What is psychological trauma, and how to deal with it?

Psychological trauma is a specific damage to the nervous system that occurs as a result of severe stress. The formation of psychotrauma can be due to many reasons and factors, accompanied by stress and experiences: unpleasant events in life, grief of loss of loved ones, betrayal of friends and loved ones, consequences of serious illnesses, etc.

Psychological trauma can also be associated with violence, suppression of will, blackmail, threats, humiliation of human dignity and other events, circumstances and actions that force a person to experience depression, depression and long-term fear.

At the Yusupov Hospital, patients undergo comprehensive treatment. In addition to drug therapy, a psychologist and other specialists work with them to help them regain their faith, since a positive attitude has a positive effect on the dynamics of treatment.

Psychological Trauma: Symptoms and Consequences

Unlike physical injuries to the body, psychological injuries are not as easy to recognize. An outside observer can guess its presence only by indirect signs - changes in behavior, facial expressions, manner of speech, ideomotor skills.

The key symptom of psychological trauma, just like physical trauma, is pain. At the same time, mental pain can be endured just as hard as physical pain. According to subjective sensations, intense emotional suffering literally tears apart the body parts. Memories of a traumatic incident do not lose their relevance and painfulness over the years, unlike events that do not have traumatic content. Sometimes a person is even ready to commit suicide in order to get rid of the psychological suffering caused by these memories. Alas, while investing huge financial resources in the development of surgical services and trauma centers, we still do not attach due importance to the organization of care for psychological trauma.

It is worth noting that psychological trauma is not always reflected in the psyche as a painful experience or involuntary memory. Experiences that could not be processed and assimilated by consciousness find release in the bodily sphere. What happens in psychology is called “conversion”.

In the overwhelming majority of conversion disorders, a symbolic connection with the nature of psychological trauma is easily detected. Thus, gynecological diseases develop in women as a result of traumatic sexual experiences or due to feelings of guilt after an abortion. Events that a person could not “digest” lead to diseases of the digestive system; “taken too closely to heart” manifests itself in the form of cardialgic syndrome.

Psychological trauma leads to loss of healthy sleep. The person may suffer from insomnia, interrupted sleep, or recurring nightmares in which they relive shocking incidents. During the daytime, the traumatic event is replayed in the mind in the form of obsessive fantasies and thoughts. All this is repeated until the person comes into contact with repressed emotions and integrates the painful experience.

And no matter how psychic contents unacceptable to the Ego are repressed into the unconscious, they still remain in the psyche and find their expression in periodic, difficult-to-control attacks of anxiety and anger that arise for no particular external reason.

As a sign of psychological trauma, various forms of restrictive and avoidant behavior - certain situations, places, relationships - deserve special attention. The leading motive of a person with a traumatized psyche is the thought: “This should never happen again!” Severe psychological trauma leads to the development of social phobia, agoraphobia, and panic attacks. One form of avoidant behavior (in particular, thoughts and memories) is alcoholism, drug addiction, and gambling addiction.

The form of psychopathology depends not only on the nature of the psychological trauma, but also on the age at which the stress occurred. Children under 12 years of age most often experience post-traumatic stress disorder with loss of information about traumatic events from memory, enuresis, neurological disorders, tics, and speech disorders. Almost 50 percent of cases starting in adolescence are also diagnosed with major depressive disorder or dysthymia (chronic depression). Experiencing psychological trauma can also act as a provocateur for a person’s departure from the norms of social life (neglect of social prestige, loss of significance of respect from loved ones).

The severity of symptoms can range from mild to very severe suffering, even disability. The destructive power of psychological trauma depends on the level of stress resistance of a person and the significance of the event. But still, the majority of injured people find the strength to lead a full life, especially if they received qualified assistance in a timely manner.

Factors of a traumatized psyche

The formation of psychotrauma is promoted not only by internal, but also by external sources, these include:

• loss of loved ones, home;
• frequent lack of sleep;
• fatigue;
• changing your usual lifestyle;
• lack of financial resources;
• moving to a new home, city or country;
• dismissal;
• conflicts in the family or at work;
• lack of family and friendly support.

Internal factors:

• age (children and the elderly are susceptible to the disease);
• gender (women and young boys are most vulnerable);
• individual traits (excessive emotionality, instability);
• personal characteristics (people who are depressed, experiencing anxiety and immaturity).

