Trauma is to the human mind and spirit what a physical injury is to the flesh.
Over the course of the COVID-19 pandemic, 14,277 people have died in Washington due to the virus. An estimated 140,000 children in the US are now dealing with the loss of a parent or caregiver.
Even outside of the pandemic, events such as natural disasters, sexual assault, war, and child abuse mean that millions of people have experienced some form of trauma in their lives. Although more than half of people who experience a traumatic event recover naturally, the other half deal with persistent symptoms that affect their daily lives.
While the emotional and psychological trauma is largely invisible to the naked eye, the tangible effects ripple throughout the physical body.
Symptoms may include sleep and eating changes, flashbacks or nightmares, panic attacks, dissociation or numbness, hypervigilance, and irritability. When these symptoms last for more than a month, it can lead to a diagnosis of post-traumatic stress disorder. PTSD often overlaps with other illnesses, such as anxiety or depression.
“About half, sometimes more, of our people who encounter PTSD [diagnosis] it will also meet a diagnosis of depression,” said Michele Bedard-Gilligan, a researcher and clinical psychologist at the University of Washington School of Medicine.
How trauma affects a person largely depends on how they adapt and process the traumatic experience and the social support they have.
Trauma survivors who have healthy, positive relationships have a better chance of recovery, Bedard-Gilligan explained, because “it makes it clear to them that it’s not their fault … that there are people they can trust, even though something bad happened.” “.
What we know about trauma
For people who experience persistent and chronic traumatic events, such as growing up with an abusive parent, the trauma is considered complex or C-PTSD.
Secondary trauma or vicarious trauma occurs among people who do not experience the trauma directly, but often support others or secondarily witness it, such as social workers, first responders, nurses, and other public service roles.
Intergenerational trauma refers to descendants of people who experienced trauma firsthand, such as children of Holocaust survivors or formerly enslaved people. Although the field is relatively young, it has led to a new study of epigenetics examining how traumatic events spread and physically alter gene expressions.
In an oft-cited 2013 study published in the journal Nature, the researchers tested the effects of intergenerational trauma by negatively conditioning male mice to the odor of acetophenone (a sweet, almond-like odor). The researchers then discovered that the pups of those mice were nervous when exposed to that same smell, just like grandparents, or third-generation mice.
To make sure this wasn’t a learned trait shared from parent to offspring, the offspring mice were separated and bred by other, unrelated mice. In addition, when the researchers dissected the pups’ brains, they found more neurons, or brain cells, that detect acetophenone than in the brains of control mice.
Research has a long way to go, but on a psychological level, mental health professionals share anecdotal stories that children of people who have faced trauma often learn and carry on their parents’ behaviors long after the event itself .
For example, a child’s sense of trust may be impaired “because that’s what their parents say: ‘You can’t trust anyone. No one is going to come to help you,’” explained Heidi Montoya, a clinical psychologist in Seattle who has worked with immigrant and refugee communities. “Now this child is having a hard time trusting and having a hard time building healthy romantic relationships or even healthy friendships.”
Those later generations are more likely than the general population to engage in risky behavior or deal with substance use such as drugs and alcohol, and engaging in that behavior can expose them to future trauma, continuing a cycle.
trauma then and now
“In fact, I think of trauma as a fairly recent common construct or concept that has been parsed out of human suffering in general,” said Dave Walker, a Kitsap County psychologist who is descended from the Cherokee Nation of Missouri.
Walker, a self-described critic of mainstream psychology, points out that the field has for too long identified the problems of the individual rather than connecting them to systemic and social failures.
And although trauma is as old as time, its study in fields such as psychology, medicine, neuroscience, and psychiatry is still evolving. PTSD, for example, was not added to the Diagnostic and Statistical Manual of Mental Disorders until 1980.
It only became a formal diagnosis after much study and advocacy by soldiers, families, and researchers.
Known as “shell shock” during World War I and later as “post-Vietnam syndrome,” similar symptoms of PTSD also appeared in survivors of assault (previously called “rape trauma syndrome”), and among children who grew up in homes abusive
More recently, trauma-informed care has become a rallying cry in education, mental and behavioral health care, and other fields. This is a departure from traditional care that focuses on what is wrong with a patient, as opposed to what happened to a person.
Mental health professionals like Walker and Montoya also point out that even in situations where people seek counseling, access to mental health care remains the biggest barrier. Having the right insurance, finding the right therapist, with the experience and background, and time and resources like childcare all need to be connected before some people finally get therapy.
“When [people] they have so many other things competing for their attention to survive, mental health will take a backseat,” Montoya said.
Healings and interventions
The trauma is not permanent.
Just like a physical wound, emotional ones will also heal with time, care, and the right tools. If recovery takes more than a couple of months or you need or want care, evidence-based treatments are available.
Bedard-Gillligan’s work at UW focuses on interventions following traumatic events. She uses cognitive behavioral therapy, which promotes solutions to negative learned patterns or core beliefs, and exposure therapy, in which people talk about and confront difficult issues in their environment.
For example, for someone who is a survivor of sexual assault, “now their house itself feels dangerous, even though it’s not really the house,” Bedard-Gilligan said. “That’s what happened at the house.”
She also tailored culturally relevant interventions for Native American and indigenous communities, leveraging her own storytelling tools.
Walker encourages trauma survivors to engage in self-expression such as poetry, writing, or singing, and exercise that helps them get in touch with their breath, including yoga or meditation, if you feel safe. .
Traditional psychiatric medication for anxiety and depression might be helpful. Psychedelics or entheogens such as MDMA or psilocybin are being explored as treatments for patients with post-traumatic stress disorder and anxiety.
Vitally, more communities are having discussions around mental health, trauma, and wellness. Stigma is still a problem, but individuals and communities will always have the ability to heal.
For Bedard-Gilligan that is the light at the end of the tunnel.
“What gives me hope is seeing people get better, seeing people who have really just experienced some of the most horrible things that any of us can imagine — recover,” he said.
