*Please note that this lesson contains several references to trauma and the events which may cause it, if you need to stop at any time please take a break, and talk to someone you trust or call Samaritans anytime on 116 123*

It is very common for people with BPD to have suffered some trauma in their lives. Sometimes you may not even realise that what you have gone through was traumatic.

What is trauma?

Trauma is a response to a stressful, frightening or distressing event. Traumatic events can happen to anyone, at any age, and everybody reacts differently to trauma.

Traumatic events could include:

• one-off events (terrorist attack, serious car accidents, life-threatening illness, chidbirth experiences, crimes such as robbery or assault)
• ongoing events (war, illness, domestic abuse)
• being physically harmed (assault, domestic abuse, violent crime)
• witnessing someone else get harmed
• living in a traumatic situation (domestic abuse, neglect)
• being affected by a trauma in your community
• harassment, bullying or discrimination relating to your identity (LGBTQ+, racism, sexism)

These events could be situations where you felt:

• threatened or frightened
• rejected or abandoned
• invalidated
• unsafe or unsupported
• powerless

Trauma affects everybody differently, you may be affected more physically or mentally. If you have been affected by trauma, you should remember that you have survived however you could, and you are having completely normal reactions.

How trauma affects us

Normally, our body realised hormones in response to danger, which we call ‘fight or flight’. This is an automatic response, we can’t control it. But trauma affects this process so that our bodies perceive danger where there is none. This can affect you in different ways. You might feel paralysed or unable to move, you might try to get away by fighting or struggling, you may hide or you may try to appease the person who shows you harm.

Here are some other things that can occur with trauma:

• Flashbacks – you may remember single aspects of an event, or relive it in full detail vividly.
• Hyperalertness – being constantly on high alert and on edge
• Anxiety and panic – panic attacks are a response to your body’s reaction to perceived danger
• Low self-esteem – trauma can affect our sense of self, and our thoughts about how we see our worth or value
• Substance misuse – using drugs or alcohol to help numb, or cope with, difficult emotions and memories
• Dissociation – feeling numb and detached
• Self-harm or suicidal ideation – as we saw in the previous lesson, self-harming occurs when we are overwhelmed by difficult emotions or distressed
• Sleep problems – problems sleeping, staying asleep or having night terrors
• Grief – not only for someone we lost, but also for the life we led before the trauma, or the things that have changed in our lives because of it
• Eating disorders – over eating, binging, purging or starving oneself can be a way of getting control over our own bodies

Post-Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder that is the result of a trauma. It’s estimated to affect 1 in 3 people who have a traumatic experience. PTSD can develop immediately after a trauma, or it can occur weeks, months or even years later.

Complex Post-Traumatic Stress Disorder (C-PTSD)

People who have suffered repeated traumas – such as severe abuse, neglect or repeated violence – may be diagnosed with complex PTSD – the symptoms are very similar to PTSD and may not develop until years later. It’s often more severe than PTSD, and symptoms are usually more severe if the trauma was experienced early in life, affcted a child’s development.

How can DBT help with trauma

DBT can help minimise the symptoms of BPD, through the use of coping skills learned in the four skills. Through mindfulness, you can learn to be grounded in the moment, and distress tolerance can help you manage the upset you feel. Emotional regulation skills can help manaing the extreme emotions the trauma causes, and can teach you to stop unwanted emotions, change or regulate them, and help you accept them.

PTSD can make it difficult for a person to trust others around them, and may make communicating needs difficult. Interpersonal effectiveness can provide the tools needed to avoid conflict, ask others for what you need, and develop your sense of worth and self-respect.