Trauma

What is Trauma?

Trauma is an emotional reaction to a distressing event. It is very normal for people to feel traumatised after these sorts of events, with people typically experiencing feelings of shock or denial. However, people can find that they experience longer-term effects.

People can experience trauma in different ways. Sometimes people will experience a one-off traumatic event, such as a physical or sexual assault, a car crash, or seeing a natural disaster. Sometimes people will experience ongoing bullying, chronic criticism, or a significant lack of warmth and nurture whilst they were growing up. These experiences can also be traumatic, and can have a long-term impact on how we feel about ourselves.

Trauma vs. Post Traumatic Stress Disorder

Post Traumatic Stress Disorder (PTSD) is a mental health disorder which is associated with someone experiencing or witnessing a traumatic event. Not everyone who experiences a traumatic event will develop PTSD. Furthermore, not every traumatic experience will meet the diagnostic criteria for PTSD. However, there are clear symptoms which are indicative of a PTSD diagnosis:

  1. Intrusions (such as nightmares, intrusive thoughts, or flashbacks about the trauma)

  2. Avoidance of things associated with the trauma (e.g. efforts to avoid thinking about or remembering the trauma, or avoidance of people, places or things that are a reminder of the trauma)

  3. Negative changes to thoughts or mood as a result of the trauma (e.g. persistent negative beliefs about the self, others or the world; not being able to remember aspects of what happened; persistent feelings of shame, guilt or anger; feeling cut off or detached)

  4. Changes in arousal or reactivity levels (e.g. feeling on guard all the time; easily startled; irritable or struggling to sleep)

Even if these criteria are not met, if you are struggling with the long-term impact of having experienced traumatic events, it is worth seeking help. Trauma can have a significant impact on people, regardless of whether they have a diagnosis of PTSD.

Treatment

People with PTSD often don’t realise that many of these difficulties are the result of experiencing trauma and are very treatable. Instead, people often find other ways of trying to manage the trauma or the resulting symptoms, such as restricting, bingeing, drinking alcohol or taking drugs. However, there is a good evidence base for the effectiveness of trauma-focussed CBT or Eye Movement Desensitisation and Reprocessing (EMDR) in treating trauma.

Where eating disorders and trauma co-occur, people may need to address both their eating disorder and trauma symptoms. I am happy to offer people trauma-focussed CBT alongside CBT-E or to recommend therapists who could offer EMDR alongside eating disorder treatment. Equally, schema therapy can be a helpful approach to take.