Stephen Derrick MEd/ UKCP registered psychotherapist
Everyday language often uses the word ‘trauma’ as a way of referring to a highly stressful event.
From the perspective of counselling and psychotherapy trauma refers to extreme stress that impacts a person’s ability to cope. The effects can be both physical and psychological.
We experience trauma differently what may be traumatic for one does not necessarily impact on another in the same way.
However people can generally react to trauma by replaying the trauma in their mind, such as ruminating on the experience, avoiding situations which may be associated with the trauma, perhaps by not driving or going out of their way to avoid the place of accident. Also people may experience flashbacks of the traumatic event which can be terrifying in their extreme. Sleep disturbance with nightmares, tearfulness, tension and feeling depressed are all fairly common symptoms experienced as a consequence.
A psychological trauma is a unique impact of an event or persistent on going experiences in which the individual may feel overwhelmed or feels threatened in some way.
An event causes psychological trauma when it overwhelms an individual’s ability to cope and they feel threatened.
Here are some of the thoughts and feelings from people who have experienced traumatic events.
“I feel terrible. I have stopped driving down the motorway since the lorry crashed into me. This is causing difficulties at work as I’m expected to drive long distances. My sleep is disturbed and I am having nightmares. I feel guilty that I’m not coping and a burden to my wife”
“I should have done more to help my friend when he was being attacked. Though I sustained injuries in trying to protect him, I don’t think I did enough. The guy just came out of an alley at us wielding a knife. My friend died and I feel so guilty, life will never be good again. I’m a coward”
The individual my feel emotionally, physically or cognitively overwhelmed and may experience symptoms impacting on their mental health and physical well being.
Trauma can include reactions to one time incidents such as a road traffic accident, natural disasters, loss or violent attacks.
Trauma also refers to reactions to repetitive or historical experiences such as child abuse, deprivation, acts of violence and the effects of torture, cultural separation and witnessing horrific events.
In my counselling with trauma I would by a gentle process of enquiry gain an understanding of the client’s history, the cause of any trauma and its effect.
I would not in the first instance focus on the ‘trauma’ rather I would want to support the client in dealing with what are often overwhelming emotional responses. In the counselling I encourage the client to self support perhaps by including types of relaxation, and healthy adaptations to how they live, giving attention to sleep, diet and appropriateness of exercise. All of which may have been negatively impacted as a result of living with the experience and consequence of trauma.
In the counselling I would support the client in helping to make sense of their trauma as they may well feel overwhelmed and confused. The counselling would give time toward dealing with any flashbacks and nightmares and deal with issues of low mood, tension, anger and avoidance.
Where appropriate I would also consider the use of EMDR which is a proven therapy for working with traumatic issues. (Please see my link on EMDR).
The aim of the counselling is to free the client from the trapped experience often associated with trauma. I would want to support and empower the client toward enabling them to integrate aspects and demands of life. So that the negative effect of trauma is not overwhelming and can ultimately be managed in a healthier and more way.