shown a link between stress response and the body, and most people who have endured traumatic events can attest to this with first-hand experience. The discomfort in our thoughts and feelings runs parallel to the discomfort in our bodies, and as we avoid one, we also avoid the other. Learning to reconnect with awareness in our minds as well as our bodies is an essential task in trauma recovery.
One of the challenges that we face as we become more aware of difficult thoughts and feelings is that they can become overwhelming. Learning to hold space without becoming overwhelmed is a central task of trauma recovery, and one way to approach this task is through parts work. Parts work is a way of understanding our various patterns of thinking and feeling as different “ways of being”–as if our internal experiences were a group of different versions of ourself, each with its own strengths and weaknesses, and each in need of being heard and understood. This type of work can be a powerful tool for confronting situations that would be overwhelming if we give ourselves over to a certain part of our internal experience, as if it had the final word. As if it was our sole identity.
Secondary Traumatic Stress
Secondary traumatic stress, also known as compassion fatigue, progresses to Vicarious Traumatization (VT)–clinically undifferentiated from PTSD–in more severe cases in a manner that parallels the progression of traumatic stress to PTSD. Many people afflicted with secondary traumatic stress have a tendency to minimize their struggle because they were not the primary survivor of the traumatic event. However research clearly shows that the effects of secondary trauma can be every bit as intense and debilitating as primary trauma. Secondary traumatic stress is often seen in healthcare providers, first responders, combat veterans, and bystanders.
Moral Injury
Moral injury is a component of traumatic stress that is often overlooked due to the difficulty one has explaining it to others. This can feel isolating for the individual with moral injury, an experience which was first observed in the early 1990s by a physician working with combat veterans who had been coerced to behave in a way that was, to them, immoral. Though it is easy to imagine this type of psychic injury occurring within the hierarchical structure of the military, today we see instances of moral injury inflicted upon individuals who are coerced through more subtle social and economic mechanisms. Moral injury, which can be present in the absence of a PTSD diagnosis, is commonly seen in academic settings, among professionals, as well as entry-level service workers, parents, and homemakers.