“Not All Trauma Leads to PTSD: Understanding How Trauma Affects People Differently”

Up until relatively recently 40% of human beings died before the age of 15, that was traumatic in all sorts of ways, for the person, for their loved ones and I’m sure it was traumatic for medical staff too.  It still happens and may never be gone completely, but it’s greatly reduced thankfully.  Trauma in scenarios like that encompasses many different reactions and emotions.  Someone who’s been through something traumatic may be deeply sad, or anxious, or ashamed or even angry.

The word Trauma has come to be associated with PTSD (post traumatic stress disorder) in many minds, but it doesn’t have to be.

If something is traumatic, it means it is wounding in some sense.  Divorces can be traumatic, car crashes can be traumatic, bullying can be traumatic, the list goes on and on.  We’re surrounded by it.

There’s two points I’d like you to consider when thinking about trauma.  One is that is that there are different types of trauma and the second is that people can react differently to it.

Let’s start with the different types.  Consider bullying and car crashes.  Bullying can go on and on for years, having to go into work or school knowing that it might be around the corner.  A person can feel scared, demeaned or ashamed on a daily basis, they’ll dread going somewhere and feel on edge the whole time they’re there.  It could be in the home too, which makes going home feel like a misery instead of a safe place.

You can call this chronic trauma, prolonged, sometimes constant, over a longer period of time.  It chips away at self confidence, it undermines someone’s sense of self worth and it often leads to anxiety disorders.  I’ll come back to that point.

The other type is acute trauma, this is more common in something like a car crash.  Car crashes are potentially terrifying, I’m not talking about a bump, I mean a crash.  They’re life threatening, injury threatening, they’ll produce a moment of extreme terror in which death can seem likely.  The sounds and sights are like nothing anyone will normally experience up to that point.  The mind has no frame of reference for what it is trying to process.  It’s a short, sharp, shocking experience… it’s acute.

I’m not saying there aren’t other types of trauma, or there can’t be overlap between chronic and acute, I’m only making the point there are different types.

So what about how it affects people.

Well, if you’ve been bullied for years and years, you might start to doubt yourself and believe you’re different to other people, you might start to avoid people because you haven’t had the best experiences with them.  Inwardly, you start to think ‘I’m weird’ so you develop tactics to manage social interactions and try to minimise how much people can see the ‘real’ you.  Each interaction becomes anxiety provoking and this is Social Anxiety Disorder.

Someone else might react to the same type of bullying by becoming angry.  They might start to feel other people are untrustworthy, or bad.   This could lead to the person expecting unpleasant interactions with people and pre-empting that by avoiding them or being defensive very quickly.  The defensiveness could lead other people to react badly and the belief that other people are bad gets confirmed.  It’s a different type of problem starting with the same type of trauma.

Similarly with the car crash example.  Someone might start to try and avoid the memory of it, because the imagery is horrific and the feeling is unpleasant.  ‘Try not to think about it,’ that’s what people say.  The more they try not to thing about it, the more it looms threateningly in their mind.  The memory comes back in nightmares and vivid ‘reliving’ and they become increasingly desperate to get rid of it.  This is PTSD setting in.

It could play out very differently though.  Perhaps the person just decides to avoid getting in cars, understandable of course, but it could be a path towards driving phobia.  Or perhaps the person struggles to rediscover their motivation, they become quite focused on the fragility and futility of life.  It’s energy sapping, their old routine doesn’t quite get going again, they spend a lot of time with their thoughts and new perceptions of the world.  This might lead to a long term demotivation and deactivation… it could be depression.

Trauma is implicated in all sorts of psychological problems, from PTSD and depression to OCD and Panic attacks.  None of them is more important or more powerful just because it has the word trauma in the title.  They’re all problems, they’re all treatable and they’re all important to try and get help for.

It’s important to say that people are different.  What one person finds traumatic, another doesn’t.  Depression and anxiety can be the result of trauma, but they can also just be the result of general life.  They’re often there without a specific, identifiable cause.  The causes could be multiple or long forgotten.  As I said, people are all different.  We’ll help you to work out what is maintaining the problem, how the problem is working and what can be done to change it.  The most important thing is change.