What is Psychological Trauma?

The word trauma originates from the Greek word wound, which originally was used to describe physical injuries and now more commonly is used to describe severe emotional and psychological distress (Trauma, 2020). ‘Individual trauma can be viewed as an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual wellbeing’ (SAMHSA, 2012, p. 2). A traumatic experience is embedded within the person and manifests itself in ways which can cause depression, stress, anxiety, psychosomatic issues, inter-personal difficulties, problems with attention, difficulties in emotional regulation and an under developed sense of self (Van der hart, 2016: Ogen, 2015; Levin, 1997; Shore, 2003).

There are two types of trauma; trauma of omission and commission.

Trauma of omission is the deprivation, denial or removal of a child’s basic needs. It can be experienced as the absence of trust, safety, nurturance and/or food and shelter. Neglect and the absence of emotional support from a child's primary care givers can hinder fundamental components of the child’s development. This causes devastating effects on the development of the child’s brain and identity essential for human development and functioning (Shore, 2003).

Trauma of commission on the other hand, is what most people think of when they refer to trauma, it refers to a singular traumatic event, such as rape, war, torture, a car accident, and physical and sexual assault.

When a person experiences both trauma or omission and commission, that is, when a person experiences trauma over a prolonged period of time that is repetitive in nature or involves multiple types of trauma, there is a disruption to the self-structure. This disruption of the self structure can cause various degrees of disorganisation, when a person has experienced this it is called complex trauma (van der Kolk, McFarlane, & Weisaeth, 1996). Cases of complex developmental and interpersonal trauma may result in criteria for PTSD, as well as encountering difficulties of an inter-personal and intra-personal nature.

PTSD is a DSM-V diagnosis under the category of trauma and stressor related disorders. According to the American Psychiatric Association (2013) the diagnostic features of PTSD are as follows:

Criterion A: experiencing or witnessing of event deemed traumatic

Criterion B: Intrusive symptoms

Criterion C: avoidance

Criterion D: negative alterations in cognitions and mood

Criterion E: alterations in arousal and reactivity

Criterion F: duration of at least 1 month

Criterion G: functional significance (distress or functional impairment in social and/or occupational domain

In order to be diagnosed with PTSD the following must be met:

• Criterion A

• One symptom (or more) from Criterion B

• One symptom (or more) from Criterion C

• Two symptoms (or more) from Criterion D

• Two symptoms (or more) from Criterion E

• Criterion F & G

Beyond the DSM-5 criterion, there is more to be understood about the experience of trauma. For example, there is a sense of voicelessness which accompanies the unbearable experience of trauma which has devastating implications for communicability. Ultimately, trauma abolishes a person's sense of agency and autonomy over their livelihood and world hood (Knox, 2011). The entrapment of trauma acts in a timeless manner, the past trauma is forever present in everyday thoughts, feelings and actions. Trauma is systematic in the way it presents in patterns and in a cyclical nature creating the opportunity to be freed from the unconscious. Until it is processed it can keep people trapped in a state of hopelessness and helplessness. The creativity and potential of the being is stunted as their attention is on upholding defences which leaves less space for human flourishing.

Meet Daniela, a compassionate Psychotherapist and Holistic Counsellor based in Melbourne. Whether you're looking for support from the comfort of your own space with online appointments, no matter where you are, or prefer in-person sessions in Murrumbeena, Melbourne, Daniela is here to guide you. Daniela brings a unique and comprehensive approach to her practice, utilising an integrated model that encompasses trauma-informed care, attachment theory, internal family systems, mentalisation, somatic techniques, and mindfulness practices. This thoughtful blend of therapeutic modalities allows Daniela to tailor her approach to meet the diverse needs of her clients.

---

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Knox, J. (2011). Self-Agency in Psychotherapy. New York: W.W. Norton & Co.

Levine, P. (1997). Waking the Tiger. Berkeley, Calif.: North Atlantic Books.

Ogden, P., & Fisher, J. (2015). Sensorimotor psychotherapy. New York, N.Y.: W.W. Norton

Substance Abuse and Mental Health Services Administration, Trauma and Justice Strategic Initiative (2012). SAMHSA's working definition of trauma and guidance for trauma-informed approach. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Schore, A. (2003). Affect Regulation & the Repair of the Self. New York: W.W. Norton

Trauma (2020). Retrieved from: https://www.lexico.com/en/definition/trauma

Van der Kolk, B. A., McFarlane, A. C., & Van der Hart, O. (1996). A general approach to treatment of posttraumatic stress disorder. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society (pp. 417–440). New York: Guilford Press.

Van der hart, O., Nijenhuis, E., & Steele, K. (2006). The Haunted Self. WW Norton & Co: New York, United States of America.

---