What is trauma and what are its internal emotional impacts?

Trauma and addiction expert, Dr Mate Gabor summarises trauma in one of the most succinct statements to date. He says, "trauma is not what happens to a person, but what happens within them". It is the lack of flexibility to respond to emotional changes that trauma leads to, according to Gabor.

This constriction, or inability to process emotions and change, is one symptom of trauma. In the context of this article, trauma does not relate to just a major catastrophic incident such as a serious accident. Whilst it does include this, it also relates to any event that leaves a lasting negative imprint on the emotional and mental well-being of a person.

So, being sent to a boarding school during formative early years is for many, a sustained traumatic event that still lives with them through how they react to stressful or lonely situations. In the case of one of my clients, moving from Somalia to the U.K. left a lasting imprint on her, because of the stark change in weather, culture, religious backgrounds and language between the two countries. The trauma has led to severe social agoraphobia, a symptom of early childhood trauma which heightened her fear responses within her body.

This brings me to the following. Early childhood trauma has significant impacts on perception and on the limbic system in the body. This includes a part of the brain called the amygdala where the emotional processing of information takes place. It is the heart of the 'fight or flight' centre, or in some circumstances, the 'freeze' response where the amygdala is overwhelmed and when the reaction is akin to shutting down the body's physical reactions into a state of passivity. The hope in this state is that any prey may lose interest.

We need to start to look at traumatic events as being key triggers in heightening the sensitivity and responsivity of the amygdala which leads me to the following analogy. Imagine trauma as a form of targeted pressure on a spring which holds a trigger in place. Sustained and repeated pressure on the spring will cause it to deform and loosen leading to a hair trigger which can be activated with little pressure. This is very unlike a spring in a trigger that has never had any pressure, meaning that a lot of force and energy is needed to depress the trigger to activate a firing pattern.

Symbolically, the former seems to be the case in people who have sustained trauma where the fight or flight responses are triggered easily in daily life and these are exhibited through emotional reactions such as panic attacks, generalised anxiety, agoraphobia, ruminations, physical compulsions, low moods and anxiety.

Allied with this, stress levels in individuals may be high and they can potentially swing from being calm to bouts of anger within a few minutes. It should also be noted that such individuals may also be prone to self-medicating with drugs or alcohol in their lives when there are additional social, work, relationship or familial pressures. Addictions are therefore a possible by-product of the trauma. 

We are finally waking up to the long-term impacts of trauma on mental health, which has long been overlooked. Whilst trauma work is now becoming centralised in mental health care, many in their fifties and sixties continue to live with the anxiety, blunted feelings, anger and pain that the legacy of trauma has left them. This has further been exacerbated by the pandemic and it is essential that we do not overlook these age groups, many of who have never understood what they were going through.

We are at a turning point in mental health care in trauma-informed work. Ensuring that we are able to work across all age groups is the best outcome that we can give to future generations to ensure that the cycles of generational trauma do not carry on.

We are also at a point where future generations can live trauma-free but to do this, we as therapists need to wholly understand the past experiences and current behaviours of clients. This also means looking at identity, belonging and their sense of where they are ('place and space') in their local communities.