What Does Traumatised Mean?

Have​ ​you​ ​ever​ ​been​ ​in​ ​a​ ​car​ ​accident,​ ​or ​on​ ​the​ ​receiving​ ​end​ ​of​ ​a​ ​physical​ ​assault?​

​Perhaps you have been involved in a natural disaster such as flood, fire or earthquake.

Or have​ ​you​ ​been​ ​a​ ​witness​ ​(close​ ​bystander)​ ​of​ a ​serious​ ​event such as, someone​ ​being​ ​killed​ ​or​ ​hurt, or arriving​ ​on​ ​the​ ​scene​ ​as​ ​a​ ​‘first​ ​responder’?

In​ ​the​ ​few​ ​days,​ ​weeks​ ​or​ ​months​ ​following​ ​the​ ​incident/s,​ ​did​ ​you​ ​experience non-normal​ ​responses​ ​such​ ​as:

• ​zoning​ ​out;
• ​blacking​ ​out;
• ​mind​ ​fog;
• ​inability​ ​to concentrate;
• nightmares;
• ​panic​ ​reactions​ ​(eg​ ​fast​ ​breathing,​ ​palpitations,​ ​sweating,​ ​tremors);
• ​or​ ​emotional outbursts?

And did​ ​those​ ​closest​ ​to​ ​you​,​ ​your​ ​family​ ​and​ ​friends,​ ​​report​ ​later​ ​to​ ​you​ ​that​ ​you​ ​lost control​ ​of​ ​your​ ​current​ ​reality,​ ​that​ ​you​ ​seemed​ ​to​ ​be​ ​reliving​ ​flashbacks,​ ​in​ ​which​ ​the​ ​experience actually​ ​starts​ ​recurring?

If​ ​so,​ ​then​ ​you​ ​are​ ​one​ ​of​ ​millions​ ​(not​ ​just​ ​thousands,​ ​or​ ​hundreds​ ​of​ ​thousands)​ ​who​ ​may​ ​have been​ ​​traumatised by such terrible events.

What Does it mean to be Traumatised?

Being traumatised means​ ​something​ ​more​ ​than​ ​just​ ​shocked and​ ​aggrieved​ ​and​ ​physically​ ​hurt.​ ​​ ​

When you are traumatised, ​your​ ​body​ ​and​ ​mind​ ​(better​ ​described​ ​as​ ​your psycho-physical​ ​self​ ​or​ ​body-mind)​ ​have​ ​somehow​ ​stored​ ​and​ ​embedded​ ​the​ ​event.

As​ ​implied​ ​above​, ​you​ ​do​ ​not​ ​have​ ​to​ ​be​ ​a​ ​soldier​,​ ​police​ ​officer​ ​or​ ​a​ ​bouncer​ ​to​ ​have suffered​ ​such​ ​major​ ​events.​ ​You​ ​can​ ​be​ ​traumatised​ ​as​ ​my​ ​brother​ ​was,​ ​by​ ​sliding​ ​off​ ​a​ ​roof, breaking​ ​your​ ​back,​ ​waking​ ​up​ ​in​ ​a​ ​hospital​ ​bed,​ ​and​ ​not​ ​being​ ​immediately​ ​briefed​ ​on​ ​the nature​ ​and​ ​extent​ ​of​ ​the​ ​physical​ ​injury​ ​and​ ​its​ ​implications.

By​ ​now​ ​most​ ​Australians​ ​have​ ​encountered​ ​the​ ​terms​ ​Post​ ​Traumatic​ ​Stress​ ​Disorder​ ​or​ ​PTSD. But​ ​as​ ​someone​ ​who​ ​has​ ​worked​ ​in​ ​clinically​-​based​ ​psychology​ ​for​ ​30​ ​years​ ​I​ ​can​ ​tell​ ​you​ ​that PTSD​ ​is​ ​only​ ​the​ ​better​ ​known​ ​subcategory​ ​for​ ​what​ ​is​ ​in​ ​reality​ ​a​ ​​family of psycho-physical illnesses,​ all​ involving “trauma” and its consequences, or after effects, on body and mind.

What is Trauma?

