What is this TRAUMA?
Published in Cody Living Magazine, October 2018
When approached to write an article on trauma, I questioned how the readers of an entertainment magazine would respond to such a serious subject. Stephanie assured me that readers have a wide variety of interests, so here is the first of three articles on trauma. The footnotes with references can be viewed at the web address at the end of the article.
The words trauma and trauma informed are thrown about these days usually followed by solemn nods of agreement, talk about posttraumatic stress disorder (PTSD) and images of combat fighters ducking when hearing a car backfire. That is true as far as it goes, however trauma as a stand-alone word is like saying building, the listener has very little to visualize. For the purpose of these articles trauma is described as:
An event that creates fear of one’s well-being, a feeling of helplessness and loss of physical safety that they can’t move on from and/or forget.
There are four primary categories of serious traumas:
1. Conception to 12ish years of age, carried and/or raised in chronic abuse, including neglect by the caregivers. Sometimes called developmental trauma disorder (DTD) or complex or childhood PTSD (cPTSD) .
2. Rape
3. Military or soldier battle trauma usually known as PTSD and people surviving battles.
4. One-time events like natural disasters or a sink hole, a serious accident resulting in physical harm to an individual and/or others around them, and being present when someone dies in a violent manner.
If you are interested to see how you rate with cPTSD you can take a 10-12 question ACE survey. Go to:
Some professionals regard PTSD as encompassing all types of traumatic stress and do not separate the trauma for treatment.
News Flash: this is not an either-or field, there are more exceptions than norms. The four may have similar symptoms to some degree nevertheless the complications, treatment plans, length of recovery, and medications are different . The reason for this is the age, mental and physical health of a person who has just experienced a life changing trauma, has never known anything else but trauma, or somewhere in between.
This brings us to the other side of understanding serious trauma: IT IS PHYSICAL . What affects the mind, the body reacts. How did humans lose their connectiveness? Somewhere during the 1900s with the blossoming of empirical experiments to prove hypotheses, the human body was successfully severed in two; the body and the brain/mind. Medical professionals dismissing it as only being in the mind and informing the client to see a mental health care provider. The mental health care provider usually has little to no understanding of the medical issues or biological paths the traumatized are suffering from, which will in turn cause more stress and trauma. Those of you reading this article that are suffering from the effects of chronic trauma are free to stand up and say: Amen, sister!
When I am helping those with childhood/complex trauma, I take a medical survey to find out where they hurt and what physical issues they deal with every day. I also chart blood pressure and heart rate. Wild, right?! If a client comes in with skyrocketing blood pressure, I know they will not be able to think clearly, and an emotional session will only do more harm, so we choose to draw, paint, sculpt (that is one of my favorites), or do chair yoga and talk is light that is led by the client .
cPTSD treatment from both personal and client experience is best under calming circumstances which includes the counseling environment. When an ACEs is taken, and the score is 4 and/or above or rape is indicated I know I will not probe into the specifics, other than age of certain events, because it is not necessary. Knowing the age is important to ascertain brain and physical development.
OK, I got off on a passionate sideline. Back to the four major types of trauma. Conception to 12ish years of age is the time of major mental and physical development for that individual. What is transferred genetically, the environment of the fetus, birth and years of development all build the foundation that chart the course of an individual’s life. The fetus is protected by the placenta to a certain extent. News Flash: DNA can be altered in the cells of developing brain tissue, meaning the stress of the mother during gestation can have a lifetime effect on the developing fetus. So, an individual’s body and mind-altering trauma can start before their feet even hit the ground.
As examples, I have had two clients with puzzling presentations.
The young man was hitting puberty, both he and his mother were disturbed by his change in temperament and symptoms of cPTSD (we’ll discuss those in the next article). We had the first session together, so they could put the pieces together and perhaps figure out what was or had gone on in his life. I asked all the normal questions one would ask, and nothing came up suspicious. A light bulb came on in my head reminding me of the subject I was in the process of studying: overloading of the placenta. When asked the mom about her pregnancy she talked about her abusive husband (at that time), the difficult pregnancy and delivery she had had. During the birth, her son had his collar bone broken and both mother and child had to stay in the hospital with nurses doing most of the baby’s caretaking. Big Aha moment.
