Kimberly Key

A Quick Guide to Understanding and Treating the Three Types of Trauma

Trauma has become a popularly used word. So much so that many have questioned if it has been overused. David Brooks recently opined the same sentiment in The New York Times entitled, “Hey, America, Grow Up!” To alleviate confusion, this article provides an explanation of the three main types of trauma and the very real health impacts, along with some suggestions for treatment.

Trauma at a Glance

Acute Trauma -  You’ve been in an accident, explosion, natural or manmade disaster, assault, and/or witnessed a death(s). The jolt is so severe that it knocks out memory and leaves you in a state of shock.

Chronic Stress Induced Trauma - You’ve encountered multiple severe stressors and traumatic exposures, yet no memory was lost. The stressors add-up and your former coping skills are not working. This is a danger zone for adopting maladaptive coping methods like addiction and anger outbursts—and rupturing immune defenses which lead to disease.

Post-Traumatic Stress Disorder (PTSD) - PTSD can result from acute trauma exposure and chronic stress induced trauma. It can also be a latent condition that stems from childhood maltreatment. Some conditions and experiences can be triggering and pull a person back in time to the original trauma. Or a person can re-enact aspects of the trauma.

Trauma and Disease

Stress & Trauma Rewire the Brain - Living in hypervigilance, anxiety, fear, and depression are common with trauma and chronic stress exposures. Decision-making is altered and the person is living in a constant state of threat and reacting from a fight-flight-or freeze response.

Alteration Occur at the DNA level -  The complex reactions to chronic stress and trauma exposure can turn on DNA while up-regulating and down-regulating DNA and neural activity in negative ways. Some of these include behavioral (like being more prone to addiction, isolation, and altered cognitions) and others can activate disease.

A Defeated Immune System - Chronic stress and trauma can shove the immune system into overdrive and disrepair. The result is chronic inflammation and an open door to viruses, infections, and diseases.

Treating Trauma

See a Therapist Trained in Trauma Treatment - While it would be nice to see a therapist, a therapist trained in trauma treatment understands the impact a listener can have when a person is recounting their trauma. The key is for each person to purposely relax their muscles like wet noodles when listening and when recounting a story. This can help to avoid re-traumatization and the inadvertent reinforcement of fear pathways through mirror neurons.

Exercises to Do at Home – Journal about the grief in your own handwriting. You can also write a story about the experience to process the feelings. Creating art can also be powerful. Meditation and yoga can also help. All of these activities are particularly powerful as they help access and balance nervous system responses that run counter to the fight, flight, or freeze response of the sympathetic nervous system.

Recipe for Heart Meditations – As you sit and take slow deep breaths in and out, try to access the energy of your heart and feel it open. Fill it with warmth and compassion and let that energy feeling expand and encircle your whole body. Focus on compassion and gratitude for every cell in your body with each breath. After a while, you can expand the feelings of compassion and gratitude for your loved ones, community, and the world around you.

Honoring Traumatized Families this Memorial Day

As we grieve fallen soldiers on this Memorial Day, I would like to dedicate this post to people everywhere who have a family history that was touched by war.

Some may not realize the roots of Memorial Day stem from the tradition of decorating graves from the Civil War (Decoration Day), a war that almost tore the country apart. Considering the upheaval and conflict in the country, it is fitting to remember the Civil War disaster and what it took to unite people and ensure freedom along with remembering similar themes from subsequent world wars. As Goethe said, “He who cannot draw on three thousand years is living hand to mouth.”

Ideally, remembering would be enough yet history often repeats itself—and the colloquial definition of insanity is doing the same thing over again while expecting different results. Why is remembering not enough?

As a therapist—and veteran, military brat, and descendant of WW II traumatized survivors—I have studied and long been fascinated by the generational transmission of trauma and grief from war that has transformed people and families in unknown ways. In fact, I think a lot of family conflict, abuse, depression, anxiety, and substance abuse stems from traumas from the wars that scarred our ancestors.

When left unprocessed (which was common for centuries and still is, especially among military personnel), grief and trauma can come out as abuse, detachment (emotionally shutting down), unconscious fear, and escapism (through substances, workaholism, excess screen time, etc.). Moreover, sometimes some family members tend to hold the excess emotions that other family members have discarded while others may become the rebellious scapegoats. Thus, each particular family member unconsciously plays out a familiar role that has been echoed in previous generations. Doing a family genogram—a type of family tree that documents relationships, careers, and psychological patterns—can eerily reveal how entrenched roles are recycled through the generations. The good news is that patterns can be changed.

While a therapist might work with an individual and family on genograms and processing grief and trauma in their lives and from those inherited by previous generations, it is not new. Many indigenous cultures have had a strong relationship with their ancestors and practice ancestral healing. They do not try to discard where they came from. Instead, they hold reverence and respect and offer prayers and rituals to earlier family members in the belief that ancestral pain may be a cause of one’s current pain.