Before we can​ ​understand​ ​’post​ ​traumatic​ ​stress’ ​we​ ​have​ ​to​ ​define​ ​what​ ​‘trauma’​ ​is.​

​Mental​ ​health professionals​ ​(ie​ ​psychologists,​ ​psychiatrists​ ​and​ ​allied​ ​health​ ​workers)​ ​have​ ​only​ ​recently defined​ ​​​it​ ​precisely​ ​(their​ ​definition​ ​though​ ​is​ ​much​ ​improved​ ​since​ ​100​ ​years​ ​ago​ ​when​ ​terms like​ ​Shell​ ​Shock,​ ​War​ ​Neurosis,​ ​Hysteria,​ ​or​ ​Weak​ ​Constitution,​ ​were​ ​in​ ​vogue​ ​and​ ​illustrated the​ ​lack​ ​of​ ​understanding).

Over recent decades, ​stress​ ​and​ ​trauma​ ​researchers​ ​discovered​ ​that​ ​the​ ​normal unstressed​ ​brain​ ​is​ ​constructed​ ​of​ ​an​ ​‘orchestra’​ ​of​ ​several​ ​finely​ ​naturally​ ​balanced​ ​systems​:

• ​​a front-of-brain​ ​attention​ ​system;
• ​an​ ​emotional​ ​limbic​ ​system;
• ​semantic​ ​vs​ ​episodic​ ​memory systems;
• ​association​ ​areas;
• ​motor-sensory​ ​areas,​ ​etc.

After ​150​ ​years​ ​of​ ​analysing​ ​and exploring​ ​the​ ​cerebral​ ​structure​ ​and​ ​function​ ​of​ ​those​ ​who have​ ​experienced​ ​trauma,​ ​it​ ​is​ ​now understood​ ​that​ ​traumatisation​ ​occurs​ ​when​ ​a​ ​life-or-limb​ ​event​ ​confronts​ ​a​ ​person​ ​(the Experiencer),​​ ​and​ ​the​ ​Experiencer’s​ ​brain​ ​activates​ ​various​ ​subsystems.​ ​

When​ ​one​ ​is​ ​healthy​ ​and not​ ​stressed​ ​/ traumatised​, ​these​ ​systems​ ​naturally​ ​and​ ​repeatedly​ ​reset​ ​to​ ​calm​ ​or​ ​balanced states.​

However, when​ a person​ ​is​ ​repeatedly​ ​stressed​ ​or​ ​acutely​ ​traumatised​, ​these​ ​systems​ ​do​ ​not​ ​reset. They​ ​can​ ​disconnect​ ​from​ ​each​ ​other,​ ​go​ ​inactive,​ ​or​ ​can​ ​start​ ​to​ ​fire​ ​up​​ ​at​ ​the​ ​wrong​ ​times.

How the Brain Reacts to Trauma

When​ ​traumatised​, ​the​ ​Experiencer’s​​ ​emotional​ ​brain​ ​centre​ ​(particularly​ ​the amygdala)​ ​gets​ ​activated​ ​and​ ​starts​ ​laying​ ​down​ ​virtual​ ​reality​ ​snapshots​ ​of​​ ​the​ ​traumatising event.​ ​These​ ​snapshots​ ​in​ ​turn​ ​get​ ​stored​ ​into​ ​the​ ​hippocampus​ ​(memory​ ​structure).​ ​

In​ ​real terms,​ ​details of the​ ​events​ ​- the​ ​attacker’s​ ​face, the​ ​explosion,​ ​the​ ​pain,​ ​the​ ​fire​ ​that​ ​entrapped​ ​you – ​all get​ ​imprinted​ ​or​ ​laid​ ​down​ ​as​ ​if​ ​by​ ​video​ ​camcorder.​ ​As​ ​such, when​ ​replaying later these memories​ ​become​ ​frighteningly​ ​real.​ ​​​The​ ​Experiencer​ ​often​ ​starts​ ​re-experiencing​ ​and​ ​hence re-enacting​ ​their​ ​mental​ ​and​ ​bodily​ ​responses,​ ​in​ ​the​ ​absence​ ​of​ ​the​ ​original​ ​event. These​ ​are termed​ ​flashbacks.​ ​The​ ​Experiencer​ ​relives​ ​not​ ​only​ ​the​ ​event,​ ​but​ ​the​ ​emotional​ ​terror​ ​of​ ​the event; they​ ​​become​ ​agitated​, ​ready​ ​for​ ​“flight​ ​or​ ​fight.”

