What is a trauma response?
Trauma responses often bring clients to therapy due to their intensely distressing and recurring nature.
The foundations of a trauma response are laid in past events, though it’s a common misconception that trauma is linked to singular, impactful tragedies. It’s repeated feelings of uncontrollable fear that are the cause, not the events themselves. Any feeling of intense fear and lack of safety can pave the way for a trauma response, becoming increasingly likely if the experience was unpredictable, unavoidable and chronic.
The most ordinary events may leave deep marks upon the nervous system, especially during childhood and adolescence. For the emotional system, a direct threat elicits the same reaction as, for example, pervasive contempt, neglect, rejection, or criticism. For many clients, the inability to name an inciting incident makes their situation doubly painful, causing them to blame themselves for their distress. Thus, successful therapy seeks not only to relieve symptoms, but also to provide a reasonable explanation for the client’s experience.
The classic signs of a trauma response are: an external, often innocuous trigger; a dramatic, prolonged shift in the client’s usual functioning; overwhelming and distressing feelings; and spiralling thoughts.
During an acute episode, clients may experience:
Panic and fear, with accompanying bodily symptoms
The urge to flee or an inability to move
Shame, guilt and self-blame
Intense grief
Feelings of despair and hopelessness
Distressing thoughts
An inability to communicate one’s immediate experience to others
Traumatic episodes are particularly insidious because they transport a client to a place of extreme helplessness, robbing them of acquired skills, self-pride, and earned perspective. This shift continuously damages and sets back a client’s ability to feel confident in their own abilities, long after the episode resolves.
Typically, episodes last a few hours to a few days, leaving the client exhausted and depleted, requiring a proportional recovery period. In cases where the triggers are chronic or the client is already vulnerable, prolonged activation of the system can lead to extended episodes with associated long recovery periods of a month or more.
In therapy, the first line of treatment is to stabilise the client, through techniques that allows them to anchor themselves during episodes. Common triggers are identified, and where possible, avoided for the initial phase of treatment. This alone can provide substantial relief and control. Over time, the emotional system is taught new pathways for managing perceived threat, and the client becomes more and more confident in assessing and preventing episodes.
The long-term impact of trauma is felt not only in intense, acute episodes, but also in damage to the client’s self-esteem and confidence, which may be considerable by the time they enter therapy. A holistic approach tackles the issue on multiple fronts: behavioural, cognitive, symptomatic, and restorative.
With a secure therapeutic relationship, active participation from the client and a supportive external environment, the likelihood of recovery is high. Over time, the episodes decrease in intensity and frequency, allowing clients to reclaim their lives and agency as overwhelming shame and guilt make room for understanding, calm and hope.
Image: Wind in the Tree Tops by C. R. W. Nevinson