Please note: The following is not meant to be professional advice to guide your mental health or treatment. These are my thoughts on some topics I’m passionate about and interested in and are based on my experiences. While I refer to some research, I didn’t provide a list of references because this is meant to be fairly informal. However, if you are interested in these topics and would like to know where I got my information from, I can certainly share some of my sources with you.
Trauma is a real hot-button topic right now in psychology. So much so, that you may have even come across it in the media lately. One of the reasons for this is that we are learning more and more about the impacts of trauma every day. Now, often, when we think of trauma, we think of major events like a devastating car crash, being a prisoner of war, rape, and armed robbery. However, there's more to trauma than that, so we'll start with a simple question: What is trauma?
Trauma Defined
Trauma occurs when we experience an event that overwhelms our ability to cope, so we experience it as being intolerable. This event will also change the way we see the world and can be easily triggered by the smallest perception of danger or the tiniest reminder of the event. In addition, when these tiny reminders happen, our reactions often feel overwhelming and uncontrollable in the moment and incomprehensible in retrospect. It feels as though our whole body reacted before we even had a moment to think about what was going on.
With that in mind, there are two types of trauma that can occur:
The reason it is important to understand the difference between Big T and Small t trauma is because we often only think of trauma as the Big T traumas. We often don't realize that other events that are more individual can impact us in the same way as Big T trauma, which can make our lives confusing when we experience symptoms of trauma, but can't identify a Big T trauma to go with them. In addition, when we experience several events (big or small) along the same theme, they can have a cumulative effect and cause our trauma responses to be even stronger. So why does that cumulative effect happen?
Nobody is born knowing everything about the world, so through our experiences we develop an understanding of and core beliefs about the world around us and how it works. This is especially true of experiences in childhood, but the process continues across our lifespan. This process happens largely subconsciously in that we don't actively think "Oh this happened, so now I will believe that." In our examples above, both the child who was abandoned to the foster care system and the child who was paralyzed alone in the grocery store may have developed a belief about the world such as "I'm all alone." Future experiences that reinforce that belief will strengthen that belief and the traumatic response. Unhelpful core beliefs that I commonly see in my work with clients include "I'm all alone," "I'm not good enough or I am unworthy," "I have no control," and "I'm not safe." Sometimes clients know right away that they believe that and sometimes it becomes more clear as we identify patterns and themes in our work together.
How Trauma Can Show Up in Our Lives
But how do we know if we are being affected by trauma, especially since there are different kinds and it can show up in different ways in our lives? A really helpful concept in understanding our trauma responses is The Window of Tolerance. As per the image below, when we are in our Window of Tolerance, we are calm, cool, collected, and connected. This means that our "thinking brain" (prefrontal cortex) is firing, we can connect with other people, we are emotionally regulated, our thinking is clear and rational, and we can self soothe. However, we can get pushed out of our window of tolerance (often by trauma being triggered), which can cause us to either become hyper-aroused (think anxiety, anger, aggression, outbursts, addictions, obsessive and compulsive symptoms, rigidness, and feeling overwhelmed) or hypo-aroused (feeling shutdown, numb, disconnected, and dissociated). When we are hyper-aroused, our sympathetic nervous system takes over (our fight or flight response) and our reactions can feel instinctual and as if we have no control over them. When we are hypo-aroused, our ancient vagal system takes over (our freeze response) and we feel completely shut down.
Now these systems are a part of our evolutionary development and were created so that we could survive our environment. They are natural responses to situations in which we perceive a threat. If we perceive that there is a threat that we can defend ourselves against, for example, if we run into an angry beaver on a walk by the river, our fight or flight system (hyper-arousal) will be activated. We will try to run or defend ourselves against the threat. If we perceive the threat as so big that fighting or fleeing isn't possible, for example, if we run into an angry grizzly bear on a hike, we will freeze (in the case of the grizzly, play dead; hypo-arousal) and hope to protect ourselves as best we can that way.
