Trauma in mental health is an odd idea. It comes from the idea of physical trauma and the short, medium and long term effect on our health that trauma can cause or contribute to, but translated across to that of our psyche. Traumatic events are real, and we can feel quite traumatised from them. Unfortunately, it has become the false explanation for a lot of mental ill health. It is important to acknowledge that PTSD is real, but it is also quite rare.

Understanding Trauma

As Mental Health Trauma came from the concept of Physical Trauma, let us look at that first.

While doing sport, I can receive a trauma to my arm. That could result in a bruise, muscle damage or a broken bone. Each of these results from the impact will have a different care path and healing rate. A badly broken bone might result in long term negative impact on my life, for example weakness in lifting, aching and occasional sharp pain. The majority of the injuries I will get to my arm will be bruising and will heal up shortly, requiring at most a few days of caution with my injured arm.

What we get from this is:

An event can cause a consequence
That event is the traumatic event
The consequence is the trauma
Trauma is most often not significant, but sometimes it is
Each consequence of a traumatic event likely needs its own treatment plan
Proper treatment results in minimal long term consequences to the affected person

Mental Health Trauma should be viewed through this lens as well. It is important not to mistake stress and distress as Trauma. These can, in time and with sufficient severity, become a Trauma Event, but they are not inherently Trauma. This is akin to mistaking a tap on the shoulder as being beaten up. Yes, you did have physical contact made with you, however, that is not a physical assault.

We have covered 5 Trauma Myths before [Link], where we covered that

We DID actually evolve to manage complex trauma
Most mental illness is NOT maladaptive behaviours from a traumatic event
Most people DON’T need trauma therapy
The root of all mental health problems is NOT trauma
Not everything is traumatic to someone

This leaves us with some important questions.

If Trauma isn’t the cause of most mental illness, what is?
Why do many therapists seem to think that it is?
If all of those things aren’t trauma, what is trauma?

I’m so glad that you asked these questions. We go through these questions in Misdiagnosed Trauma [LINK].

Treating Mental Trauma

Fundamentally Trauma is characterised by:

Maladaptive Behaviours
- Impulsive Behaviours
Fragmented Memory
- Flashbacks and Nightmares
Powerlessness
- Reclaiming Power

It is important to stabilise a person before engaging in active Trauma Therapy. We cover that in “The 5 Phases of Trauma Therapy” [LINK].

TLDR 6 Phases of Trauma Therapy

Phase 1 – Understanding Trauma (This)

Phase 2 – Balance Neurotransmitters

Phase 3 – Stabilise Environment

Phase 4 – Stabilise Self

Phase 5 – Mood Management

Phase 6 – Trauma Therapy

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Once the person has stabilised, each of the above characteristics needs to be examined.

Maladaptive Behaviours

First it is important to address some maladaptive behaviours to minimise ongoing consequences from poor behaviour. This isn’t a total fix in the first cycle, just an adjustment to decrease harm. Some of this is addressed by the 5 Phases of Trauma Therapy.

Impulse Behaviours may be exacerbated by neurotransmitter balance problems, and if indicated, should be the primary treatment method. Secondarily, and in parallel, assisting the person with greater interoception – recognising the internal warning signs and signals so that the behaviour can be addressed before it manifests.

We have talked about retraining the brain elsewhere [LINK], where we change the default behaviour to a chosen learned behaviour.

Fragmented Memory

Ever had your computer reset for some reason in the middle of editing a document? When you finally get your computer up and running, the program might say “we have recovered a document, do you want to save it?” If you are ready to do so, that fantastic. If not, imagine that message coming up every time you go to do something complicated – “not now! I’m busy!”

Well this can be your memory of the Traumatic Event.

Defragmenting the memory means taking a fresh look at the event that occurred after you have learned some important analysis concepts. Often we have forgotten key details or joined two or more events together, confusing the event and making it harder to comprehend. When we look at an event that is very triggering, it is important to know how to manage those triggers, which is covered in the 5 Phases of Trauma Therapy.

To truly learn from an event, to grow new abilities, and to heal from past pains involves understanding what actually happened and looking at that again now that you have the tools to understand the event.

Powerlessness

A great deal of our ongoing inability to heal from a Traumatic Event is feeling powerless before it. This is exacerbated when a person has biological factors that are exacerbating their experience, especially when these are not addressed. We need to

A key part of the talking and learning component of Trauma Therapy is recognising why we feel powerless and creating a way to regain our power.

Consider going on a roller coaster ride to someone you trusted driving very crazily. For the purpose of this example, both end with no injury to you. The choice to go on the roller coaster made that crazy car ride quite different to the one where your friend went odd and drove in a similar way. Once they started, nothing you could reasonably do could stop them until they were done, yet the roller coaster isn’t as bad as the car drive. The difference is choice, and choices gives you power.

Some of the traumatic events that we have lived through were so far out of our control that we can feel like we have no power over them. And truly, we cannot go back in time and change the events that happened to us. We do have power over now, and we can exercise power over our memories and what we learn from them. Part of re-working the experience with new tools is to learn new things about ourselves, the situation and whatever caused that experience. This gives us power to grow from this.

We can also use that experience to create a difference in the world. We could create an artwork, write a book, or connect to someone who has similarly gone through an awful situation. Some method of turning a bad and horrid experience into a creation of good. When you do this, you reclaim that experience as yours and turn it to become a positive. In transforming the event to a positive creation, we attain mastery of our experience, rather than being a slave to the triggers of the event.