There have been a number of traumatic events in our area over the past year, including the high profile murder of Anamosa State Penitentiary staff members by inmates, a local police officer killed while on duty, and the 2020 derecho. I have been honored to support community members as they recover from these (and other) traumatic events, and I have been thinking about the importance of education and awareness about the psychological impact of trauma.
We hear about psychological trauma and PTSD most often with respect to our military service members and combat experiences. However, it is estimated that at least 50% of people will experience a major traumatic event in their lives. Psychological trauma includes combat-related trauma, sexual abuse and assault, motor vehicle or other accidents, natural disasters and personal assault.
Trauma is a difficult, but not necessarily life-limiting, part of the human experience. We have evolved to be able to cope with and overcome trauma. Just as our bodies can heal naturally from even deep physical wounds, we have psychological mechanisms designed to help us respond to and overcome painful, traumatic experiences.
However, our cultural and familial belief systems and understandable attempts to cope with traumatic experiences sometimes make it difficult to recover well following trauma.
Importantly, the development of PTSD or other mental health diagnoses (e.g, anxiety, depression, eating disorders, substance abuse) following trauma is not an indication of weakness or failure. There are many factors that affect whether or not someone will develop long-term negative life-impairing consequences of trauma, many that we do not have control over. These include childhood abuse or neglect, personal or family history of mental health problems, limited coping mechanisms, or a belief that strong feelings or crying demonstrates “weakness” (beliefs that are often promoted to men more than women and by military or correctional or law enforcement agencies).
However, there are factors that reliably predict better outcomes after trauma, and I hope this article helps empower you to take the steps that are within your control to allow your body and mind to heal as well as possible if you do encounter traumatic events.
Avoidance is the No. 1 predictor of developing PTSD, and substance abuse is the No. 1 predictor of non-recovery of PTSD.
Humans are very creative in the ways they avoid feeling painful events, including staying too busy with work and other activities, distraction, substance abuse, sleeping, working out, eating, gambling, avoiding relationships, and otherwise adjusting life to avoid people, places or things that might remind you of difficult events.
These strategies make perfect sense: just as you learn to avoid touching a hot stove after you got burned, we try to avoid painful memories.
Unfortunately, trauma does not work this way. Once we have a memory, it is part of us forever, even if for a time we are able to suppress it or we cannot remember it verbally. Mental health providers have found that the only way to not feel the “bad stuff” (anxiety, fear, horror, depression, guilt, shame, loss of control) is to not feel the “good stuff” (love, joy, hope, wonder, excitement, contentment).
One of the core symptoms of PTSD is emotional numbness; this is likely an innate mechanism to help us get through traumatic events in the short-run. How could you live through and relive sexual abuse if you have to be present to the feelings all the time? How could you live for months or years in a combat zone if you felt the full weight of the fear and death and destruction around you? However, when used over the long-run, we miss out on all of the beauty and goodness that also exists in the world.
To be clear, most typically this numbing is not an intentional or conscious process, but is a way the body protects itself when overwhelmed. However, it takes a lot of energy to suppress emotions and memories regularly, and the traumatic memories always come back, and with them, additional costs and consequences created by our attempts to avoid feeling pain. Over time, people with chronic PTSD will need to use stronger and stronger avoidance mechanisms (i.e, more and stronger substances, further limiting of human interaction, consideration or completion of suicide).
The antidote to avoidance, and the key to recovery from trauma, is to be willing to remember and feel the painful experiences fully so that they can move through your body and soul. This does not mean you will “forget” your memories or the pain. But willingness to feel is critical to reducing the impact trauma has on our lives.
For those who have experienced trauma recently (or who will in the future), the best way to avoid developing more serious effects is to feel and remember the traumatic events. This can be very painful in the short-run, but is literally our body’s natural mechanism for recovery.
Consider an experience most of us have had: You see a car accident while driving down the highway. Afterwards, you may have images replaying in your mind. These may be graphic and distressing, but you typically allow them. You may go home and tell your family or friends about them. You may dream about the experience that night. You might remember the gruesome details the next morning. But gradually (and oftentimes, fairly quickly), with exposure to these memories and any experiences they bring up, the images, memories and feelings will fade.
Using this approach with bigger, more impactful traumatic events is the goal of trauma work and recovery. Advancing neuroscience and trauma research indicates the possibility of best recovery by willingly facing painful memories and the feelings they generate. Options for this exposure work include:
- Take time to intentionally remember things. Give yourself 5-10 minutes a day to sit and think through events that happened (and notice and allow any feelings or physical sensations that arise when you do).
- Talk to loved ones about painful memories and experiences. Label and share about the fear, horror, guilt, shame, overwhelm, and other emotions that you felt during traumatic times and thereafter.
- Write about your experiences, including the details of them and the feelings and thoughts they generate.
- Express the trauma and its effects through art, writing, performance or other means. This can help you work through it and sometimes even help to use difficult events for good in the world.
- Walking and movement can sometimes help us stay with painful events more easily. Consider walking while thinking about traumatic events, or walking while talking to a loved one about them. Yoga or other forms of mind/body therapies are useful in releasing the physical effects of trauma and calming our nervous systems.
Be patient with yourself and your experiences. We each come into our traumatic experiences with different strengths and limitations, and you may recover more or less quickly than others.
Research has shown consistently that a willingness to face memories, images, feelings and sensations generated by trauma predicts those who will make the best recovery.
If you find yourself stuck and wanting more support in recovery, which may be necessary for more extreme or repeated trauma, consider formal mental health treatment. While there are some medications that might help with symptoms of depression, anxiety, and sleep, trauma-specific psychotherapy is the most effective treatment for trauma.
Be sure to ask potential providers about their expertise with trauma-focused treatments, which include Prolonged Exposure, Cognitive Processing Therapy, Eye Movement Desensitization and Retraining, Acceptance and Commitment Therapy, Accelerated Resolution Therapy, Written Exposure Therapy and more.
While trauma and other painful experiences will forever be a part of our psychological make-up, there are treatments that are proven to help us regain meaning, purpose and depth of emotion in our lives. If you or your loved ones have experienced trauma, even decades ago, consider informal or formal treatments and have hope that life can get better. Please reach out if you would like additional information or local resources for trauma recovery.
Dr. Lauren Welter is a licensed psychologist. She lives on a livestock and crop farm near Monticello, Iowa, with her husband Dan and their children. Contact her through her website, www.prairiehomewellness.com or call 319-975-8705.