However, what can happen with trauma is that our alarm bells that tell us when we need our fight-flight-freeze systems can become oversensitive. Anytime we are reminded of the trauma in the tiniest way (for example, when our negative core belief[s] gets triggered), it can send us into hyper- or hypo-arousal in moments when it is unnecessary. I love the way the image I've embedded below summarizes the Window of Tolerance so concisely and for the website of the creator of this fantastic visual, go here. You can also get a more detailed description of The Window of Tolerance and strategies for staying in it, at this website as well.
Trauma Defined
Trauma occurs when we experience an event that overwhelms our ability to cope, so we experience it as being intolerable. This event will also change the way we see the world and can be easily triggered by the smallest perception of danger or the tiniest reminder of the event. In addition, when these tiny reminders happen, our reactions often feel overwhelming and uncontrollable in the moment and incomprehensible in retrospect. It feels as though our whole body reacted before we even had a moment to think about what was going on.
With that in mind, there are two types of trauma that can occur:
- Big T trauma - These are the events that we typically think of as traumatic. Big T Traumas are events in which we or someone we know were either seriously harmed or there was a threat that we or someone we know would be seriously harmed or killed. An example of this might be if you experienced abandonment by a caregiver as a child, perhaps, being left in the foster care system and bouncing around from one home to the other. As a child, abandonment is life threatening, because we are incapable of surviving on our own.
- Small t trauma - These events are more unique to the individual person. An event may profoundly affect me in a traumatic way, but have no negative impact on you at all. An example of this is if we had 2 families each with 5-year-olds that got separated from their parents in a grocery store. One of the 5-year-olds might think it's the greatest day of their life and raid all of the candy. The other 5-year-old might stand paralyzed with fear. How each 5-year-old interprets the situation will be a result of many factors including their genetics, personality, parents, prior experiences of the world, and their parents response to them when they are found.
The reason it is important to understand the difference between Big T and Small t trauma is because we often only think of trauma as the Big T traumas. We often don't realize that other events that are more individual can impact us in the same way as Big T trauma, which can make our lives confusing when we experience symptoms of trauma, but can't identify a Big T trauma to go with them. In addition, when we experience several events (big or small) along the same theme, they can have a cumulative effect and cause our trauma responses to be even stronger. So why does that cumulative effect happen?
Nobody is born knowing everything about the world, so through our experiences we develop an understanding of and core beliefs about the world around us and how it works. This is especially true of experiences in childhood, but the process continues across our lifespan. This process happens largely subconsciously in that we don't actively think "Oh this happened, so now I will believe that." In our examples above, both the child who was abandoned to the foster care system and the child who was paralyzed alone in the grocery store may have developed a belief about the world such as "I'm all alone." Future experiences that reinforce that belief will strengthen that belief and the traumatic response. Unhelpful core beliefs that I commonly see in my work with clients include "I'm all alone," "I'm not good enough or I am unworthy," "I have no control," and "I'm not safe." Sometimes clients know right away that they believe that and sometimes it becomes more clear as we identify patterns and themes in our work together.
How Trauma Can Show Up in Our Lives
But how do we know if we are being affected by trauma, especially since there are different kinds and it can show up in different ways in our lives? A really helpful concept in understanding our trauma responses is The Window of Tolerance. As per the image below, when we are in our Window of Tolerance, we are calm, cool, collected, and connected. This means that our "thinking brain" (prefrontal cortex) is firing, we can connect with other people, we are emotionally regulated, our thinking is clear and rational, and we can self soothe. However, we can get pushed out of our window of tolerance (often by trauma being triggered), which can cause us to either become hyper-aroused (think anxiety, anger, aggression, outbursts, addictions, obsessive and compulsive symptoms, rigidness, and feeling overwhelmed) or hypo-aroused (feeling shutdown, numb, disconnected, and dissociated). When we are hyper-aroused, our sympathetic nervous system takes over (our fight or flight response) and our reactions can feel instinctual and as if we have no control over them. When we are hypo-aroused, our ancient vagal system takes over (our freeze response) and we feel completely shut down.
