Taking The Leap: Seeking Initial Counseling After A Trauma

For many, it can be a challenge to accept that they need help from others when trying to get on track and find their way after traumatic events. It can be humbling to accept that letting someone else can help you begin to feel healthy and happy again. Trauma can happen to anyone at any time, causing many individuals to develop post-traumatic stress disorder (PTSD). 

Trauma can be anything that happens in your life that has a lasting impact and causes deep distress. Trauma could result from prolonged exposure to psychological trauma such as neglect or more physical trauma like an assault or car accident. It could be childhood trauma that you do not even consciously remember. You could also experience trauma from witnessing a serious or frightening scene, such as the mistreatment of someone else, that trauma memory can affect you for weeks, months, or years to come. 

Post-traumatic stress disorder (PTSD) from trauma may also be caused by something like being diagnosed with a serious medical condition such as cancer or heart disease. Trauma is essentially a lasting marker in the brain resulting in unpredictable emotions, flashbacks, feelings of numbness, moments of dissociation, or even physical symptoms like nausea or headaches.

Trauma and traumatic events can vary

No case of trauma and no person are the same; while the same event may leave a lasting impact on one person, another person who has experienced trauma may not be as deeply impacted. That same person may falter in another situation, as individual resiliency is idiosyncratic and hard to predict. We expect those exposed to a natural disaster, violent attack, or car crash to be traumatized by their past trauma while forgetting that some traumas are more difficult to recognize, like racism, oppression, or discrimination.

Our society has deeply rooted patterns and mechanisms that can lead to the suppression of people based on their gender, race, or ideology. These can be traumatic experiences for individuals. Certain concessions that we encounter daily may not seem abnormal but may also be maladaptive coping that we utilize to survive trauma. These things affect us on a deeper level than we may recognize, validating a call for reflection into our existing thought patterns and schemas.

Causes of post-traumatic stress disorder

Although military combat may be considered an obvious cause of post-traumatic stress disorder, it is not the only cause. Traumatic experiences encompass a wide range of life events, and any of these may trigger a person to develop mental disorders such as post-traumatic stress disorder (PTSD). Some of the most often reported causes associated with experiencing trauma include:

• Violent physical attack
• Rape or sexual assault
• Serious accidents such as a car or plane crash
• A natural disaster such as a tornado, hurricane, flood, or earthquake.
• Abuse, neglect, or bullying
• Racial trauma
• Domestic violence
• Childbirth
• Witnessing or surviving a terrorist attack or other act of violence
• Serious illness
• Losing a loved one
• Fearing for your life for any reason
• Caring for others who are in a traumatic event (such as first responders)

If you are facing or witnessing the abuse of any kind, the National Domestic Violence Hotline is available. Call 1-800-799-SAFE (7233) or Text "START" to 88788. You can also use the online chat.

First responders

One particular group of individuals who tend to experience trauma regularly is at high risk for developing post-traumatic stress disorder. These people include police officers, ambulance drivers or paramedics, emergency medical technicians (EMTs), firefighters, doctors, and nurses, search and rescue teams, the Coast Guard, and so on. The trauma they experience can have a widespread impact on their mental health. There are special assessments and support groups for first responders who think they may need help treating trauma.

What happens after trauma or a traumatic event

Post-traumatic stress disorder, while often associated with military post-combat, is something that can develop in any individual who has experienced some sort of trauma. Behaviour research done in Chicago, Illinois found that 43% of those patients who visited the Cook County Hospital were experiencing post-traumatic stress disorder, and most of them were gunshot or stabbing victims. 

When you encounter a stressor or experience a trauma, your nervous system reacts by releasing certain chemicals that elicit particular survival responses. This is known as the infamous fight or flight response, characterized by the activation of the sympathetic nervous system, meant to keep the individual from harm.

The fight or flight response

The fight or flight response, which is also known as the acute stress response, was discovered by physiologist Walter Cannon while studying the sympathetic nervous systems and stress response of animals during digestion. During the fight or flight response, the heart rate is high, and blood is mobilized toward the arms and legs, leaving less energy to be used for cognitive functions or immunity. This is why your thinking may seem fuzzy or muted during periods of fight or flight, or when you experience trauma. 

People in this state may make rash decisions that are not based on clear thinking. The physical and emotional response caused more frequently by PTSD can lead the individual to experience extreme distress due to an over-reactive nervous system keeping them on edge and expecting a threat, even if there may not be an actual threat at that moment.

How do you know if you have post-traumatic stress disorder?

Immediate trauma counseling is uncommon, and many people may not know that they are experiencing post-traumatic stress disorder until something happens that causes a noticeable reaction. For example, you may be having nightmares but not connect them to trauma until the nightmares become worse or you start being unable to go places or talk to people. You may experience a panic attack or overwhelming emotions without seeming cause at work or school. Here are some of the most common symptoms of PTSD from trauma:

• Nightmares
• Flashbacks (reliving the traumatic incident)
• Terrifying images or thoughts
• Panicking when you see or hear something that reminds you of the traumatic incident
• Aggravation, emotional reactions, or feeling on edge
• Dissociation (not being aware of where you are)
• Difficulty processing emotions
• Trouble concentrating
• Inability to sleep or stay asleep
• Lack of sexual drive
• Inability to do certain tasks
• Lack of interest in normal activities you usually enjoy
• Trembling, shaking, shivering
• Reckless or self-destructive behavior
• Panic attacks (rapid heart rate, sweating, shaking, nausea, agitation, feeling like you are going to die)
• Avoiding certain places or people that remind you of the traumatic incident
• Depression, feelings of sadness
• Feeling numb or cut off
• Feeling alone or like nobody cares
• Self-medicating with drugs or alcohol
• Inability to have a lasting relationship
• Guilt or hopelessness
• Lack of appetite
• Chronic pain or nausea
• Blaming yourself for the traumatic incident
• Constant anger or shame
• Thoughts of self harm or harming others

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available to assist 24/7.

