Sunday, 16 August 2020

My World Feels Unsafe: Is This Psychological Trauma?

Most people will experience an event in their lives that could be seen as traumatic, but will not recognise it as such. That’s primarily because after the shock of the event, we quickly settle back down and life goes back to normal. When we recall the event from memory, we are not distressed by it anymore.

Let’s say a dog suddenly runs out in front of the car we’re driving. We screech to a halt missing the dog by inches. The dog runs off, and the owner is nowhere to be seen. We sit there overcome by how much worse this could have been.

After shaking, and possibly swearing for a few minutes, we carefully drive off and slowly calm down. By the time we arrive at our destination, we might still be somewhat annoyed, but by the end of the day, the significance has faded away. By the following day, we are clicking our tongue about irresponsible dog owners but otherwise OK.

The thing about trauma is that it remains with us in the present moment and, slowly but surely, begins to unravel our lives.

When most of us think about psychological trauma we think about it in terms of the medical definitions that are readily available to read on the internet.
The term most often used for trauma in the medical world is Post Traumatic Stress Disorder (PTSD).  PTSD from the medical perspective is viewed as a psychiatric disorder, a mental illness.

Looking on the Internet will reveal, not only the medical definition of trauma and the symptoms we experience:

But also lists of the situations and life events which are deemed to be traumatic:

As a therapist, my take on trauma and PTSD is somewhat different in that my definition of psychological trauma is the response to ANY lived event we experience that leaves us feeling that our world is no longer a safe place.

This definition takes what makes a lived experience traumatic way outside the standard definition of the threat of death to ourselves or someone we love.

Some of the things which happen to people that make us feel unsafe in the world are readily recognised by most of us. Interestingly, most of the commonly acknowledged traumatic events are those that involve physical harm or death. So, surviving a plane crash or a war zone are events we can all recognise as being traumatic. Most of us get that surviving childhood abuse or domestic violence can also leave people feeling traumatised. These are things that are almost always on the lists of situations that can result in psychological trauma.

Traumatic events that are less readily recognised as traumatic can be events like childbirth, finding out you have a life-changing illness, experiencing a miscarriage, the death or taking away of someone or something that you cherish, and life events which are so disruptive and chaotic that we feel we have no control or autonomy over what is happening to us. These are the experiences which can have an equally traumatic effect, not because they directly threaten to end our lives physically, but because they threaten our emotional or psychological survival by having a profound and devastating impact upon us.

This is why it’s so important that we respect the definition of the person who actually experienced something they feel has traumatised them, and avoid telling people they’re not traumatised because it doesn’t fit in with our definition of what trauma is or is not.

What happens to us when our world becomes unsafe is that an alarm goes off in our heads telling us we’re in danger, and we need to do whatever is necessary to protect ourselves from harm. We go into survival mode.

Usually, once we perceive that the danger is over, this alarm in our heads turns itself off. (Think about the example with the dog running in front of the car). But, with trauma, this doesn’t happen, the alarm remains on and the memory of the traumatising event remains in the present. This is why we get triggered and why we experience traumatic symptoms – we are still in survival mode.

In fact, if you think about it, the things we experience as the consequence of being traumatised, the symptoms like hypervigilance, anxiety, insomnia, these are all survival strategies that are running in overdrive and we can’t turn them off. What we’re actually doing are all the right things to do if we were still under threat. What our brain is not recognising is that there is no danger and the alarm can turn off. So, why does the alarm stay on? The fundamental answer is that the brain has decided that, for some reason, despite appearances to the contrary, ‘my world is still not safe’. Therefore the alarm stays on and the brain remains stuck in survival mode.

My therapeutic approach to resolving this is to explore what has gone on that has left our brain ‘stuck’ in survival mode, and then find ways to gently coax our mind into recognising that we can stand down the alarm and come out of survival mode. That despite what we believe, our world is a safe place.

Whilst this seems very simple and obvious, it’s an intense and complex piece of therapeutic work. But the thing about trauma survivors is that they are invariably tenacious, courageous and determined to change, even though they may not perceive themselves as such. That is what will get them through.

Useful books to read:
The BodyKeeps The Score’ by Bessel Van Der Kolk (2014).
Gives a good understanding of how we become traumatised and what to do about it.

Hijacked ByYour Brain’ by Julian Ford and Jon Wortmann (2013).
This book gives the closest explanation to my own thoughts on how we become traumatised when our world becomes unsafe.

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