Now these systems are a part of our evolutionary development and were created so that we could survive our environment. They are natural responses to situations in which we perceive a threat. If we perceive that there is a threat that we can defend ourselves against, for example, if we run into an angry beaver on a walk by the river, our fight or flight system (hyper-arousal) will be activated. We will try to run or defend ourselves against the threat. If we perceive the threat as so big that fighting or fleeing isn't possible, for example, if we run into an angry grizzly bear on a hike, we will freeze (in the case of the grizzly, play dead; hypo-arousal) and hope to protect ourselves as best we can that way.
However, what can happen with trauma is that our alarm bells that tell us when we need our fight-flight-freeze systems can become oversensitive. Anytime we are reminded of the trauma in the tiniest way (for example, when our negative core belief[s] gets triggered), it can send us into hyper- or hypo-arousal in moments when it is unnecessary. I love the way the image I've embedded below summarizes the Window of Tolerance so concisely and for the website of the creator of this fantastic visual, go here. You can also get a more detailed description of The Window of Tolerance and strategies for staying in it, at this website as well.
Working on Trauma
So what now? What if you have developed a core belief (or several) that is unhelpful in your life and/or are having trauma responses that are making your life difficult? What if you think this is happening, but have no idea if it is for sure? What do you do?
There are a couple of ways that you can get started with this work.
Something to keep in mind is that because trauma can be one of the more emotionally intense experiences one can have and it can feel like we have little control over our response to it, it is work that might be difficult to resolve completely on your own. Of course, everyone is at different places in their journey, has different access to resources (money, energy, and time), and has different preferences for how they get started. You might be at a place in your life where just having an awareness that trauma might be an issue for you is enough. You might be mostly interested in doing some reading first or you might be ready to jump into therapy. Start with what feels possible for you right now.
What you can expect when doing trauma work with me:
If you've never been to therapy or you have and have had a really negative experience in therapy, you may want to start by reading about what you can expect in therapy in general (with me) here. Right now, I'm going to speak more specifically to the trauma work that I do as opposed to what therapy in general looks like.
Because trauma can cause us to have reactions that feel uncontrollable, the first step in working with trauma is to identify what's specifically happening for you and work on strategies so that you feel you have more control over those reactions. We look at how you generally cope with emotions and work on strategies to have more control over them. Essentially, we work on strategies that can bring us back from hyper- and hypo-arousal and on widening our window of tolerance so that we're not so easily sent out of it. This is important work to do at the beginning of our work together, because when we start working specifically on the trauma, sometimes it can cause some intense emotions or memories to surface here and there. As a result, it's important that you have strategies to cope with those emotions or memories if they come up and that you feel confident using those strategies before we start the trauma-specific work. How long this phase lasts can vary from person to person; sometimes it's one session and sometimes it's several. How long it takes is dependent upon how well you manage your emotions currently, how severe and deep-seated your reactions are, and how much time and energy you have between sessions to practice strategies. For more on expectations for therapy, check this out.
Once we feel we are in a more stable place regarding managing reactions and your emotions, the next phase is to tackle the trauma specifically. The technique that I use for tackling trauma is called EMDR (eye movement desensitization and reprocessing). I chose this technique for my training because it's very effective and efficient. In addition, if a client is uncomfortable disclosing all of the details of the trauma or their life, with EMDR they don't have to in order for it to be effective. so it can help a wide number of people.
In a nut shell, EMDR helps us identify the core beliefs (aka negative cognitions) we hold that are linked to the traumatic experiences we've had (big or small) and the reactions we're having (hyper- or hypo-arousal), so that we can reduce the distress around those experiences and incorporate more helpful beliefs (aka adaptive cognitions). Through EMDR we process the traumatic events and come out the other side seeing them differently - in a more helpful and healthy way. This is what stops the trauma from affecting us so negatively. We do this by applying bilateral stimulation (which means we activate the left and right side of the brain alternatively) which is believed to help your body and mind engage in the natural healing process that already exists within you (for the nerdy in the room, it's believed to encourage 40 hz gamma bands of neural activity in our brain, which seems to be our brains sweet spot for processing). Although the original method of bilateral stimulation was with eye movements, I also have "tappers/buzzers" that you can hold in your hands that gently buzz each hand or headphones that will send a mild tone to each ear in an alternating fashion. Although it can certainly be an emotional experience to go through this process, it can be a necessary part of the beast so we take it in as small of chunks as is needed for it to not be overwhelming, we do it only as frequently as you want, we always close the session with a containment and calming exercise, and we don't do it until you have the tools you need to feel confident in containing anything that comes up between sessions. For more detailed reading on EMDR, check this website out. I also have attached a couple of the handouts and images that I use to explain this process with my clients at the bottom of the page as well.
