Understanding trauma

Understanding trauma reactions

A range of events can be emotionally impactful, including events such as physical or sexual assault, natural disasters such as floods, bushfire and droughts, or situations where we feel our life or our loved ones are in danger. People can respond to these events in many ways, from feeling immediate stress through to a diagnosable long-term trauma-related mental health condition.

Immediate responses to threatening experiences can help us protect ourselves from danger. They can help us with responses such as ‘fight’, ‘flight’, ‘freeze’ or ‘fawn' response (involving people-pleasing behaviour to appease an aggressor and avoid conflict). Even once the immediate danger is over, many people experience reactions for a while after the event, including:

• feeling their emotions change quickly, and that they can become anxious or teary at things that might seem small 
• thinking a lot about what happened
• having trouble sleeping
• changes in their appetite and wanting to eat more or less than usual
• feel scared, guilty or angry.

Some people can experience more significant reactions, including:

• Intrusive reminders of the event – these may be involuntary and distressing memories, dreams, or flashbacks of the event. As well as strong emotions, there may be physical symptoms such as sweating, heart palpitations or panic attacks.
• Avoiding reminders of the event – avoiding activities, places, people, thoughts or feelings associated with the event. This can include avoidance by using drugs and alcohol.
• Mood and thought changes – having difficulty remembering the event, feelings of guilt, fear or shame, having low mood or feeling detached. People may also engage in self-harm or experience suicidal ideation. 
• Physical and behavioural changes – e.g.
  o    feeling anxious 
  o    feeling jumpy 
  o    feeling irritable
  o    acting recklessly or immaturely
  o    concentration problems
  o    difficulties sleeping
  o    blaming others for the event
  o    an unexplained pain or illness. 

Trauma is individual—what may be traumatic to one person may not be to someone else. Responses to trauma are also individual—they can include involuntary memories, mood and thought changes, behaviour changes and physical responses.

Post-traumatic stress disorder

Some people continue to experience these strong reactions related to a traumatic experience months after it occurred. These reactions may be post-traumatic stress disorder (PTSD).

It is estimated that between 2% and 20% of all people who have experienced traumatic events develop PTSD. In Australia, around 1–2% of adults experience PTSD each year, while approximately 12% experience PTSD at some time in their lifetime.

Various factors can contribute to people developing PTSD, including your body’s stress response, previous mental health issues, a family history of mental health issues, your support network or other factors. 

Complex trauma

Some people are exposed to multiple events that make them feel unsafe, threatened or in danger that they cannot escape. This repeated exposure over time can negatively impact mental health, relationships and other areas of a person’s life. 

Examples of potential sources of complex trauma include:

• repeated trauma in childhood, e.g. child abuse, neglect, family and community violence, exploitation and other adverse childhood experiences
• violence in the community, e.g. domestic and family violence, experiences of civil unrest, war or genocide, forced migration or displacement, sexual exploitation and trafficking, extreme medical trauma and/or re-traumatisation.

Thoughts, behaviours and emotions that may reflect complex trauma include:

• difficulties with emotion – including strong emotional reactions that feel out of control, challenges in expressing emotion or even a sense of being numb to emotion
• negative self-belief – this view may be based on experiences with others and can lead to feelings of worthlessness and shame
• problems maintaining healthy relationships – difficulty feeling close to another person, challenges trusting others or a general feeling of disconnection, distance or being cut off from other people.

More than 5 million Australian adults are estimated to be living with the impacts of complex trauma, which can include intergenerational trauma and vicarious trauma.

Intergenerational trauma

Intergenerational trauma refers to how the experience of trauma can be passed down between generations. These experiences can be passed down as children learn from their parents’ reactions and beliefs. 

Some communities, such as Aboriginal and Torres Strait Islander peoples, may be more likely to experience intergenerational trauma because of wide reaching events or activities that impacted entire populations. For instance, examples of historical or more recent events that may continue to contribute to trauma in Aboriginal and Torres Strait Islander communities include:

• conflict, massacres and dispossession of traditional lands and resources
• introduced disease and starvation resulting in death or serious illnesses
• forced removal of children
• discrimination and racism
• being separated from culture, communities or country.

Vicarious trauma

Vicarious trauma can occur when people are indirectly exposed to someone else’s trauma, resulting in negative impacts on their mental health that may be challenging to process. Examples can include:

• witnessing a distressing event
• being told about a traumatic event or situation
• experiencing natural disasters (e.g. bushfires, flooding, cyclones) that take place nearby 
• hearing news stories about traumatic events.

Coping after a traumatic event

Here are some approaches that may help you cope with a traumatic event:

• Talk to mental health professionals.
• Talk about the traumatic event early (getting timely support might be a factor in preventing your normal stress reactions from developing into PTSD).
•  Seek social support.
• Talk to family and friends, or someone else who is good at listening and offering support.
• Stay away from drugs and alcohol as a way of coping.

Here are strategies people can use to help with symptoms and recovery from PTSD:  

• Learn ways to soothe the mind and body when going through flashbacks or intrusive memories. 
• Learn about the idea of a ‘window of tolerance’, which conceives of an optimal emotional zone where we feel grounded and able to deal with life’s stressors.
• Take part in activities that are meaningful or fun. 
• Avoid isolation by developing a support network of trusted friends or family members, and reaching out to them when you need help. 
• Take care of physical health by getting enough sleep and staying active.  
• Share and connect with others who have had similar experiences e.g. join a peer support group.

Managing triggers

A ‘trigger’ is something that sparks a memory of the traumatic event that can lead to distressing sensations, emotions, thoughts and further memories of the event. Triggers can be internal, like memories or physical sensations that remind you of the traumatic event, or they can be external, like returning to the place where it happened or approaching the anniversary of the event. It can be helpful to develop a plan to help you manage triggers, including knowing what will help you in the moment. 

When you feel the distress rising:

• recognise the emotion or physical sensation
• allow yourself to feel the sensation, remembering your plan
• use grounding techniques like describing your surroundings, observing the emotion or focusing on a different task
• breathe calmly and deeply

When the sensation passes—and it will—seek support if required.

Be mindful of your triggers so you can find ways to manage them before a reaction occurs, where you can. For example, if you know a certain location is triggering, make sure you have someone with you when you go to that location.