Causes of psychological trauma

No one has yet managed to avoid psychological trauma of at least mild severity. It can be argued that life is inherently traumatic. Any unexpected event that threatens a person’s values ​​can trigger the occurrence of psychological trauma.

In some cases, it is not necessary to personally be a participant in a tragedy to receive psychological trauma. Sometimes it is enough to be an outside observer of scenes of violence or an accident that happened to another person for harm to the psyche.

At the same time, observing or participating in dramatic events in itself is a mandatory, but not sufficient condition for traumatization. In principle, any incident can go unnoticed for the mental life of one person, or provoke the development of psychopathology of any severity in another. The outcome is determined by the extent to which a person assesses the event as threatening his integrity and life. Since the ability to rationally comprehend what is happening in childhood is not yet sufficiently developed, most mental trauma is formed during this period.

The catalyst is not external events, but the way of reacting to them. For example, hitting a child during physical punishment alone does not guarantee that he will develop psychological/emotional trauma. It all depends on how the child perceives the parents’ behavior - as a fair reaction to his misconduct or moral violence and a real threat to his life.

For the development of psychopathology, it is important whether at the moment of stressful exposure there was an opportunity to vigorously respond to it. If it is impossible to translate mental stress into action and the forced suppression of an emotional reaction, the risk of a mental breakdown increases significantly. When the victim reacted to the event according to his temperament (from crying to an act of revenge), the affect decreases. An insult to which the offender managed to respond, at least in words, is remembered differently than what he had to endure.

How psychologist Daria Milai will help cope with the disease

I listed all the symptoms of the disease and gave a detailed definition of psychological trauma. If you are going through such a difficult period, sign up for my consultation, I will help you:

• develop a quick response to a stressful situation;
• restore trust in loved ones and acquaintances;
• get rid of negative thoughts;
• overcome fear and anxiety;
• safely and easily deal with the causes of internal blocks;
• control behavior and emotions.

Your decision to turn to me for help must be conscious. It’s worth coming when you stop denying the problem and accept it.

Types of psychological trauma

In psychology, there are several classifications of psychotrauma. Depending on the intensity and duration of the impact of negative factors on the psyche, the following types are considered.

1. Shock psychological trauma (fright neurosis). Characterized by spontaneity and short duration. Occurs in response to sudden, completely unforeseen events. The death of a relative after a long serious illness is perceived differently than his unexpected passing away. As a result of sharp emotional arousal, clouding of consciousness occurs and most physical and mental functions are blocked. Instinctive urges to escape, defend or attack, characteristic of all mammals, come to the fore. All kinds of affects, delirium, and seizures may be observed. Instead of nervous excitement and increased motor activity, emotional stupor and paralysis of the will may occur. At the same time, no calls, persuasion, or slaps in the face will bring a person out of a state of disorientation.
2. Acute psychological trauma. It is also relatively short-term in nature. Develops under the influence of negatively colored experiences due to a break in relationships, moral humiliation. Humiliation is a serious blow to the psyche, since maintaining self-esteem in the eyes of other people or one’s own is the deepest value of any individual.
3. Chronic psychological trauma. It takes a long time to develop—sometimes several years or even decades. It is formed when a person’s psyche is exposed to prolonged exposure to negative factors (unfavorable climate in the family, imprisonment, illness or injury leading to physical impairment or disability).

Depending on the nature of the traumatic events, the following types of psychological trauma are distinguished.

1. Existential. Occurs due to an acute awareness of one’s mortality, but emotional rejection of this fact. Occurs after experiencing life-threatening events (dangerous disease, accident, being in a combat zone, natural disaster, accident).
2. Trauma of loss (of a loved one, significant person). It is especially difficult in childhood.
3. Psychological trauma of relationships. Difficult to diagnose. It is formed when a person is in an unhealthy relationship that destroys his psyche for a long time. For example, a parent, spouse or child has been behaving unpredictably for years, because he has mental disorders, suffers from alcoholism, drug addiction. Relationship trauma can also result from betrayal by a loved one.
4. The trauma of one's own mistakes. Arises due to a person’s inability to accept the fact that he committed actions that led to irreparable consequences. For example, a driver hit a pedestrian, a surgeon made a mistake that cost the patient’s life.

