Week 3, Session 1: Trauma and PTSD
Hello everyone! We're back for the first session of Week 3.
If this is the first time you’re reading this, welcome! We’re so happy to have you here. However if you’re just starting out please do head back to the first session. We build on material throughout the weeks, and we don’t want you to miss anything!
Let’s get started with today’s session!
The goals for this session are:
- Develop our understanding of trauma
- Learning about Post Traumatic Stress Disorder (PTSD)
- Practice the Safe Place technique
And as always, we do grounding exercises at the start of every session to bring us to the “present”.
**Today’s grounding exercise will be…
**We are going to try and imagine a place or scene that makes us feel Safe. It can be somewhere you’ve been before, a place you remember, maybe from a holiday; or it could be somewhere you’ve heard about, maybe in a story, or it could be somewhere that you invent and make up yourself.
That a few deep breaths....in your Safe Place, you can see the things you want, and imagine touching and smelling them, and hearing pleasant sounds. You can feel calm and happy. Have another look around and remember that this is your Safe Place and you can come here whenever you want to feel calm and secure.
We have learnt so far, that traumatic reactions come in a variety of ways and can feel different for each of us.
Our exposure to what we call a “single traumatic event” (a one time experience) can happen in different ways:
- We experience the traumatic event ourselves
- We witness, in person, the traumatic event
- We learn someone close to us experienced or was threatened by the traumatic event
- We are repeatedly exposed to graphic details of traumatic events (i.e., something happened in our community).
Some people's reactions after a traumatic experience can dissipate quite soon after the incident has happened. In fact, in the majority of cases of single traumatic incidents, people often experience short-term distress which tends to resolve without the need of professional help.
On other occasions, symptoms of trauma can persist for longer than a month, and that's when we start talking about Post Traumatic Stress Disorder (usually referred to as PTSD). As the trauma therapist who wrote this course says: “Trauma reactions are normal responses to very abnormal situations.” Sadly, some traumatic situations like abuse are becoming more and more common but we refuse to ever see them as normality. Everyone deserves to be treated right.
What happens with post-traumatic stress disorder, is that the feelings and reactions that accompanied the event don’t go away. PTSD makes that past feel like the present: mentally and physically.
But, what is really happening behind the scenes? Our mind is trying to integrate the traumatic episode into our memory but, given the horrific nature of the event, it can't do that without causing us distress or disruption. This session, we are going to be thinking about PTSD and learning about the symptoms involved in common traumatic reactions.
First, let's review some key facts :
- You might experience PTSD if you have gone through an experience that you have found traumatic.
- Not everyone that goes through a traumatic experience develops PTSD.
- Developing the disorder depends on how you deal with the experience. It is not dependent on the severity of the experience.
- You are likely to recover from PTSD.
Now let's dive straight in. In psychology, trauma symptoms are usually separated in 3 big categories:
Hypervigilance (On constant ‘red alert’)
- Panicking when reminded of the trauma
- Irritability or easily upset
- Irrational and intense fear
- Difficulty concentrating
- Feeling jumpy and easily startled
- Difficulty falling or staying asleep
- Anger or aggressive behaviour
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Frequent periods of withdrawal into oneself
- Feeling like you have to keep busy
- Avoiding anything that reminds you of the trauma
- Feeling physically numb or detached from your body
- Being unable to express affection
- Using alcohol or drugs to avoid memories.
Reliving symptoms: Acting or feeling like the event is happening again
- Vivid flashbacks
- Intrusive thoughts or memories
- Intense distress at real or symbolic reminders of the trauma
- Physical sensations such as pain, sweating, nausea or trembling.
Remember, this is not an exclusive list, and other symptoms can play a part in the way you respond to trauma. However, if you have experienced some of these for over a month we would recommend talking to your doctor about it.
As you may have been able to notice when we went through the symptoms, Trauma can have a big impact on our bodies. The physical effects we usually experience after a traumatic event are connected to our body's secretion of hormones like adrenaline and cortisol-the hormone we release when we are stressed.
Remember the fight-flight-freeze response, those 3Fs? That’s it! Our bodies would have released these hormones when we were experiencing the traumatic event and according to research, when we are suffering from post traumatic stress, our body keeps reading threats into situations that are no longer dangerous and therefore, continues to release stress hormones.
These three main categories of symptoms - hypervigilance, avoidance, and reliving - relate in a lot of ways to the function of our nervous systems that we talked about at the end of Week 1. The nervous system that controls our 3F response and more broadly our stress reactivity is the sympathetic nervous system, while the nervous system that controls the body’s restorative functions, the ‘rest and digest’ system, is the parasympathetic nervous system.
So if we relive certain aspects of the trauma, like we just addressed, our sympathetic nervous system secretes many of the same hormones that we did in the original instance of trauma, as though it were happening again. Or when we experience hypervigilance, we treat our environment as a constant source of threat and so our sympathetic nervous system is pretty constantly ‘alert’. Usually, our nervous systems cycle through phases of activity in balance with each other. But between reliving the fear response and hypervigilance to everything in our environment: our sympathetic nervous system needs a break.
That’s where some of the avoidance symptoms come in: the numbness, the loss of interest and pleasure, even difficulties remembering the trauma. Our systems are overworked and overwhelmed, and we disengage as a way of surviving. This doesn’t mean, however, that our parasympathetic nervous system is activated, and we actually experience the rest we need. Our nervous systems are out of balance, which is related to us experiencing symptoms of PTSD, and putting those systems back in balance is part of trauma recovery.
Which is to say, this cycle of symptoms can be exhausting! Whichever symptoms you may experience or relate to, it is worth saying that experiencing the effects of trauma is exhausting for the body.
And also, another point: whether you witnessed trauma in person or you saw in the media, the trauma reactions will still be there and can present in the same way. As we mentioned before, what we find traumatic varies from person to person. Meaning that you might have experienced a very difficult event in your life “in person” that you did not find traumatic, but then one day you see a video of a police shooting on social media that creates a traumatic reaction. This means our amygdala can get equally triggered from that moment on by hearing a car backfire and thinking it is a shooting because you have been severely affected by watching police shootings on television.
Today we have explored trauma reactions and PTSD - we hope that this has been helpful to identify the signs and symptoms of the trauma reaction. In the next session, we will be looking at Complex PTSD and learning some self care techniques.
The homework for this week is… Practice your Safe Space that we talked about at the beginning of the session. Whether it’s a real place, a fantasy place, or somewhere you have made up in your mind, try to flesh out the details. What does it look like, what is in that space? What can you hear, smell, see, touch? If imagining or filling out this space feels like too much, just focus on one physical sensation. What do you want to smell in that space, or hear?
If you are feeling creative and ready, try drawing your safe place! Use whatever medium feels good for you - pencil, marker, paint, crayon - whatever you have, and draw in your favourite colours. This is your place. If you would find it helpful, maybe put this picture somewhere you can see it easily, so that if you become stressed you can look at it. That could be on your desk, or in your backpack, or by your bed -- wherever you can turn to it in times of need. Or maybe drawing the safe space is what soothes and grounds you, so keep those drawing materials ready somewhere you can use them if you become stressed.
Use this exercise however suits you best.