The other case was a young woman in her twenties who was seriously troubled with cPTSD symptoms and was very annoyed because she reported never having any of the situations or events that are usually present to develop those symptoms. After the normal questions, I asked about her mother’s pregnancy and delivery with her. Oh, my goodness, what a story. Her birth mother had cancer while carrying her and had refused treatment until the baby was born. After the birth the mother died within three months, the baby was passed around the extended family members until the father remarried which was two years later. My client did not remember this happening to her, she only knows that she loves her mama and daddy and had a wonderful childhood.
Pre-birth and childhood trauma can make an individual more susceptible to developing PTSD after a traumatic event like a natural disaster or facing the violence and stress of combat. cPTSD can be the key factor in many physical disorders in adulthood like cardio-vascular, fibromyalgia, irritable bowel syndrome/constipation, bladder issues, and stress related illness are some of the physical issues.
In the next issue I will cover behaviors and treatments.
For viewing the footnotes please go to www.summitfamilycounseling.com.
For questions and comments, you can contact Linda at: linda@summitfamilycounseling.com or by using the Contact Form on this website.
Linda Rogers M.A., NCC is currently a doctoral student specializing in Health Psychology which is the study of the relationship of psychophysiological factors and the detriment of health. She has been researching cPTSD for the past 12 years for personal and professional growth.
Endnotes:
Secondary trauma is also a concern however, it does not have the tragic effects that the other three have.
Yes, the mother’s egg and the father’s sperm are called the germ line, and if one or both parents suffer from unresolved trauma, that can be passed to the fetus before it even starts growing.
Julian D., Ford, Damion Grasso, Carolyn Greene, Joan Levine, Joseph Spinazzola and Bessel van der Kolk. (2013) Clinical Significance of a Proposed Developmental Trauma Disorder Diagnosis: Results of an International Survey of Clinicians. Journal of Clinical Psychiatry 74 (8). D’Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. (2012). Understand Interpersonal Trauma in Children: Why We Need a Developmentally Appropriate Trauma Diagnosis. American Journal of Orthopsychiatry 82 (2).
Sar, V. Developmental trauma, complex PTSD, and the current proposal of DSM-5. (2011). European Journal of Psychotraumatology 2011. So much to read so little time!!
Childress, J. E., McDowell, E. J., Dalai, V. V. K., Bogale, S R., Ramamurthy, C., Jawaid, A., et al. (2013). Hippocampal Volumes in Patients with Chronic Combat-Related Posttraumatic Stress Disorder: A Systematic Review. Neuro-Psychiatryonline.org. Lehavort, K., Der-Martirosian, C., Simpsom, T. L., Shipherd, J. C. & Washington, D. L. (2013). Role of Military Social Support in Understanding the Relationship Between PTSD, Physical Health, and Healthcare Utilization in Women Veterans Journal of Traumatic Stress 26.
ACE (Adverse Childhood Experiences Study) was developed by Kaiser Permanente from 1995-1997 for doing research for obese patients. It was incorporated into medical examinations at that time it has slowly disappeared from the scene, which is so unfortunate.
Ok, they should be different. If a treatment and/or medication is not working the diagnosis is probably off with the exception of allergies. I know that is not a very popular belief however the body is one whole unit with medical/physical reactions in the brain. For instance, if a medical doctor was treating you for a virus it would not affect the bacterial infection you happen to have.
Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. NYC, NY: Penguin Group. I highly recommend reading this book to anyone seeking knowledge about severe trauma.
At the end of our time I take the BP again and in all my cases their BP had returned to an acceptable level. They keep a daily chart of their BP so the 1st and 2nd will be listed.
Provencal, P., & Binder, E. B. (2014). The affects of early life stress on the epigenome: From womb to adulthood and even before. Experimental Neurology 268. Doi: 10.1016/j.expneurol.2014.09.001
Guan, S., Ning, L., Tao, N., Lian, Y., Liu, J., & Ng. T. B. (2016). Effects of maternal stress during pregnancy on learning and memory viz hippocampal BDNF, Arc (Arg.31) expression in offspring. Environmental Toxicology and Pharmacology 46.
Springer, K W., Sheridan, J., Kuo, D., & Carnes, M. (2003). The long-term health outcomes of childhood abuse. Journal of Internal Medicine 18 (10). Chartier, M. J., Walker, J. R., & Naimark, B. (2010). Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization. Child Abuse & Neglect 34.