Interested in further reading/information on the subject?
Dr. Bessel van der Kolk is a well-known expert on trauma and wrote a very accessible and interesting book called The Body Keeps Score, which I would highly recommend for therapists and clients.
Dr. Gabor Mate discusses the importance of listening to our bodies and the role that stress and trauma can play in physical illness in When The Body Says No. He also discusses the impact of trauma on addiction in In the Realm of Hungry Ghosts and on ADHD in Scattered Minds. He has several Youtube videos that you can check out as well addressing the topic.
Dr. Francine Shapiro also wrote an accessible book called Getting Past Your Past, which is more specific to EMDR, but is also quite good.
Dr. Laurell Parnell offers concrete strategies that can be used immediately by clients to support their healing in Tapping In.
Overcoming Trauma Through Yoga: Reclaiming Your Body by David Emerson, Dr. Elizabeth Hopper, & Dr. Peter Levine discusses using yoga to reconnect with your body as a safe space after trauma.
There are so many resources to recommend that are dependent on what you're looking for, so this list could go on forever, but for now, I'll leave it at that. There's also several trauma-focused Facebook pages that you can follow that will often post good articles if you're interested, such as The Trauma Project.
So what now? What if you have developed a core belief (or several) that is unhelpful in your life and/or are having trauma responses that are making your life difficult? What if you think this is happening, but have no idea if it is for sure? What do you do?
There are a couple of ways that you can get started with this work.
- You can do some exploring and investigating on your own. Check out some of the further resources I have suggested below and explore the websites I have linked to throughout. If there are strategies that you come across in your exploration, feel free to start trying them out if you feel comfortable and a detailed enough description is provided for them so that you know when it is appropriate and beneficial to use them.
- Find a therapist that specializes in trauma (such as myself). It's important when finding a therapist that the person is a good fit for you. If you think we might be a fit, feel free to learn more about me here, about my services here, or contact me here. If not, Psychology Today is an excellent website that you can use to find private practice therapists in your area. When you're reading through profiles, make sure that they mention trauma as an area of focus. Further, if you want to see a therapist, but don't have access to a private practice therapist at this time, check out my page here for suggestions for free or sliding scale therapy in the Fort Saskatchewan area. Because therapy is an investment (in time, money, and energy), you might want to do some reading on different approaches (e.g. EMDR, prolonged exposure, somatic experiencing, trauma-informed yoga therapy or dance and movement therapy, etc.) and choose a therapist that offers the approach you are interested in. In the additional resources below, there are several options that can help you navigate finding an approach that you'd like. Bessel van der Kolk's The Body Keeps Score is especially good for this as he discusses several trauma approaches in the latter part of the book.
Something to keep in mind is that because trauma can be one of the more emotionally intense experiences one can have and it can feel like we have little control over our response to it, it is work that might be difficult to resolve completely on your own. Of course, everyone is at different places in their journey, has different access to resources (money, energy, and time), and has different preferences for how they get started. You might be at a place in your life where just having an awareness that trauma might be an issue for you is enough. You might be mostly interested in doing some reading first or you might be ready to jump into therapy. Start with what feels possible for you right now.
What you can expect when doing trauma work with me:
If you've never been to therapy or you have and have had a really negative experience in therapy, you may want to start by reading about what you can expect in therapy in general (with me) here. Right now, I'm going to speak more specifically to the trauma work that I do as opposed to what therapy in general looks like.
