How to Recover From Trauma After a Traumatic Event

Post-Traumatic Stress Disorder (PTSD) is often associated with combat veterans and survivors of rape or physical assault, but it’s not limited to those categories. Sadly, trauma is more common than we may realize. The World Health Organization (WHO) found that 70.4% of respondents in a survey about trauma had been traumatized sometime in the past (Keller et al., 2017).

PTSD isn’t inevitable after trauma; not all traumatized people develop it. The condition occurs most frequently in situations involving other people, such as the sudden loss of a loved one, or sexual assault.

Defining Trauma

What is trauma? Merriam-Webster defines trauma as (a) “an injury…”, (b) “a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury,” or (c) “an emotional upset.”

A traumatic event can lead to overwhelming emotions that make it difficult for a person to function in all areas of life, including relationships, work, spirituality, and more.

Traumatic events can include:

• Personal – physical abuse, sexual abuse, rape, assault, being shot at, having any sort of near-death experience.
• Circumstantial – exposure to war or violence.
• Common events that still have a traumatizing effect – the death of a loved one, divorce, the breakup of a relationship, a major move, an accident, abandonment, major surgery, or neglect.

According to the U.S. Department of Veterans Affairs (2015), common symptoms of trauma include:

• Shock
• Numbness
• Feeling disconnected
• Anxiety and fear
• Guilt
• Difficulty concentrating or making decisions
• Being easily startled
• Isolation
• Helplessness
• Sadness or hopelessness
• Mood swings, irritability, or anger outbursts
• Distrust
• Nightmares or flashbacks
• Insomnia
• Racing heart
• Easily agitated
• Headaches, stomach aches, difficulty eating

Post-Traumatic Stress Disorder

Again, not everyone who has been traumatized develops PTSD. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (American Psychiatric Association, 2013) says that PTSD can follow sexual trauma, serious physical harm, or the threat of harm.

The trauma doesn’t have to be personally experienced to cause PTSD. The traumatized person may:

• Witness the trauma
• Find out that someone close to them has experienced it
• Be repeatedly exposed to the details of trauma (such as first responders)

A person with PTSD will often try to stay away from places or situations that remind them of the traumatic event(s). Their symptoms may include nightmares, mood swings, hypervigilance, disturbing memories, and other emotional, cognitive, and physical disturbances.

Complex Trauma

In recent years, PTSD has been widely discussed in popular culture, but other diagnoses often result from trauma (Scheeringa, Zeanah, Myers, & Putnam, 2003).

Child abuse victims, for example, frequently present with other diagnoses, including attention-deficit/hyperactivity disorder, phobic disorders, oppositional defiant disorder, and anxiety disorder (Ackerman, Newton, McPherson, Jones, & Dykman, 1998).

Trauma that occurs in early childhood is particularly destructive since it disrupts the attachment system and leads to difficulty with emotional regulation (van der Kolk, 2005).

What is complex trauma? It happens after a series of traumatic events that lead to increasing effects each time (van der Kolk, 2005, Courtiois, 2008). Complex trauma is usually interpersonal in nature and often occurs during childhood – e.g., chronic neglect, repeated sexual abuse, or any mistreatment that takes place for an extended period of time.

You may have heard of the relatively well-known ACE (adverse childhood experiences) study that was conducted by Kaiser Permanente and the Centers for Disease Control and Prevention (Feletti et al., 1998).

In 1998, Kaiser Permanente and the Centers for Disease Control and Prevention conducted a study that has become familiar to many: the ACE (adverse childhood experiences) study, which researched the following situations:

• Abuse (physical, sexual, or psychological)
• Neglect
• Domestic violence
• Separation from parent/caregiver
• A parent/caregiver being incarcerated
• A household member having mental illness or abusing substances

The study found that these ACE’s were substantially related to increased rates of depression, obesity, sexual promiscuity, substance abuse, and suicide attempts later in life. The more ACE’s a child experienced, the higher the association with adverse outcomes. In the end, researchers concluded that ACE’s were also related to causes of death in adults, such as cancer and liver disease.

Complex trauma in children impacts their development, including cognitively. For example, Bessel van der Kolk (2005) stated that “the brain-based stress response systems of these children appear to become permanently changed as they focus attention on the need to ensure safety rather than on the many growth-promoting interests and activities that secure children find attractive and stimulating.”

Hyperarousal means that your natural threat arousal level is heightened as you’re on the lookout for danger. As an example, in 2006, people who witnessed the 9/11 attacks still had overactive threat arousal systems (Ganzel et al., 2007). Hyperarousal occurs in traumatized children; they’re always alert to danger, even when no imminent threat exists (Perry, 2006).

How to Recover from Trauma

Recovery after trauma doesn’t happen overnight. It’s usually a lengthy process requiring patience and perseverance. But there is hope; effective coping techniques are available that can significantly facilitate healing and improve quality of life. Bath (2008) suggests three areas that need attention for a traumatized person, calling them the “three pillars”: safety, connections, and managing emotions.