Resilience for Health

My mother told me: “Don’t go to work as a psychologist, otherwise you will take everything too close to your heart.” Mothers are like that, they know everything in advance. How can I not take it to heart when I hear several times a day stories of cruelty, neglect, violence, misunderstanding, self-hatred, failure, breakups, bullying, death and illness... I know that my view of humanity is strong distorted by the abundance of such stories, but sometimes it begins to seem that there is so much cruelty in the world that all the psychologists, doctors, teachers and spiritual figures in the world will never be able to cope with it.

I am always on guard about my professional burnout, because sometimes self-confidence fades under the pressure of human suffering. Helping professionals are finding different antidotes to burnout. For me, for example, this is personal therapy, supervision with more experienced professionals, intervision groups with colleagues, yoga, cycling, solitude, creativity, communication with a child.

I write about this not only to brag, but also to share my experience.

Yes, it happens: even in the darkness, amid the unbearably scary stories, there are ways to take care of yourself, build a social support system and develop resilience.

In English there is a word resilience, which means three skills at once:

• withstand heavy loads before running out of strength;
• remain productive and emotionally stable even under severe stress;
• recover quickly after strength tests.

The good news is that this resilience (sometimes called resilience in academic circles) can and should be learned. This is not an innate trait that you either have or don't have. And it is precisely this that promotes recovery and healing even after encountering adverse childhood experiences.

You can compare building resilience to learning to play a musical instrument: if you spend an hour on scales once in your life, you are unlikely to learn how to play a Bach symphony. But if you devote at least 15 minutes a day to practice, then after some time your fingers will learn to create this beauty themselves. It’s the same with mental health: small but regular steps can work wonders.

Keeping records of your experiences, moments of contemplation, healthy sleep, walks, physical activity, regular and varied nutrition, creativity - this is already a huge contribution to emotional balance and a meaningful, rich life. Even if it sounds quite banal.

However, developmental trauma is interpersonal trauma: a person has harmed a person. And they cannot be healed alone. This is why trendy self-esteem apps and online meditation marathons won’t help improve your quality of life in the long run. Ariel Schwartz believes that when dealing with trauma, a secure (yet professional) relationship with a therapist is essential: “Overall, the most important thing is to choose someone you feel is safe, trustworthy, compassionate, and understanding.”

Choosing a specific therapist is a topic for an entire book, so for now we’ll just focus on the variety of approaches that have been proven to help people work through their traumas and improve their quality of life.

Stages of psychological trauma

In the dynamics of the condition of persons exposed to sudden stress factors, the following stages of response are distinguished.

1. Phase of vital reactions (duration - from several seconds to 15 minutes). Characterized by changes in the perception of the time scale and intensity of stimuli. For example, there is a decrease in pain sensitivity during fractures and burns. The work of the psyche is completely subordinate to the imperative of survival as a biological unit, which leads to a reduction in moral norms and restrictions. For example, a person jumps out of a burning building, forgetting that his relatives are in it, who also need to be saved. During rehabilitation, it is important to convey to victims that in extreme situations it is almost impossible to resist the powerful instinct of self-preservation.
2. Acute emotional shock with symptoms of overmobilization (from 3 to 5 hours). A person’s attention sharpens, the speed of mental processes and efficiency increases, and reckless courage appears. Behavior is aimed at saving the people around him, realizing moral ideals and ideas about professional duty.
3. Psychophysiological demobilization (up to 3 days). Understanding the scale of the tragedy. Among the emotional reactions, confusion, depression, and emptiness come first. Attention and memory disorder. Physiological symptoms include weakness, difficulty breathing, pale skin, tremors, and disturbances in the digestive system.
4. Resolution stage (from 3 to 12 days). The victims report stabilization of their mood and well-being. However, according to objective data, the majority of injured people have vegetative disorders, there is a low level of performance, a reluctance to discuss what happened, and the emotional background remains reduced.
5. Recovery stage (12 days after receiving psychological trauma). Activation of communication with the absence of positive changes in the physiological state of the body.
6. Stage of delayed reactions (after a month or later). Sleep disorders, irrational fears, psychosomatic disorders, pronounced negativism, conflict.

As a result of prolonged traumatic exposure, the following stages of psychological trauma are observed.