If you have any of these mental health symptoms or feelings related to post traumatic stress disorder or trauma, it may be time for you to talk to seek out mental health resources to treat trauma and learn healthy coping skills. It can be helpful to reach out to friends and family for support or speak with a licensed therapist who is specifically trained to provide trauma-informed care. You may have trouble keeping a job, having a lasting relationship, and caring for yourself. In addition, continual stress can contribute to physical problems like heart disease or stroke. In some cases, it may be beneficial to combine treatment options. A trained professional can help you address memories, find the best treatment plan, and determine if prescription medications like selective serotonin reuptake inhibitors (SSRIs) may be right for you to heal from trauma. 

Seeking mental health treatment can be crucial if you’re working to process your feelings following a traumatic event or trauma. Generally, treatment involves therapy, whether in-person at an individual practice or online. Here are two common initial counseling methods that may help you after experiencing a trauma.

Cognitive behavioral therapy

Treatment for those who have experienced trauma is unique in every case but usually involves some form of cognitive behavioral therapy (CBT) to attempt to recognize and smooth out the existing triggering thought patterns and behaviors and replace them with healthier and less reactive ones. Cognitive behavioral therapy can be used to address all kinds of mental health disorders, such as depression, trauma, bipolar disorder, and generalized anxiety disorder. It works by breaking down the link between the mind (cognition) and the body (behavior). The initial session typically involves the therapist completing an assessment to determine whether you have PTSD and other mental health disorders such as depression, disassociation, and anxiety. From there, you and your therapist will work together to determine avenues and goals for treatment.

Trauma treatment typically, but not always, takes about five to 15 sessions that last between 30 and 60 minutes, depending on the cause and severity of the post-traumatic stress disorder. The premise behind cognitive behavioral therapy is to develop healthy coping skills that target traumatic stress symptoms and thought patterns, bolstering positive thought patterns in the brain through attended repeated exercises. 

Online trauma therapy

Although finding the right mental health services can be intimidating, the internet has allowed for the emergence of online interfaces like BetterHelp.com, which help to remotely connect those needing help with appropriate licensed mental health professionals such as a skilled trauma therapist. BetterHelp.com is the largest mental health care resource in the world, with over 35,000 licensed therapists and counselors to help you.

Online therapy may be especially helpful for people who are experiencing post-traumatic stress disorder, which can make it difficult to leave the house. Online therapy can be conducted via video conferencing, texting, email, telephone, and instant messages. By identifying and working through our traumas and how they affect us, we can find ways to cope and live a more satisfying and comfortable life. Affordable online therapy options may also make it easier for people to find a therapist within their budget.

Online therapy is just as effective as in-person therapy for a variety of conditions and concerns, including PTSD and trauma focused therapies. In a 2020 meta-analysis, medical reviewers evaluated 15 studies conducted on the efficacy of online therapy for PTSD treatment. This analysis found that quality of care, patient satisfaction, and reduction of PTSD symptoms with online therapy were all comparable to those of in-person therapy.

Trauma-informed therapy for longstanding PTSD

For those who have experienced a traumatic event in the past and are currently experiencing symptoms of PTSD, there are some types of trauma therapy that are used to help manage symptoms and decrease the emotional impact of the experience over time. According to the National Center for PTSD, cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), and prolonged exposure (PE) work best as trauma focused treatments.

EMDR

Eye movement desensitization and reprocessing (EDMR) is an interactive form of trauma focused therapy that uses specific eye movements along with talk therapy to help process a client’s trauma story, such as a sexual assault or other violent attack. Eye movement desensitization and reprocessing therapy targets the memory of the experience, and uses bilateral stimulation to decrease the physical and mental impacts of that memory to improve mental health. The desensitization and processing of one’s memory of a traumatic event can help them better cope, making eye movement desensitization and reprocessing therapy one of the most effective forms of trauma therapy. This therapy process may also be participated in online. it can be difficult, though, to find a practitioner who provides eye movement desensitization and reprocessing therapy online.

CPT 

Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy. It is different than eye movement desensitization and reprocessing because instead of focusing on the traumatic experience itself, it guides trauma survivors through the emotions connected to the experience. With CPT, your trauma therapist offers strategies to analyze and challenge thoughts surrounding your trauma, to attempt a new perspective. Like CBT, CPT can be done either in person or online. 

Exposure therapy

This form of trauma treatment to treat PTSD encourages patients to confront their fears in a safe environment to break the pattern of avoidance and fear. Like EDMR, it is trauma-focused. For example, if a client experienced a deadly tornado, their therapist may slowly incorporate photos and live footage of natural disasters into their sessions. VR, visualization, and real-life exposure may also be used to help people recover from their trauma responses. Some forms of exposure therapy are tailored for in-person sessions, though other forms may be done online as well.

In summary, the following methods are used to treat PTSD and trauma: 

• EMDR
• CPT
• Exposure therapy