Because trauma can cause us to have reactions that feel uncontrollable, the first step in working with trauma is to identify what's specifically happening for you and work on strategies so that you feel you have more control over those reactions. We look at how you generally cope with emotions and work on strategies to have more control over them. Essentially, we work on strategies that can bring us back from hyper- and hypo-arousal and on widening our window of tolerance so that we're not so easily sent out of it. This is important work to do at the beginning of our work together, because when we start working specifically on the trauma, sometimes it can cause some intense emotions or memories to surface here and there. As a result, it's important that you have strategies to cope with those emotions or memories if they come up and that you feel confident using those strategies before we start the trauma-specific work. How long this phase lasts can vary from person to person; sometimes it's one session and sometimes it's several. How long it takes is dependent upon how well you manage your emotions currently, how severe and deep-seated your reactions are, and how much time and energy you have between sessions to practice strategies. For more on expectations for therapy, check this out.
Once we feel we are in a more stable place regarding managing reactions and your emotions, the next phase is to tackle the trauma specifically. The technique that I use for tackling trauma is called EMDR (eye movement desensitization and reprocessing). I chose this technique for my training because it's very effective and efficient. In addition, if a client is uncomfortable disclosing all of the details of the trauma or their life, with EMDR they don't have to in order for it to be effective. so it can help a wide number of people.
In a nut shell, EMDR helps us identify the core beliefs (aka negative cognitions) we hold that are linked to the traumatic experiences we've had (big or small) and the reactions we're having (hyper- or hypo-arousal), so that we can reduce the distress around those experiences and incorporate more helpful beliefs (aka adaptive cognitions). Through EMDR we process the traumatic events and come out the other side seeing them differently - in a more helpful and healthy way. This is what stops the trauma from affecting us so negatively. We do this by applying bilateral stimulation (which means we activate the left and right side of the brain alternatively) which is believed to help your body and mind engage in the natural healing process that already exists within you (for the nerdy in the room, it's believed to encourage 40 hz gamma bands of neural activity in our brain, which seems to be our brains sweet spot for processing). Although the original method of bilateral stimulation was with eye movements, I also have "tappers/buzzers" that you can hold in your hands that gently buzz each hand or headphones that will send a mild tone to each ear in an alternating fashion. Although it can certainly be an emotional experience to go through this process, it can be a necessary part of the beast so we take it in as small of chunks as is needed for it to not be overwhelming, we do it only as frequently as you want, we always close the session with a containment and calming exercise, and we don't do it until you have the tools you need to feel confident in containing anything that comes up between sessions. For more detailed reading on EMDR, check this website out. I also have attached a couple of the handouts and images that I use to explain this process with my clients at the bottom of the page as well.
Interested in further reading/information on the subject?
Dr. Bessel van der Kolk is a well-known expert on trauma and wrote a very accessible and interesting book called The Body Keeps Score, which I would highly recommend for therapists and clients.
Dr. Gabor Mate discusses the importance of listening to our bodies and the role that stress and trauma can play in physical illness in When The Body Says No. He also discusses the impact of trauma on addiction in In the Realm of Hungry Ghosts and on ADHD in Scattered Minds. He has several Youtube videos that you can check out as well addressing the topic.
Dr. Francine Shapiro also wrote an accessible book called Getting Past Your Past, which is more specific to EMDR, but is also quite good.
Dr. Laurell Parnell offers concrete strategies that can be used immediately by clients to support their healing in Tapping In.
Overcoming Trauma Through Yoga: Reclaiming Your Body by David Emerson, Dr. Elizabeth Hopper, & Dr. Peter Levine discusses using yoga to reconnect with your body as a safe space after trauma.
There are so many resources to recommend that are dependent on what you're looking for, so this list could go on forever, but for now, I'll leave it at that. There's also several trauma-focused Facebook pages that you can follow that will often post good articles if you're interested, such as The Trauma Project.
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| trauma_and_neural_networks.pdf |
| window-of-tolerance.pdf |
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