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(p. 138) 10 Common Reactions to Trauma 

(p. 138) 10 Common Reactions to Trauma
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date: 17 October 2019

This form describes some of the common reactions that people have after a trauma. Because everyone responds differently to traumatic events, you may have some of these reactions more than others, and some you may not have at all.

Remember that many changes after a trauma are normal. In fact, most people who directly experience a traumatic event have severe problems in the immediate aftermath. Many people then feel much better within 3 months after the event, but others recover more slowly, and some continue to experience debilitating symptoms. The first step toward recovery is becoming more aware of the changes that you have undergone since the trauma. Some of the most common problems after a trauma include the following.

  1. 1. Anxiety and fear. Anxiety is a common and natural response to a dangerous situation. For many people it lasts long after the trauma ended. This happens when views of the world and a sense of safety have changed. You may become anxious when you remember the trauma. But sometimes anxiety may come from out of the blue. Triggers or cues that can cause anxiety may include places, times of day, certain smells or noises, or any situation that reminds you of the trauma. As you begin to pay more attention to the times when you feel anxious, you can discover the triggers for your anxiety. In this way, you may learn that some of the out-of-the-blue anxiety is really triggered by things that remind you of your trauma.

  2. 2. Re-experiencing of the trauma. People often “re-experience” the traumatic event. For example, you may have unwanted thoughts of the trauma and find yourself unable to get rid of them. Some people have flashbacks, or very vivid images, which can feel as if the trauma is occurring again. Nightmares are also common. These symptoms occur because a traumatic experience is so shocking and so different from everyday experiences that you can’t fit it into what you know about the world. So in order to understand what happened, your mind keeps bringing the memory back, as if to better digest it and fit it in with your experiences.

  3. 3. Increased vigilance is also a common response to trauma. This includes feeling “on guard,” jumpy, jittery, shaky, nervous, on edge, being easily startled, and having trouble concentrating or sleeping. Continuous vigilance can lead to impatience and irritability, especially if you’re not getting enough sleep. This reaction is due to the freeze (e.g., deer in the headlights), fight or flee response in your body, and is the way we protect ourselves against danger. Animals also have the freeze, fight or flee response when faced with danger. When we protect ourselves from real danger by freezing, fighting or fleeing, we need a lot more energy than usual, so our bodies pump out extra adrenaline to help us get the extra energy we need to survive.

    (p. 139) People who have experienced a traumatic event may see the world as filled with danger, so their bodies are on constant alert, always ready to respond immediately to any attack. The problem is that increased vigilance is useful in truly dangerous situations, such as if you are in a war zone or you are being robbed. But increased vigilance becomes harmful, when it continues for a long time even in safe situations.

  4. 4. Avoidance is a common way of trying to manage PTSD symptoms. The most common is avoiding situations that remind you of the trauma, such as the place where it happened. Often, situations that are less directly related to the trauma are also avoided, such as going out in the evening if the trauma occurred at night, or going to crowded areas such as the grocery store, shopping mall or movie theatre.

    Another common avoidance tactic is to try to push away painful thoughts and feelings. This can lead to feelings of numbness or emptiness, where you find it difficult to feel any emotions, even positive ones. Sometimes the painful thoughts or feelings may be so intense that your mind just blocks them out altogether, and you may not remember parts of the trauma.

  5. 5. Many people who have experienced a traumatic event feel angry. If you are not used to feeling angry, this may seem scary as well. It may be especially confusing to feel angry at those who are closest to you. People sometimes turn to substances to try and reduce these feelings of anger.

  6. 6. Trauma may lead to feelings of guilt and shame. Many people blame themselves for things they did or didn’t do to survive. For example, some assault survivors believe that they should have fought off an assailant, and blame themselves for the attack. Others who may have survived an event in which others perished feel that they should have been the one to die, or that they should have been able to somehow prevent the other person from dying. Sometimes, other people may blame you for the trauma.

    Feeling guilty about the trauma means that you are taking responsibility for what occurred. While doing so may make you feel somewhat more in control, it is usually one-sided, inaccurate and can lead to feelings of depression.

  7. 7. Grief and depression are also common reactions to trauma. This can include feeling down, sad, or hopeless. You may cry more often. You may lose interest in people and activities that you used to enjoy. You may stay home and isolate yourself from friends. You may also feel that plans you had for the future don’t seem to matter anymore, or that life isn’t worth living. These feelings can lead to thoughts of wishing you were dead, or doing something to try to hurt or kill yourself. Because the trauma has changed so much of how you see the world and yourself, it makes sense to feel sad and to grieve for what you lost because of the traumatic experience. If you have these feelings or thoughts, it is very important that you talk to your (p. 140) therapist. Your therapist is trained in how to handle these thoughts and experiences and will help you get through this.

  8. 8. Self-image and views of the world often become more negative after a trauma. You may tell yourself, “If I hadn’t been so weak this wouldn’t have happened to me.” Many people see themselves in a more negative light in general after the trauma (“I am a bad person and I deserved this”).

    It is also very common to see others more negatively, and to feel that you cannot trust anyone. If you used to think about the world as a safe place, the trauma may suddenly make you think that the world is very dangerous. If you had previous bad experiences, the trauma may convince you that the world is indeed dangerous and others are not to be trusted. These negative thoughts often make people feel they have been changed completely by the trauma. Relationships with others can become tense, and intimacy becomes more difficult as your trust decreases.

  9. 9. Sexual relationships may also suffer after a traumatic experience. Many people find it difficult to feel intimate or to have sexual relationships again. This is especially true for those who have been sexually assaulted, since in addition to the lack of trust, sex itself can be a reminder of the assault.

  10. 10. Many people increase their use of alcohol or other substances after a trauma. Often, they do this in an attempt to “self-medicate” or to block out painful memories, thoughts, or feelings related to the trauma. People with PTSD may have trouble sleeping or may have nightmares, and they may use alcohol or drugs to try to improve sleep or not remember their dreams. While it may seem to help in the short term, chronic use of alcohol or drugs will slow down (or prevent) your recovery from PTSD and will cause problems of its own. Fortunately, there are treatments, such as this one, that can help you recover from PTSD and experience long-term relief from symptoms without the use of alcohol or drugs.

Many of the reactions to trauma are connected to one another. For example, a flashback may make you feel out of control, and will therefore produce anxiety and fear, which may then result in your using alcohol or drugs to try to sleep at night. Many people think that their reactions to the trauma mean that they are “going crazy” or “losing it.” These thoughts can make them even more anxious. As you become aware of the changes you have gone through since the trauma, and as you process these experiences during treatment, the symptoms will become less distressing and you will regain control of your life.