The Impact of Trauma
What is Trauma?
The APA defines trauma as: an emotional response to a terrible event. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.
What Happens to the Brain When a Trauma Occurs?
Trauma every person, and their brain differently. What we do know is how the brain processes a scary or upsetting event when it happens.
Amygdala: This part of your brain is designed to detect and react to people, places, and things in the environment that could be dangerous. It's like the ever present body guard. This is important for safety and survival. After a trauma is experienced, the amygdala can become even more highly attuned to potential threats in the environment. This can cause a person to closely monitor their surroundings to make sure they are safe at all times (hyper-vigilance). A person might find that they have strong emotional reactions to people, places, or things that might be threatening or that remind them of the trauma. This hyper-vigilance can make it difficult to pay attention at work or school, go new places, or interact with people you don’t know.
Medial Prefrontal Cortex (mPFC): This part of the brain helps to control the activity of the amygdala and is the part that works in therapy to identity what is a real risk versus a trigger to past trauma . Connections between the mPFC and amygdala are sometimes not as strong in people who have experienced trauma. As a result, the mPFC is not as effective at stopping the amygdala from reacting to people, places, and things that are in fact safe. This can lead to persistent elevations in fear and anxiety about cues that remind you of the trauma you experienced.
Hippocampus: This part of the brain is involved in learning and memory. It's like the file cabinet of the brain. Impairments in learning and memory have been seen in people who have experienced trauma. This suggests that trauma may affect how the hippocampus develops. Trauma likely impacts a variety of types of learning and memory, such as the ability to learn and remember information about the surrounding environment. As a result, people who experience trauma may not be able to remember information about how to tell if something is safe or dangerous. An example of this would be your brain feeling safe when walking past a dark alley, but feeling unsafe when walking around a dark corner in your home.
Are These Changes Permanent?
There is hope! The brain is an amazing organ and how the ability to learn, adapt and change for the rest of our lives. Changes to the brain due to trauma, can improve over time. Therapy is an important part of this process. So is your therapist. It's critical that you find a therapist that you feel safe with, and supported by. It's also important that you only use a therapist who uses evidence based approaches to treating individuals impacted by traumatic experiences and events.
What is PTSD and CPTSD?
PTSD stands for Post Traumatic Stress Disorder. This can happen in people who have experienced or witnessed a traumatic event, those who have been threatened with death, sexual violence or serious injury, and those who have experienced emotional, physical, sexual, verbal or spiritual abuse.
CPTSD stands for Complex Post Traumatic Stress Disorder. CPTSD is different from PTSD in that it usually involves a repeated experience of traumatic events. These events can be throughout a life span.
ACEs: Adverse Childhood Experiences
What are ACEs and Why are they Important?
ACEs stands for Adverse Childhood Experiences. These are experiences that someone had as a child, that could impact the choices and experiences that they have as an adult. There has been a lot of research about adverse childhood experiences, and how exactly they impact the future. There are also a lot of questions about what could be missing from the list of adverse experiences (like poverty, adoption and racism). What we do know for sure is that the higher you "score" on the ACEs scale, the more likely it is that you will experience issues around stability with mental and physical health, and the more likely it is that someone will end up involved in the legal system, using substances to cope, or picking friends and partners who are not healthy (and often not safe).
What are considered Adverse Childhood Experiences (ACEs)?
There are 10 things that are listed on the ACEs questionnaire. They fall under the following themes of experiences (occurring in a child's life before the age of 18):
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Mental illness (of caregiver)
- Separation or Divorce of caregivers
- Substance abuse (of caregiver)
- Violence against a caregiver
- Mental illness and/or Suicide (caregiver)
- Having a relative who has been sent to jail or prison
What are risk factors that increase the likelihood of experiencing adverse childhood experiences? The CDC lists the following:
Individual and Family Risk Factors
- Families experiencing caregiving challenges related to children with special needs (for example, disabilities, mental health issues, chronic physical illnesses)
- Children and youth who don’t feel close to their parents/caregivers and feel like they can’t talk to them about their feelings
- Youth who start dating early or engaging in sexual activity early
- Children and youth with few or no friends or with friends who engage in aggressive or delinquent behavior
- Families with caregivers who have a limited understanding of children’s needs or development
- Families with caregivers who were abused or neglected as children
- Families with young caregivers or single parents
- Families with low income
- Families with adults with low levels of education
- Families experiencing high levels of parenting stress or economic stress
- Families with caregivers who use spanking and other forms of corporal punishment for discipline
- Families with inconsistent discipline and/or low levels of parental monitoring and supervision
- Families that are isolated from and not connected to other people (extended family, friends, neighbors)
- Families with high conflict and negative communication styles
- Families with attitudes accepting of or justifying violence or aggression
Community Risk Factors
- Communities with high rates of violence and crime
- Communities with high rates of poverty and limited educational and economic opportunities
- Communities with high unemployment rates
- Communities with easy access to drugs and alcohol
- Communities where neighbors don’t know or look out for each other and there is low community involvement among residents
- Communities with few community activities for young people
- Communities with unstable housing and where residents move frequently
- Communities where families frequently experience food insecurity
- Communities with high levels of social and environmental disorder
What are protective factors (things that decrease the impact or chances of ACEs)? The CDC lists the following:
Individual and Family Protective Factors
- Families who create safe, stable, and nurturing relationships, meaning, children have a consistent family life where they are safe, taken care of, and supported
- Children who have positive friendships and peer networks
- Children who do well in school
- Children who have caring adults outside the family who serve as mentors/role models
- Families where caregivers can meet basic needs of food, shelter, and health services for children
- Families where caregivers have college degrees or higher
- Families where caregivers have steady employment
- Families with strong social support networks and positive relationships with the people around them
- Families where caregivers engage in parental monitoring, supervision, and consistent enforcement of rules
- Families where caregivers/adults work through conflicts peacefully
- Families where caregivers help children work through problems
- Families that engage in fun, positive activities together
- Families that encourage the importance of school for children
Community Protective Factors
- Communities where families have access to economic and financial help
- Communities where families have access to medical care and mental health services
- Communities with access to safe, stable housing
- Communities where families have access to nurturing and safe childcare
- Communities where families have access to high-quality preschool
- Communities where families have access to safe, engaging after school programs and activities
- Communities where adults have work opportunities with family-friendly policies
- Communities with strong partnerships between the community and business, health care, government, and other sectors
- Communities where residents feel connected to each other and are involved in the community
- Communities where violence is not tolerated or accepted
So what can you do if you've already experienced ACEs and you are wondering about the impact, or you already see the impact? That's where finding a therapist to support you comes in. You need a therapist who is Trauma Informed, and who understands what ACEs are and can help you process your experiences, and learn how to continue building the resiliency that already exists inside of you.