1. Initial phase: finding yourself in a long-term psychotraumatic situation. In essence, it coincides with the psychological reaction to a sudden stressful impact and demonstrates the passage through the 6 stages of response described above.
2. Adaptation period. A person, to the best of his ability, reconciles himself with the life situation and limits himself to satisfying immediate needs. Later, activity decreases, a feeling of helplessness and apathy appears. The strength to resist troubles is undermined (for example, an unemployed person loses hope and refuses to try to find a job; if he is captured, he wants to free himself).
3. The stage of returning to normal life. At first, a person may not be aware of his negative emotions. Stress can be masked by a feeling of joy and euphoria. But soon it gives way to depression, irritation, and anger.

Signs of psychotrauma

Emotional symptoms include:

• mood swings;
• irritation;
• alienation;
• feelings of guilt and shame;
• decreased self-esteem and self-confidence;
• confusion;
• anxiety and fear;
• isolation;
• feeling of uselessness.

Physical signs include:

• sleep disturbance, fearfulness;
• changes in breathing and heartbeat;
• any functional disorders in the systems (for example, bowel disorders);
• muscle tension;
• fussiness;
• deterioration of cognitive abilities;
• fatigue.

How to get rid of psychological trauma?

Be prepared for the fact that treatment of psychological trauma may take many years. Periods of remission may be followed by exacerbations. Of course, it is much better when there is at least supportive therapy and monitoring of a person’s mental state by a specialist. Pathological processes in the psyche with an incompletely cured injury can occur unnoticed by an inexperienced observer. And then result in unexpected aggravations in the form of attacks of depression, unmotivated outbursts of aggression.

How to identify a suitable specialist?

A traumatized person with somatic disorders usually turns to general practitioners who, without particularly delving into the causes of the client’s condition, prescribe only symptomatic treatment. And in some cases, after numerous examinations, the client is informed that he does not have any diseases.

Treatment of psychological trauma is the task of psychotherapists, psychiatrists, and hypnologists. In this case, the psychotherapeutic method is not so important as the qualifications and experience of a specialist who understands what problems the client can work with in his condition, and the stimulation of what mental material is best avoided.

Proponents of the psychoanalytic approach, specialists in body-oriented therapy, and Gestalt therapists know how to get rid of psychological trauma. The only thing is that the use of cognitive therapy in its pure form may be ineffective due to its appeal to the rational part of the psyche. But hypnotherapy, the subject of which is primarily the client’s unconscious, is an effective method of treating psychological trauma - both primary and auxiliary.

Sometimes one memory and story about traumatic events in a state of hypnotic trance is enough to save a person from psychological trauma. In psychology, this phenomenon is called “catharsis” by analogy with the term proposed by Aristotle to denote the facilitating, healing effect of works of art on a person, when, experiencing fear, hatred, despair together with the hero of the story, the viewer cleanses the soul.

How to help a loved one overcome psychological trauma?

Family support may be the deciding factor in healing. Of course, if she is mentally intact and has sufficient potential to cope with the therapeutic role.

A common mistake on the part of family and close friends is the desire to immediately “work through” painful experiences. Don't put pressure on the person. Do not use pincers to extract information from him about the events that happened and his feelings about this. It is likely that it is still very difficult for him to talk about what happened. He will definitely share with you when he is ready. The main thing is to make it clear that you can be counted on.

In a state of acute stress, a person has difficulty solving the simplest everyday problems. Take care of buying and preparing food and paying utility bills. Make sure your relative/friend eats on time and takes medications.

Don't take symptoms of trauma personally. The person may become irritable, aggressive, or act very cold and distant. Please be patient and understanding. In most cases, this doesn't mean you're doing anything wrong.

You cannot help another person if you yourself are unable to maintain peace of mind. Whatever terrible event happens to your loved one, do not allow yourself to be dragged down into the abyss of sadness. Maintain an optimistic outlook on life and faith that your friend will cope with what happened.

How to cope with psychological trauma on your own?

Experts do not deny the possibility of spontaneous recovery based on the individual’s own resources. Following the following recommendations from psychologists will help increase your chances of healing.

Admit the problem

What happened to you really affected you. Don’t at least lie to yourself that everything is fine with you. Take off the mask of a strong man who is knee-deep in the sea. Receiving psychological trauma is no more shameful than catching the flu virus. No one is immune from this.