The​ ​phenomena​ ​of​ ​trauma-based​ ​flashbacks​ ​and​ ​subsequent​ ​re-enactments​ ​happens​ ​when​ ​the self-regulatory​ ​systems​ ​of​ ​the​ ​brain​ ​(mainly​ ​the​ ​prefrontal​ ​lobes)​ ​are​ ​no​ ​longer​ ​cabled​ ​into​ ​and thus​ ​no​ ​longer​ ​control​ ​the​ ​emotional​ ​alert​ ​centre​ ​(the​ ​amygdala)​ ​and​ ​the​ ​memory​ ​recorder​ ​(the hippocampus).

Once​ ​your​ ​amygdala​ ​goes​ ​on​ ​‘red​ ​alert’, ​your​ ​pituitary,​ ​hypothalamus,​​​ ​and​ ​motor​ ​cortex​ ​areas kick​ ​into​ ​action.​ ​This​ ​in​ ​turn​ ​activates​ ​most​ ​of​ ​the​ ​sympathetic​ ​nervous​ ​system​​​​​ ​functions​ ​of your​ ​body​ ​including​ ​your​ ​adrenal​ ​glands,​ ​your​ ​breathing,​ ​your​ ​heart,​ ​your​ ​​​metabolism,​ ​your immune​ ​system,​ ​and​ ​your​ ​blood​ ​clotting​ ​system,​ ​among​ ​others.​ ​Basically​ ​your​ ​Flight-Fight-Flee system​ ​is​ ​switched​ ​on: y​​ou​ ​are​ ​now​ ​in​ ​Overdrive.

The​ ​problem​ ​occurs​ ​when​ ​the​ ​Flight-Fight​ ​subsystem​ ​switches​ ​remain​ ​stuck​ ​in​ ​the​ ‘​on’​ ​position​ ​or​ ​shut​ ​down altogether.​ ​Or,​ ​the​ ​switches randomly​ ​switch​ ​on​ ​or​ ​off.​ ​When​ ‘​on’,​ ​the​ ​person​ ​starts​ ​re-experiencing​​​ ​and​ ​reliving​ ​the​ ​horror​ ​or the​ ​threat​ ​of​ ​the​ ​traumatic​ ​event,​ ​even​ ​in​ ​the​ ​​ ​present​ ​moment,​ ​many​ ​weeks,​ ​months​ ​or​ ​years after​ ​the​ ​actual​ ​event.

Are You Trapped by Trauma?​

In​ ​a​ ​sense,​ ​the​ ​traumatised​ person ​becomes​ ​trapped​ ​in​ ​a​ ​Star​ ​Trek-​style Virtual​ ​Reality​ ​Room ​(holodeck)​. They​ ​may​ ​get​ ​aggressive​ ​and​ ​feel​ ​like​ ​they​ ​have​ ​to​ ​scream​ ​and​ ​punch​ ​their​ ​way​ ​out​ ​of​ ​a strangle​ ​hold,​ ​even​ ​when​ ​they​ ​are​ ​now​ ​at​ ​a​ ​picnic​ ​with​ ​family.

At​ ​the​ ​other​ ​end​ ​of​ the ​trauma​ ​spectrum,​ ​the​ ​Experiencer​ ​may​ ​feel​ ​it’s​ ​best​ ​to​ ​run,​ ​hide​ ​or​ ​freeze. They​ ​may​ ​dash​ ​out​ ​of​ ​the​ ​auditorium​ ​sweating​ ​and​ ​panicky​ ​during​ ​a​ ​public​ ​lecture​ ​on​ ​the benefits​ ​of​ ​eating​ ​alkaline​ ​foods.​ ​The​ ​unfortunate​ ​side​ ​story​ ​is​ ​that​ ​these​ ​actions​ ​being​ ​so​ ​out​ ​of context​, ​upsets​ ​those​ ​nearby​ ​and​ ​creates​ ​embarrassment​ ​or​ ​shame​ ​for​ ​the​ ​traumatised.