With that shared, I am not sure how many people in America know their ancestral history. I take note that this day is often celebrated with festive barbeques, echoing that people have forgotten and perhaps that they don’t want to look closer. Perhaps forgetting represents the detachment and numbing effect of prior trauma. “Why look back when you can keep moving forward?”

My answer is that looking back and understanding can facilitate forgiveness and associated peace and compassion. Looking back can foster empathy and allow one to release old wounds stored in the DNA and inherited neural programming. Looking back can also reveal some heroes, role models, and powerful lessons. Looking back can empower your future and future generations, especially when you share lessons from your family history with your children.

For me, looking back helped me understand how my paternal grandfather was traumatized by WWII and his time on the USS Indianapolis (which was referenced in the movie, “Jaws” and famous because it was torpedoed and 576 men were eaten by sharks until the remaining 316 people were rescued four days later). My grandparents had a terrible divorce which scarred my mother in many unfathomable ways that led her to acting out in my childhood. Meanwhile, my father’s parents were prisoners of war and I grew up hearing abhorrent stories from my grandfather while my grandmother passed somewhat young from cancer on my father’s birthday.

Here is the takeaway. I was in a foster home for a short time because my parents were charged with child abuse. I know this deeply affected my brother and sister—and their children who faced similar and most likely worse experiences. I am horrified and saddened to have witnessed this. I do not share this in any way to dishonor my family. It took a lifetime for me to process and heal from these wounds and to be able to admit some of these secret parts of my upbringing. I deeply love my family and ache that deep wounds have repeated themselves. I sit in meditation and prayer for them daily and also try to practice ancestral healing. I do not blame anyone in my family. I do blame wars though. That is why I dedicate this post to the families on this Memorial Day as I think there are more losses than we realize. I hope this inspires reflection and healing for others.

Is the News Reinforcing Your Trauma?

Mary was seven years old when she witnessed her father assault her mother. It was the last time she saw him as her mother packed their belongings that night and moved across the country. Mary resolved she would avoid being be like her mother and would do everything perfectly so that a man would never harm her. Instead, Mary dated a series of men that were emotionally and/or physically abusive. To make matters worse, all of them left her and triggered her deep abandonment wounds. Mary (not her real name and addressed here with her permission) came into my office to work on childhood trauma and abandonment issues. Now, her daily diet of news (which is steeped in traumas, leadership betrayals, political strife, emotionally charged legal decisions, and climate change) is triggering Mary’s trauma wounds while increasing her anxiety and depression. 

Mary is not the only one. I would suspect that every person is touched by current events, whether they realize it consciously or not. There’s even a phenomenon known as a Morally Injurious Experience (MIE) that comes from experiencing a traumatic event or situation that conflicts with one’s moral beliefs. In a military context, it has been defined as engaging in or observing betrayals like a leadership failure, or violence and sexual assault, along with situations where a person has been unable to prevent an injury, death or war-related destruction. Thus, one can have a childhood trauma like Mary did when observing her father assault her mother and then one can have an MIE when observing other people's traumas and betrayals in other contexts. Moreover, an MIE can retrigger unresolved traumatic wounds from childhood.

Trauma Recovery is Challenged by Broken Trust

 

Betrayals break trust. Cover-ups break trust. Discrimination breaks trust. Moreover, leadership and hero betrayals can have traumatic consequences for many. Examples include heightened despair, anxiety, guilt, shame, resentment, spiritual and existential angst (meaninglessness), post-traumatic stress disorder (PTSD), substance abuse, self-harm, relationship distress, and exacerbated medical conditions. Healing from broken trust can be challenging; and witnessing repeated reports of trust violations in the media can cement a mindset that is resistant to healing.

Be Mindful About Media Consumption to Avoid Exacerbating Trauma

Be aware that media headlines thrive on material that can trigger trauma and reinforce mistrust. Remember, the news motto is, "If it bleeds, it leads." Pervasive distrust, betrayals,  toxic communications, bullying behaviors, and violence often dominate the headlines and can be tiggering for  people, especially for those with a deep history of betrayals from their earliest authority figures. Watching endless news about leadership betrayals can trigger traumatic feedback loops that sustain the trauma and increase depression and anxiety, along with giving fuel to not so positive coping mechanisms. So, please pay attention to how news and media consumption may inflame past traumas. Working with a therapist about your responses to media and leadership betrayals can help.

What can you do if you are triggered?

• As in a hurricane, check your doors and windows and stay inside. That means check the messages that are coming into your ears and out your mouth and make sure you are okay, safe and that you’re not doing something that inflames the current conditions.
• Evacuate if you must and find shelter where it’s safe. Seek help with a professional, group, and surround yourself with trusted friends. 
• Avoid getting into triggering debates and arguments with others, while re-evaluating relationships that thrive on negativity.
• Employ more green time over screen time. Getting outdoors can expose you to healthy oxygen and neurochemicals from the plants and trees while getting some vitamin D from sunshine.
• Take care of your physical body and nourish it with healthy foods, water, and exercise. Get sleep.
• Don’t be afraid to call 911 in an emergency.