Trauma

Here, we explain more about psychological trauma, common causes and responses, and how therapy may be able to help.

What is psychological trauma?

Psychological trauma can develop after experiencing or witnessing a particularly distressing event, or a series of events. You may feel overwhelmed, unsafe or unable to cope afterwards. People respond to traumatic experiences in different ways, and a range of emotional and physical reactions can occur.

Trauma specialist Greg James explains more about trauma, including how we humans process trauma, what is considered a traumatic event, and what support is available.

What can cause psychological trauma?

Trauma is subjective and can have a variety of causes. Many different experiences can be traumatic. What feels traumatic varies from person to person, and people can respond differently to similar events.

Below are some examples of events that could lead to psychological trauma.

Abuse

This can refer to physical, emotional, sexual or verbal abuse. Abuse can be a one-off experience or happen repeatedly over a longer period of time.

Accidents

Being involved in an accident can lead to a traumatic response. Examples include car accidents, a bad fall, and accidentally harming someone else. Even if you were not physically harmed by the accident in question, being involved and experiencing the event can still lead to traumatic feelings.

Brain tumour and brain injury

Experiencing a brain injury or being diagnosed with a brain tumour can be distressing for the person affected and those close to them. The experience of diagnosis, treatment and changes to everyday life may feel traumatic for some people, and emotional support may be helpful.

Natural disasters, war, and other catastrophic events

This can relate to natural disasters such as earthquakes, tsunamis and hurricanes as well as man-made events like war and bombings. Being involved in these kinds of events can affect you both directly and indirectly.

Physical injury

Some physical injuries can have a lasting impact. You may have had a limb amputated and need to learn to cope with your new disability, or you may be left with physical scarring and chronic pain. Some people may benefit from emotional support alongside physical rehabilitation.

Bereavement or terminal illness

A diagnosis of terminal illness, or the death of someone close to you, can be deeply distressing and may be experienced as traumatic by some people.

Violence

Experiencing violence in any way can be traumatic. Whether you’ve been the victim of physical violence, threatened with violence, or even witnessed violence, you could find yourself experiencing symptoms of psychological trauma.

Near-death experiences 

A close encounter with death, such as a serious accident, medical emergency or life-threatening illness, can be frightening or distressing. Some people may find the experience difficult to process afterwards or experience ongoing trauma-related responses.

If these feelings are affecting your daily life or wellbeing, counselling can offer a supportive space to explore what happened and how you are feeling.

Signs and responses following trauma

Trauma responses vary from person to person. For some people, symptoms ease over time, while for others they may persist or emerge later. 

Some common symptoms of psychological trauma include:

• Flashbacks – When you re-experience the traumatic event mentally or physically.
• Insomnia – After a traumatic experience, it is common to have difficulties sleeping due to nightmares or mentally going over details of the event.
• Anxiety – Some people may feel anxious or experience panic attacks following a traumatic experience.
• Stress – Even if you handled stress very well before the traumatic event, you may find it harder to manage afterwards.
• Anger – Some people may experience anger following a traumatic experience. You might be angry at the person who traumatised you, at the event itself or even at the world. This can lead to outbursts and difficulty managing anger.
• Depression – Some people may experience symptoms of depression following a traumatic or distressing experience. This can include persistent low mood, feelings of hopelessness or, for some people, thoughts of suicide.
• Changes in how you feel about yourself – It can be easy to lack self-belief and self-confidence after you have experienced something traumatic. You can be left questioning your identity and what you have to offer the world.
• Alcohol or drug use – Some people may use alcohol or drugs as a way of coping with difficult feelings following trauma. If you're concerned about your alcohol or drug use, support is available.
• Emotional detachment – For some, the emotions that arise are so intense that they cannot cope with them at all. Some people may feel emotionally numb or disconnected from themselves or their surroundings. This can sometimes be associated with dissociation. 

Trauma and hypervigilance

Some people who have experienced trauma may experience hypervigilance. This is when your brain becomes highly attuned to potential danger, constantly on the lookout for something bad. You may notice that you jump easily at sudden sounds or that your heart rate is high. This heightened awareness can feel exhausting and affect how you respond to everyday situations.

If hypervigilance is affecting your daily life, a mental health professional can help you explore ways to manage it. Working with a counsellor can help you become more aware of your hypervigilance so you can seek out alternative reactions that support your wellbeing.

There are many ways you can begin to reduce hypervigilance, from practising self-reflective exercises, e.g. pausing before reacting, tolerating difficult emotions and observing sensations, to creating self-care routines, putting in boundaries with others, even just slowing down. 

- Counsellor Gregori Saava, What is emotional hypervigilance?

What is medical trauma? 

Medical trauma refers to any negative or traumatic experience that occurs in a medical setting. Trauma in this instance might be illness, pain, procedures or distressing treatments. This type of trauma can be particularly difficult to deal with as it may lead people to avoid seeking medical help. This might further heighten symptoms. 

There are several causes of medical trauma. Here are a few examples:

• Birth trauma. Some people develop PTSD following a traumatic birth. Experiences such as an emergency caesarean or a baby needing neonatal intensive care can be particularly distressing.
• Heart attacks and cancer. Experiences such as a heart attack, cancer diagnosis, or intensive medical treatment can be distressing or traumatic for some people.

What is childhood trauma?

Experiencing frightening or distressing events during childhood can have a lasting impact on some people. Some potentially traumatic experiences in childhood may also be described as adverse childhood experiences (ACEs).

Children and young people may experience potentially traumatic events including:

• sexual, physical or emotional abuse
• bullying
• bereavement
• neglect
• witnessing or experiencing violence.

Even if your trauma happened many years ago, support can help you process what happened and explore how your experiences may be affecting you now.

When to seek help for trauma

No matter how major or minor you think your experience was, you may benefit from professional help. As we all react differently to these types of events, it’s important not to compare yourself to other people, even if they went through the same experience.

You don't need to wait until things feel unmanageable to seek support. If trauma-related feelings or symptoms are affecting your daily life, relationships or wellbeing, you may find it helpful to speak to a mental health professional or your GP.

It is especially important to seek support if you experience any of the following:

• You find it difficult to manage day-to-day life.
• You are finding it difficult to form or maintain relationships.
• You are using drugs and/or alcohol to cope with how you are feeling.
• You are experiencing distressing or persistent flashbacks.
• You feel emotionally numb or disconnected.
• You are experiencing ongoing anxiety or stress following a traumatic experience.

Therapy for trauma and PTSD

If you are experiencing ongoing difficulties following trauma, different forms of psychological therapy may be helpful. If you have PTSD, recommended treatments include trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR).

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) explores how your thoughts, feelings and behaviours are connected. Trauma-focused CBT is specifically adapted to help people process traumatic experiences and manage trauma-related thoughts, feelings and behaviours.

Eye movement desensitisation and reprocessing (EMDR)

EMDR uses bilateral stimulation, such as side-to-side eye movements, taps or sounds, while working with traumatic memories. It aims to help people process these memories so that they become less distressing.

Finding the right support for trauma

If you’re finding it difficult to cope after a traumatic experience, you don’t have to work through these feelings alone. A counsellor or therapist can offer a safe, supportive space to explore what you’re experiencing at a pace that feels manageable for you.

Finding someone you feel comfortable with is important. You can browse counsellors who work with trauma, or use our advanced search to find a professional based on your needs, preferences and location.