Note: This part of the course covers trauma, its symptoms and possible causes – if at any time in this module you find things challenging or difficult, please take a break, and reach out to someone for support if you need to or call Samaritans on 116 123. 

What is trauma?

Trauma occurs when an external threat overwhelms a person’s coping resources. It can result in immediate psychological distress, sometimes diagnosed as post-traumatic stress disorder (PTSD), or it can affect other aspects of the person’s life over a period of time.

Sometimes people aren’t even aware that their problems are related to a trauma that occurred earlier in life. Many people who experience mental distress have experienced significant trauma in their lives. This trauma may not be recognised.

Trauma is unique to each individual — the most violent events are not always the events that have the deepest impact. Trauma can and does happen to anyone, but some groups — including women and children, people with disabilities and people who are homeless or living in institutions — are particularly vulnerable due to their circumstances.

‘Traumatic reactions occur when action is of no avail. When neither resistance nor escape is possible, the human system of self-defence becomes overwhelmed and disorganised’ (Herman, 1992).

Trauma can affect people in many different ways. These are often grouped under three headings:

Re-experiencing

• Flashbacks — reliving the trauma suddenly and unexpectedly — this can be like reexperiencing the event ‘live’ in the moment, and can induce racing heart, and fight or flight effects.
• Nightmares.
• Frightening thoughts.

Avoidance

• Staying away from places, events, or objects that are reminders of the experience.
• Feeling emotionally numb.
• Feeling strong guilt, depression, or anxiety.
• Losing interest in activities that were enjoyable in the past.
• Having trouble remembering the traumatic event.

Hyper-alertness that cannot be easily controlled

• Being easily startled.
• Feeling tense or ‘on edge’.
• Having difficulty sleeping, and/or having angry outbursts.
• Being constantly alert and vigilant (known as hypervigilance)

All or any of the above manifestations of trauma are very distressing in themselves, and are very damaging to mental wellbeing. They are barriers to recovery, and they limit the possibilities for healthy social interactions and living an enjoyable life.

Trauma can result from a wide variety of events: experiencing or witnessing violence; abuse; accidents; abandonment or neglect; cultural dislocation; natural disasters. Chronic stress factors like poverty and racism can also have traumatic effects over time. Trauma can be intensified by happening early in life; by recurrence and also be secrecy whether imposed by perpetrators or self- imposed due to self-blame and shame.