The word ‘trauma’ or ‘traumatic’ is often used to describe, jokingly, the slightest upset or inconvenience a person encounters in Life. Everything in life can be described as ‘traumatic’. Or if it was narrowly avoided, could otherwise have resulted in a person feeling ‘traumatised’. Though the word seems ever present today, the concept of ‘trauma’ as a presenting problem is a very recent development.
Trauma wasn’t considered ‘a thing’ (in today’s parlance) until the middle of last century. Before then, the idea of trauma or traumatic experiences were dismissed or overlooked, and people who experienced trauma were expected to simply “get over it” and move on. Trauma today is regarded as one of top five presenting problems a person can suffer. It dramatically increases the risk for seven out of 10 of the leading causes of death in the United States. It affects brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed. People who are exposed in very high doses have triple the lifetime risk of heart disease and lung cancer and a 20-year difference in life expectancy (CDC and Kaiser Permanente 2019).
“Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.
The only way to change the wiring of our brains is through relating to others.”
While addiction has a long history dating back to ancient times (Carl Fisher 2022), the recognition of trauma as a significant presenting problem requiring attention and treatment has only emerged in the last century. It is important to examine how this recognition has evolved in order to better understand and address the impact of trauma on individuals.
The recognition of trauma as a discrete psychological disorder can be traced back to the work of neurologist W.H.R. Rivers early 20th century. During World War I, many soldiers experienced what was then known as “shell shock” during combat, a condition characterised by all the classic symptoms of trauma we understand today.
- Physical symptoms, such as headaches, dizziness, and tremors.
- Emotional symptoms, such as anxiety, depression, and irritability.
- Cognitive symptoms, such as memory problems, difficulty concentrating, and confusion.
- Behavioural symptoms, such as insomnia, nightmares, and avoidance of associated places or activities.
- Hyper-vigilance, or being on constant alert for potential danger.
- Flashbacks, or re-experiencing the traumatic event in one’s mind.
- Dissociation, or feeling disconnected from one’s surroundings or emotions.
“Trauma is a fact of life. It does not, however, have to be a life sentence.
Trauma is about loss of connection to ourselves, to our bodies, to our families, to others, and to the world around us.”
But aside from Lindemann’s work, research on trauma largely continued to focus on its effect of combat on military personnel through to the Falklands, Iraq and Afghanistan. The professional focus was on a person’s their symptoms with especial regard for their speed and ability to ‘recover’ and either rotate back to combat or to return home and reintegrate into normal life.
“For every soldier who serves in a war zone abroad, there are ten children endangered in their own homes.”
van der Kolk
During the 1960’s and early 70’s an increasing number of psychiatrists maintained people experience events which they find ‘traumatic’ and the psychological effects of these traumatic incidences play out in ways which are identical to those found in combat veterans. These events can be ‘shock trauma ‘ such as accidents, assaults or natural disasters. ‘Developmental’ and ‘relational’ trauma such as child abuse. And “intergenerational trauma” a terms used to describe the ways in which trauma can be transmitted across generations, both through biological and cultural means.
“Wait a minute, the same things that were happening to those soldiers, in a sense, happened in families.”
McMahan (Fortunate Daughter 2021)
During the 1970’s and 1980’s the field of psychology began to pay more attention to the effects of childhood trauma, such as physical and sexual abuse within families. Trauma also began to enter popular awareness through several popular books and the rise of cable television.
“The problem with trauma is that it messes up the brain, especially in the capacity to observe the ordinary flow of life without fear and foreboding.”
van der Kolk
The Jungian analyst Marion Woodman explored the role of trauma particularly in the form of emotional and psychological wounds, and their ability to manifest in the body and psyche to have a significant impact on an individual’s life and relationships (The Ravaged Bridegroom,1990). Woodman believed this process could involve working with dreams, symbols, and archetypes, as well as exploring the body and its somatic experiences.
“Trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body.”
van der Kolk
In terms of clinical research, the American physicians Dr. Vincent Felitti and Dr. Robert Anda are credited for their seminal work during the 1990’s on the link between childhood trauma and adverse health outcomes in adulthood. The Adverse Childhood Experiences (ACE) study, still represents one of the largest investigations ever conducted on the relationship between childhood trauma and health outcomes. It involved over 17,000 participants and confirmed that individuals who experienced childhood trauma, such as abuse, neglect, or household dysfunction, had a significantly higher risk of developing a range of negative health outcomes later in life, including chronic diseases, mental health disorders, and substance abuse.
“The body is the first reality, the first landscape on which we live. Our experience of it is the foundation of the psyche, the foundation of the life process.”