In​ ​an​ ​attempt​ ​to​ ​arrest​ ​the​ ​upsurge​ ​of​ ​a​ ​repeating​ ​horrific​ ​scene​ ​or​ ​painful​ ​event​,​ ​it​ ​makes sense​ ​(even​ ​in​ ​virtual​ ​reality)​ ​for​ ​people​ ​to​ ​fight​ ​off​​​ ​their​ ​attackers,​ ​revert​ ​to​ ​panic​ ​mode,​ ​flee​ ​the scene,​ ​or​ ​collapse – or​ ​a​ ​mix​ ​of​ ​these.

And​ ​if​ ​they​ ​are​ ​not​ ​willing​ ​to​ ​seek​ ​help​ ​and/or​ ​no​ ​one​ ​is​ ​there​ ​to​ ​help,​ ​they​ ​often​ ​become​ ​one​ ​of the​ ​‘walking​ ​dead’:​ ​alternatively​ ​self​ ​medicating​ ​with​ ​alcohol,​ ​medicines​ ​or​ ​drugs​ ​to​ ​control​ ​the feelings​ ​of​ ​disconnection​ ​and​ ​dread,​ ​the​ ​upwelling​ ​of​ ​threat​ ​imagery.​ ​

Continually​ ​reliving​ ​the​ ​trauma​ ​can​ ​lead​ ​the​ ​Experiencer​ ​down​ ​into​ ​more​ ​chronic​ ​co-morbidities such​ ​as​ ​dullness,​ ​confusion,​ ​depression,​ ​or​ ​co-occurring​ ​health​ ​issues​ ​(eg​ ​heart,​ ​vascular, lung,​ ​autoimmune​ ​conditions).

Traumatic​ ​events​ ​have​ ​been​ ​found​ ​to​ ​make​ ​long​ ​lasting​ ​imprints​ ​on​ ​the​​ ​brain,​ ​body and​ ​social​ ​relationships​ ​of​ ​the​ ​Experiencer.​

​Much research has been done into treatment of trauma over the last 45 years – I encourage you to read my article “Meditation and Recovery from Trauma” to find out more about what has proven to be effective.

Author: Dr Terry Olesen, BA (Hons), M Psych,  PhD Psych, MAPS.

For over 25 years, Brisbane Psychologist Dr Terry Olesen has been helping people via psychology-based counselling. He finds it particularly rewarding to work with people with a ‘life situation knot’: feeling stymied, distraught, sad or angry, while facing external challenges such as job loss, health issues or a death in the family. The topic of his doctoral research was work-life adjustment and mental health, which, in addition to his years of clinical practice, gives him the expertise to help people with trauma, anxiety and related difficulties.

To make an appointment try Online Booking. Alternatively, you can call M1 Psychology Brisbane on (07) 3067 9129

NB Terry Olesen is not currently practising at M1 Psychology, however if  you call us on (07) 3067 9129 we would be happy to suggest another psychologist at our practice with experience in this area.

References:

• Van​ ​der​ ​Kolk,​ ​B.​ ​​The Body Keeps the Score: Brain Mind and Body in the Healing of Trauma. Viking​ ​Press,​ ​2014.
• Kabat-Zinn,​ ​J.​ ​​ ​​Mindfulness​ Meditation:​ Cultivating the Wisdom of​ Your Body and Mind​​ ​ (CD-rom).​ ​Simon​ ​&​ ​Schuster​ ​Audio.​ ​​www.SimonSaysAudio.com
• Walton,​ ​Alice​ ​(contributing​ ​Writer),​ ​Forbes​ ​Magazine,​ ​​7​ Ways​ Meditation Can Actually Change The Brain. Section:Pharma and Healtcare,​​ 9​ ​Feb​ ​2015.
• Fadel Zeidan; Katherine T Martucci; Robert A Kraft; John G McHaffie; Robert C Coghill. Neural correlates of mindfulness meditation-related anxiety relief. Social Cognitive and Affective Neuroscience, Volume 9, Issue 6, 1 June 2014, Pages 751–759, https://doi.org/10.109