A traumatic event involves a single experience, or an enduring or repeating event or events, that completely overwhelm the individual's ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks or years, as the person struggles to cope with the immediate danger. Trauma can be caused by a wide variety of events, but there are a few common aspects. There is frequently a violation of the person's familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. This is also seen when people or institutions depended on for survival violate or betray the person in some unforeseen way.
Psychological trauma may accompany physical trauma or exist independently of it. Typical causes of psychological trauma are sexual abuse, violence, the threat of either, or the witnessing of either, particularly in childhood. Catastrophic events such as earthquakes and volcanic eruptions, war or other mass violence can also cause psychological trauma. Long-term exposure to situations such as extreme poverty or milder forms of abuse, such as verbal abuse, can be traumatic (though verbal abuse can also potentially be traumatic as a single event).
However, different people will react differently to similar events. One person may experience an event as traumatic while another person would not suffer trauma as a result of the same event. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.
After a traumatic experience, a person may re-experience the trauma mentally and physically, hence avoiding trauma reminders, also called triggers, as this can be uncomfortable and even painful. They may turn to alcohol and/or drugs to try to escape the feelings. Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience. Triggers and cues act as reminders of the trauma, and can cause anxiety and other associated emotions. Often the person can be completely unaware of what these triggers are. In many cases this may lead a person suffering from traumatic disorders to engage in disruptive or self-destructive coping mechanisms, often without being fully aware of the nature or causes of their own actions. Panic attacks are an example of a psychosomatic response to such emotional triggers.
Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present. Upsetting memories such as images, thoughts, or flashbacks may haunt the person, and nightmares may be frequent. Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night.
Memory of the traumatic experience(s) may become accessible only via the associated emotions: factual memories that place the event(s) in temporal and spatial context may not be accessible. This can lead to the traumatic events being constantly experienced as if they were happening in the present, preventing the subject from gaining perspective on the experience(s). This can produce a pattern of prolonged periods of acute arousal punctuated by periods of physical and mental exhaustion.
In time, emotional exhaustion may set in, leading to distraction, and clear thinking may be difficult or impossible. Emotional detachment, as well as dissociation or "numbing out", can frequently occur. Dissociating from the painful emotion includes numbing all emotion, and the person may seem emotionally flat, preoccupied or distant. The person can become confused in ordinary situations and have memory problems.
Some traumatized people may feel permanently damaged when trauma symptoms don't go away and they don't believe their situation will improve. This can lead to feelings of despair, loss of self-esteem, and frequently depression. If important aspects of the person's self and world understanding have been violated, the person may call their own identity into question.
These symptoms can lead to stress or anxiety disorders, or even post traumatic stress disorder, where the person experiences flashbacks and re-experiences the emotion of the trauma as if it is actually happening.
Trauma is often defined as a coping response to and a consequence of overwhelming situations. However, as an individual's sense of being "overwhelmed" is subjective, the occurrence of trauma is also subjective. There is evidence to suggest that how people cope with extremely stressful situations is associated with the amount of trauma suffered from such events.
For an event to have a traumatizing effect it is not necessary that physical damage occur. Regardless of the source of the trauma, the experience has four common traits: it was unexpected, it was psychologically overwhelming, the person was unprepared or unable to cope with it, and there was nothing the person felt they could do to prevent or mitigate it. Thus, it is not the event per se that determines whether an experience is traumatic, but the subjective experience of that person. Examples of situations which may be experienced as psychologically traumatic by some individuals include:
Psychological trauma may be understood as an experience of unbearable emotion. A painful emotion can become unbearable in the absence of a relationship in which it can be held. Our finitude and the finitude of all our important connections with others make us vulnerable to psychological trauma.
There is also a distinction between trauma induced by recent situations and long-term trauma which may have been buried in the unconscious from past situations such as childhood abuse.
Trauma is often overcome through healing; in some cases this can be achieved by recreating or revisiting the origin of the trauma under more psychologically safe circumstances, such as with a therapist.
French neurologist Jean-Martin Charcot argued that psychological trauma was the origin of all instances of the mental illness known as hysteria. Charcot's "traumatic hysteria" often manifested as a paralysis that followed a physical trauma, typically years later after what Charcot described as a period of "incubation" .
Sigmund Freud, Charcot's student and the father of psychoanalysis, examined the concept of psychological trauma throughout his career. Jean Laplanche has given a general description of Freud's understanding of trauma, which varied significantly over the course of Freud's career: "An event in the subject's life, defined by its intensity, by the subject's incapacity to respond adequately to it and by the upheaval and long-lasting effects that it brings about in the psychical organization" .
Psychological trauma is treated with therapy and, if indicated, psychotropic medications. Recent studies try to show the effect of trauma on human memory. This kind of study is useful in order to verify the attendibility of eyewitnesses involved in criminal acts.
Therapies used in the treatment of psychological trauma include:
Following traumatic events, persons involved are often asked to talk about the events soon after, sometimes even immediately after the event occurred in order to start a healing process. This practice may not garner the positive results needed to recover psychologically from a traumatic event. Victims of traumatic occurrences who were debriefed immediately after the event in general do fare better than others who received therapy at a later time. Yet, there is one indication that forcing immediate debriefing may even distort the natural psychological healing process .
According to Lawrence G. Calhoun and Richard Tedeschi, both professors at the University of North Carolina at Charlotte, trauma experiences can lead to growth, though this is not inevitable. They have found that "reports of growth experiences in the aftermath of traumatic events far outnumber reports of psychiatric disorders." They state that these changes can include
...improved relationships, new possibilities for one's life, a greater appreciation for life, a greater sense of personal strength and spiritual development. There appears to be a basic paradox apprehended by trauma survivors who report these aspects of posttraumatic growth: Their losses have produced valuable gains ...They also may find themselves becoming more comfortable with intimacy and having a greater sense of compassion for others who experience life difficulties.
Still, they add, "posttraumatic growth does not necessarily yield less emotional distress."
...posttraumatic growth occurs in the context of suffering and significant psychological struggle, and a focus on this growth should not come at the expense of empathy for the pain and suffering of trauma survivors. For most trauma survivors, posttraumatic growth and distress will coexist, and the growth emerges from the struggle with coping, not from the trauma itself.
They point out that "there are also a significant number of people who experience little or no growth in their struggle with trauma."