1) Safety

A safe place is one of the most important aspects of trauma recovery. This includes both physical safety and an emotionally safe setting for working through emotions and the experience of trauma. For a child who has been traumatized by a caregiver or other trusted adult figure, ensuring this safe place can be complicated.

Bath suggests two ways to provide safety for a child: giving them a sense of control by letting them have a say in decisions and making sure they have consistency in their everyday life.

2) Connections

Often, trauma victims may have the impulse to isolate themselves, but isolation doesn’t facilitate healing; instead, it can result in depression and loneliness. Isolation also precludes the possibility of talking about the trauma, which is an essential step in the healing process when the trauma victim is ready to engage in it.

Talking about what happened helps develop a cohesive and understandable narrative which allows for good processing of the trauma. Support groups are often available to address specific trauma situations.

3) Managing Emotions

Along with a safe place and safe people, the following methods can help with emotional management after trauma:

• Breathing: Anxiety leads to shallow breathing, which circulates less oxygen throughout our bodies, which in turn makes anxiety worse. Deliberate deep breathing can help counteract this effect through various exercises. Smartphones apps are available for this as well.
• Mindfulness: This practice involves gaining mastery over your thoughts instead of letting them have the control. Often anxiety can be significantly reduced by using mindfulness. Daniel Siegel is a helpful resource for this practice.
• Relaxation: Hyperarousal increases cortisol, which is a stress hormone. A high level of cortisol over an extended period of time often leads to health problems. As mentioned above, deep breathing can help with relaxation, and so can progressive muscle relaxation, stretching, and yoga.
• Avoidance of alcohol or other substances as a means of numbing or escape: Engaging in addictive substances and activities only provides temporary relief. In the long run, it will increase negative patterns of anxiety and depression. Numbing the pain isn’t the same as processing it. Feeling the pain is obviously unpleasant, but that’s what will lead to healing.
• Grounding: If you’re experiencing derealization (feeling out of touch with yourself and your surroundings) or panic, grounding can help. Feel your feet standing on the ground, look around at your surroundings, speak out loud describing what you see.
• Managing the stress of daily life: If you need to take a break from work, do so. If you need help carrying out your daily responsibilities, ask for it.
• Journaling: This is another helpful way of processing emotions instead of ignoring or numbing them.
• Physical activity: Exercise is a powerful antidepressant. It gives you endorphins and reduces cortisol levels.
• Healthy eating: Good nutrition gives your body what it needs and makes you feel better.
• Sleep: Sleep is essential for well-being and can help your brain process and manage the emotions you’re experiencing.

Again, trauma recovery is a process. It can take a long time. It’s also not linear – there are ups and downs throughout the process. One day you may feel much better, and the next you’re struggling again. External reminders or anniversaries of the event may trigger a fresh wave of emotions. This doesn’t mean healing isn’t happening; each triggering event offers a new opportunity for growth.

Many trauma victims end up recovering without professional assistance. If your symptoms are overwhelming or you’re struggling to function in everyday life, or you are having thoughts of harming yourself or someone else, professional help is vital to come alongside you and guide you towards healing.

Treatment for Healing from Trauma

There are specific effective treatments for trauma beyond talk therapy. Two of the most frequently used methods are EDMR and trauma-focused cognitive behavior therapy.

Eye Movement Desensitization and Reprocessing (EMDR)

EDMR is based on the theory that memories can exist in an unprocessed state in the brain. This means they are nonadaptive (Francine Shapiro, 2012). Since trauma is associated with such high levels of stress at the time of the event, this may prevent memories from being processed. A child who is cognitively undeveloped may be unable to process the event. Other situations can also lead to a lack of good processing.

What happens to these memories? They remain intact in their original states, along with the physical sensations, thoughts, emotions, and visual images that occurred at the time of the trauma.

The EDMR Research Foundation has demonstrated that bilateral stimulation using a standard protocol “unsticks” these memories and allows for them to be processed into adaptive forms. Bilateral stimulation is a left-to-right pattern of eye movements, tapping, or auditory stimulation. This method of therapy is widely considered to be empirically validated for use in treating PTSD.

Along with the typical treatment, there are EDMR protocols for traumatic events that occurred recently, within recent days or months, because memories require time to consolidate. Experts debate the amount of time needed; many say it’s around 3-6 months.

Trauma-Focused Cognitive-Behavior Therapy (TF-CBT)

TF-CBT is a type of therapy that helps a trauma victim work through the thoughts and emotions related to their trauma. TF-CT may be comprised of relaxation training, learning to regulate emotions, pressing the thoughts associated with the trauma, and developing a narrative of the trauma.

This type of therapy can happen in an individual, family, or group setting, or as part of couples psychotherapy. Referral for evaluation by a medical doctor may be included as part of the process.

Whether you have experienced trauma yourself, or someone you love is walking through the pain of trying to heal, please know that there is help and hope for the future. A Christian trauma therapist can help you find that hope and walk with you on the road to recovery.