The term trauma is commonly used in conjunction with various disorders, including post-traumatic stress disorder (PTSD), complex PTSD, disorders of extreme stress not otherwise specified (DESNOS), complex trauma, and developmental trauma disorder (DTD). Trauma is often used to refer to both the events that produce distress and to the distress itself. Technically, trauma refers only to the event, not the reaction and there is significant disagreement between experts as to what is and what is not traumatic.
Trauma is a subjective experience precipitated by life-threatening or life-altering events. The degree of danger is not as relevant as how dangerous the subject believes it to be. What is trauma-inducing for one person may have no discernible effect on another.
Post-traumatic stress disorder (PTSD) is a diagnosable, mental health condition, triggered by a terrifying event, including rape, assault, natural disaster, accidents, surgery and war. Symptoms may begin immediately or not surface for an extended period and may include flashbacks, nightmares, anxiety and uncontrollable thoughts about the event.
Developmental trauma disorder (DTD) describes childhood trauma such as chronic abuse, neglect, stress, abandonment and a wide variety of domestic adversity. The majority of traumatised children will not develop PTSD. Instead, they are at risk for a range of complex emotional, cognitive and physical illnesses that last throughout their lives.
In some respects, however, these definitions are largely academic. While trauma may be associated with numerous diagnosable disorders, trauma itself is not disorder. Consequently, it can be legitimately addressed outside of formal diagnosis by evidence-based, clinical interventions including EMDR, mindfulness and focussed yoga practice.
Trauma overwhelms the individual and is characterised by a loss of control. Even when the event is over, the trauma experience can continue, producing an altered state of mind that negatively affects a person’s thinking, behaviour, and psychological and physiological well-being. A trauma condition develops when the mind-body is unable to return to a normal range of nervous system regulation.
Trauma symptoms vary widely and may continue for indeterminate periods. Physiological symptoms include an increased tendency to dysregulate, decreased cognitive ability and increased levels of physical illness and injury. Psychological impacts include feeling unsafe, immobilised and trapped. Raised levels of aggression and addictive behaviour are commonly reported as well as isolation, emotional numbing, dissociation, guilt, shame and distrust of others.
Trauma recovery begins with safety and stabilisation. Understanding trauma and recognising its common symptoms is an important first step. Establishing a sense of bodily safety, abstaining from self-injury, finding a safe environment are equally important. The aim is to begin the process of establishing a safe and stable environment in the present, setting the conditions to facilitate safe remembrance of trauma without reliving it, effectively coming to terms with the traumatic past.
Recent studies have shown the relative ineffectiveness of traditional cognitive approaches in regard to trauma resolution. As a result, the concept of employing innovative methods and practices that provide a more comprehensive and holistic strategy for addressing trauma, including somatic based therapies, is becoming more accepted.