During the last week of September, the number of calls to the National Sexual Assault Hotline skyrocketed and the Rape, Abuse, & Incest National Network assisted 201 percent more people than usual. This drastic increase was a direct response from the testimony of Dr. Christine Blasey Ford and the sentencing of Bill Cosby. This effect is not unusual. After national events bring trauma to the forefront, we often see survivors of similar events come forward. For example, the movie Saving Private Ryan prompted WWII veterans who had been quiet for decades to talk about their time overseas and seek help. Each anniversary of the 9/11 attacks has hundreds of survivors experiencing PTSD symptoms.
Yet, despite the recent publicity, many people still don’t understand what trauma means, how it becomes interwoven with other emotions and behavior and what quality treatment entails. In fact, our society traditionally approaches trauma with a “suck it up” mentality that minimizes it, portraying lingering emotions and pain as weakness. The unfortunate consequence of this misperception is that many people with traumatic experiences remain silent and don’t get the help they so desperately need. This can have a long-term impact on their lives. To create meaningful change, we must understand trauma and work together to develop a more trauma-informed society.
Trauma is defined as an event in which a person fears for their life or physical safety or the life or safety of others. What makes recognizing or acknowledging it more difficult is that this distressing or disturbing experience is subjective. What is traumatic for one person might not be for another. For example, extreme events such as a tornado, car accident or another devastating occurrence can cause immediate trauma. However, trauma responses can also develop because of experiences such as violence, verbal, physical or sexual abuse, and domestic violence, among others. Studies show that even emotional and physical neglect or emotional abuse can have as much impact – immediate and long-term - on people as sexual or physical abuse.
From an evolutionary standpoint, our minds and bodies are programmed to go through a healing process following a trauma: feeling the memories of the event, talking about the event, and undergoing sadness, heightened anxiety, hypervigilance, and fear. Individuals unable to complete this natural healing process are stuck. When someone is exposed to or threatened with death, serious injury, or violence, and they are unable to heal, they can develop post-traumatic stress disorder (PTSD).
For context, 70 percent of people in the U.S. experience at least one traumatic event in their life, and up to 20 percent of them suffer from PTSD as a result. For many people with PTSD, avoiding memories in the short-term may feel safer and allow them to continue to function in their daily lives. However, in the longer-term that avoidance may prevent them from healing fully.
The Lasting Effects of Trauma
Every experience we have affects us and shapes how we interact with the world, and traumatic experiences are no different. Even someone who goes through a healthy healing process will carry effects of their trauma for the rest of their life.
When dealt with in a healthy way, trauma can spur survivors to post-traumatic growth, resulting in a positive effect. A family whose loved one passed away from addiction and creates a charity in their honor is an example of post-traumatic growth.
On the other hand, an individual who doesn’t heal will likely experience negative long-term effects. Some will go on to develop complex PTSD, where the trauma causes the brain to change, thereby impairing their neurological, emotional, relational, and self-identity development. These individuals often have difficulty with strong emotions and may act impulsively or shut down entirely. They also tend to have low self-esteem, and are inherently destructive, which manifests in unhealthy relationships.
Treatment for Trauma and Substance AbuseThere’s a complex relationship between trauma and substance use disorders. In fact, there is evidence there is a shared genetic vulnerability for these disorders. This could contribute to why both occur at high rates together. In these cases, individuals discover that when they use substances, they don’t feel as fearful or anxious. They then develop a tolerance and need more and more until their heavy use makes their PTSD symptoms worse. It becomes a vicious cycle that’s difficult to break without comprehensive treatment.
The good news is that there are a lot of excellent evidence-based practices to treat PTSD on its own or with co-occurring addiction and mental health disorders. At Caron, we’ve seen strong outcomes with a range of therapies that treat symptoms, such as anxiety and fear, which can trigger an alcohol and drug relapse if not addressed in a comprehensive way.
Therapies include cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), and trauma-focused cognitive behavioral therapy (TF-CBT). Some patients also respond to trauma-sensitive yoga, body focus treatments, and sensory motor therapy. Unlike traditional yoga, the focus of trauma-sensitive yoga is helping the person develop a sense of empowerment and safety in their body. It’s a trauma-sensitive approach.
We often encourage support groups for survivors of trauma. This type of community helps them normalize their experiences are replace isolation and shame with a connection to other survivors. I see this all the time at Caron during group therapy sessions, where someone sharing his or her story inspires others to talk about their experiences. The growth of the #MeToo movement also demonstrates how the power of a social community can provide support for survivors of trauma. Social support has been shown to greatly help cancer and cardiac patients, and it’s no different for psychiatric patients.
We have considerable work ahead to create a more trauma-sensitive society. Research shows that trauma doesn’t have to define or destroy someone. Many survivors in recovery are thriving and taking amazing steps to educate, raise awareness and empower others to seek support and live fulfilling lives.