Don't hold back your emotions

Don't be scared or ashamed of your emotions. Anger, fear, sadness, resentment, thirst for revenge - these are all normal human reactions. And if you allow yourself to feel them, they will not necessarily entail any destructive actions. It is much more dangerous to keep negativity within yourself, since it tends to accumulate and discharge at an unexpected moment in the form of uncontrollable affects. Negative feelings can be expressed on paper - try keeping a diary. If you want to vent your anger, you can buy a punching bag. Or try turning on music with the appropriate mood (aggressive, sad) and start dancing.

Working with psychological trauma

Try to find the strength to reproduce in your memory the events that provoked the development of psychological trauma. It seems that such actions can only cause re-experiencing suffering. However, the meaning of psychological trauma is precisely to block consciousness or certain feelings in order to protect the Ego.

As you review what happened, pay special attention to the events that cause you the most discomfort. Thus, without avoiding unpleasant sensations, you will unblock your consciousness and be able to perceive everything adequately. If you find gaps in your memories, your mental defense mechanisms may be very strong. And to get around them, you will have to resort to regressive self-hypnosis.

Stay Real

Even if through force, try to solve all everyday issues. Don't forget to take care of your physical health. Don't isolate yourself from the world. Keep in touch with friends and family. Communicating with them will help you feel like life goes on.

Don't get hung up

It is human nature to direct all his attention to what has brought him the greatest suffering. We become so immersed in the problem that we forget to notice all the good things that are present in our lives. And although your values ​​have probably changed dramatically after difficult events, if you want, you can always find little things for which you feel grateful. Allow yourself to feel your pain. But try to find an activity that will also bring you some bright emotions.

Get rid of guilt

Don't fall into the trap of feeling guilty. This primarily concerns victims of violence. Self-deprecating thoughts that you should have behaved differently, that you missed the chance to prevent the tragedy, are absolutely unfair.

Find a support group

Take a look around. Perhaps there is a person in your circle who is now going through the same thing as you, and in his person you will find an understanding interlocutor? Try looking for like-minded people on forums on the Internet. You may be lucky and find someone who has already dealt with a problem similar to yours. And this person will give you good advice.

Get rid of secondary benefits

There is a possibility that the fears and psychosomatic disorders that developed as a result of psychological trauma bring you some unconscious benefits. Psychiatrists call this phenomenon flight into illness. Most often, helplessness is practiced to get rid of some unpleasant responsibilities. For example, psychological trauma serves as an excuse to give up the struggle of life, to lower the bar of demands on oneself in work and interpersonal communication. To figure out what your secondary benefit from the disease may be, answer the questions.

1. What does the symptom prevent me from doing? The answer indicates the desires that were prohibited.
2. What does this symptom force me to do? The answer to a question with the prefix “not” shows which desires are blocked.
3. What unacceptable and undesirable things will happen if I realize my blocked desires? The answer to this question demonstrates the beliefs that you need to let go of in order to recover. If independent work does not bring results, seek help from a specialist, for example, psychologist Nikita Valerievich Baturin.

Is it possible to be cured

You should not engage in self-treatment, in order to overcome a depressed state as quickly as possible and get rid of psychological trauma forever, you should contact a clinical psychologist or psychotherapist. Specialists themselves prescribe a course of correction. To fully restore health, I use the following methods of combating the disease:

• Gestalt therapy;
• neurolinguistic programming procedures;
• provocative technique;
• cognitive behavioral psychotherapy;
• psychic suggestive therapy.

If the patient has a severe form of the disorder, he may be prescribed medical help.

Life scenarios

The famous psychologist Eric Berne proposed the idea of ​​“life scripts” that dictate our actions and our behavior in general.

This is an unconscious life plan that we borrowed from our parents, and which gives us the illusion of control over the situation and life.

Usually by the age of 7 this script has already been laid down, and in the future a person builds his life largely due to the influence of this unconscious script. When solving his life problems, a person is forced to solve the problems of his parents, his grandparents. You need to understand that this is not a detailed exact copy of the generic script, but a general direction and constant work on mistakes, your own and those of your ancestors.

This situation is aggravated in childhood by directive messages from parents to their child , when parents, out of “good intentions,” instill in their child guidelines on how to live.

A directive is a hidden order, implicitly formulated in the words or actions of a parent, for failure to comply with which the child will be punished.

Not explicitly (with a spanking or a slap on the head, silent blackmail or scolding), but indirectly - with one’s own sense of guilt before the parent who gave this directive. Moreover, the child cannot understand the true reasons for his guilt without outside help. After all, it is by following directives that he feels “good and correct.”