Since the mid-1990s, the editors of the DSM have consistently opposed further expanding the definition of PTSD. The original definition was intentionally strict, meant to avoid the possibility that ALL mental disorders are simply caused by trauma. The concern was that while stress contributes to most psychiatric problems PTSD diagnoses could be made quickly and carelessly, without pursuing underlying mental disorders, such as anxiety and depression.
“‘Taking that leap, means all the rest of the knowledge ever accumulated about mental disorders goes out the window.”
Dr Allen Frances
On one side of the debate were therapists and advocates who believed that people could repress traumatic memories and recover them later in life, often through therapy. They argued these recovered memories were valid and should be taken seriously, even if they surfaced years after the event took place.
“The body is the living record of our lives. It holds the patterns of our thoughts, our behaviours, our beliefs. It contains the sum total of our experiences, and it is constantly revealing the state of our health, our well-being, our truth.”
By 2000, the ‘memory wars’ led to a greater awareness of the complexity of memory and the potential for both accuracy and inaccuracy. The professional response was a more cautious response by therapists working with traumatic memories focusing called “trauma-informed therapy.”
Trauma-informed therapy is based on a number of key principles, including safety, trustworthiness, choice, collaboration, and empowerment. It emphasises the importance of creating a safe and supportive environment in which individuals can explore their experiences and feelings at their own pace, and in which they have agency and control over the therapeutic process.
During 2010, the ‘decade of the brain’ provided neurobiological evidence for the way in which the people respond to life threatening situations and helped to clarify some of the issues around ‘false memories’. Advances in neuro-imaging technologies (CAT and fMRI scans) and neurobiological research helped to shed light on the physiological and neurological underpinnings of trauma and related disorders. For example, researchers have identified specific areas of the brain that are activated. ‘light up’, in response to perceived threats, as well as changes in brain structure and function that can occur as a result of trauma.
“All addictions are attempts to regulate our internal states – to manage our emotions, thoughts, and experiences. Whether we are trying to escape from pain or looking for excitement, our addictions serve the same purpose. They offer temporary relief and a sense of control, but ultimately they only deepen our suffering.”
The polyvagal theory was put into practice by clinicians such as Deb Dana who developed a range of trauma informed interventions based upon it for example “Rhythm and Resilience,”
The work of Dr. Gabor Maté is known for his work on (especially intergenerational trauma) and its relationship to addiction. In his book “In the Realm of Hungry Ghosts” Maté explores the connections between trauma and addiction. He suggests substance abuse is often a coping mechanism for individuals who have experienced trauma and are struggling with emotional pain and distress.
Dr. Dan Siegel work on trauma has contributed to a growing understanding of the impact of trauma on the brain and the importance of building healthy relationships and promoting neural integration in promoting healing and recovery.
“The essence of trauma is that something happened too fast, too soon, or too much for our nervous system to handle.”
The acknowledgment of trauma has led to the pursuit of a more comprehensive and compassionate approach to trauma treatment and prevention. Trauma-focused therapies, such as cognitive-behavioural therapy (CBT), eye movement desensitization and reprocessing (EMDR), and somatic experiencing (SE), aim to help individuals recover from the effects of trauma. Trauma-informed care approaches have also been developed to help organizations and individuals understand how trauma can affect individuals and how to create safe and supportive environments.
Overall, the recognition of trauma as a significant issue has come a long way, and it is essential that we continue to acknowledge and address trauma to help individuals recover and lead healthy and fulfilling lives
Although this brief article has granted us a glimpse into the realm of trauma, I would like to highlight the significance of animation in comprehending it. Animation holds the potential to be a formidable instrument in treating several aspects of trauma, especially for children and young adults who might struggle to articulate or grasp their encounters through the conventional ‘talking cure’. There are numerous ways in which animation can be utilized for trauma therapy, some of which are:
- Psychoeducation: Animation can be used to help individuals understand the neurobiological and psychological effects of trauma, as well as the symptoms and coping strategies associated with trauma. This can be especially helpful for individuals who may have difficulty understanding complex or abstract concepts.
- Visualization: Animation can be used to help individuals visualize and process traumatic experiences in a safe and controlled way. For example, a therapist may use animation to guide an individual through a guided imagery exercise in which they visualize a positive outcome to a traumatic event.
- Distraction: Animation can be used as a form of distraction during traumatic or distressing experiences, such as medical procedures or exposure therapy. Watching an animated film can help to reduce anxiety and provide a sense of comfort and safety.
- Self-expression: Animation can be used as a form of creative self-expression for individuals who may have difficulty expressing themselves verbally. Drawing or animating their experiences can help individuals to process and express their emotions in a nonverbal way.
- Skill-building: Animation can be used to teach individuals coping skills and techniques for managing symptoms of trauma, such as grounding exercises, mindfulness, or relaxation techniques. Animations can make these skills more engaging and accessible for individuals.