There is, simply put, no easy way to summarize trauma, its effects. or its resolution. If there is anything I have learned in my 15 years of providing therapy to trauma survivors, it is that individuals are unique in the ways that life experiences affect them.
Therapists with specialized training in trauma treatment are often taught to differentiate "single incident trauma" from what is referred to as "complex (or chronic) trauma". This distinction is at times arbitrary and it does not suggest that single incident trauma is less harmful than complex trauma, as both types often significantly affect a person's functioning and quality of life. This differentiation can, at times, simply be useful in understanding how trauma affects people and how trauma therapy works.
Single Incident Trauma and Posttraumatic Stress Disorder (PTSD) As the name would suggest, single incident trauma is typically something that occurs one time, or a circumscribed number of times. Some of the more common single incident traumas I have treated include:
motor vehicle accidents
sexual or physical assaults
witnessing acts of violence
the sudden death of a loved one
Essentially, traumatic events are those that dramatically overwhelm your ability to cope and profoundly affects your sense of well being. Following such events, some individuals may develop symptoms of Posttraumatic Stress Disorder (PTSD), which include:
Intrusive thoughts or images of the traumatic event, nightmares, or flashbacks
Getting very upset when exposed to trauma-related cues, such as seeing a car accident on TV or reading about an assault in your local newspaper
Avoidance of talking or thinking about the trauma, or being around people or places that remind you of the event
Symptoms of increased arousal are also common and may include being easily startled, being easily irritated or having anger outbursts, difficulty sleeping, or difficulty concentrating.
For some people, these symptoms resolve a month or so following the event, without any form of intervention. However, for many individuals these symptoms persist and begin to affect interpersonal relationships, work and school functioning, or even physical health.
Single incident trauma and PTSD symptoms can be treated with Cognitive Behavioral Therapy (CBT), medication, or a combination of these two treatments. Specialized types of CBT for PTSD include Prolonged Exposure (PE) therapy and Cognitive Processing Therapy (CPT).
Complex Trauma & Contextual Therapy In my practice, I routinely see individuals who have experienced not one or two traumas, but instead a lifetime of trauma. These experiences often begin in childhood and may take the form of physical or sexual abuse, or exposure to other forms of maltreatment and adversity including witnessing domestic violence, exposure to parental drug use or suicide, and neglect. Sadly, such individuals are often at heightened risk for later experiencing other forms of traumas and many are continuing to experience trauma and other forms of abuse or adversity at the time they present for therapy.
Trauma that occurs repeatedly, or early in development, may have profound effects on the individual's physical and mental well being. Individuals who have experienced complex trauma often display the PTSD symptoms described above, in addition to broader difficulties with emotional regulation and impairments in their sense of self. Chronic stress and early trauma may be associated with memory problems, such that the person may find they cannot remember large portions of their childhood, or they may have difficulty recollecting day-to-day events such as how they got from point A to point B or what they bought at the supermarket. Individuals with complex trauma histories may also experience problems regulating their mood and impulses.
I was trained in Contextual Therapy for the treatment of complex trauma. Contextual Therapy is a humanistic, skills-based approach that combines aspects of Cognitive Behavioral Therapy, Interpersonal Therapy, and Dialectical Behavior Therapy (DBT). In this type of therapy, the therapeutic relationship is of uttmost importance as new skills are learned and a sense of safety created. As treatment progresses, the individual is guided towards resolving what has happened in the past and building a life that feels meaningful and worth living.