Trauma Evaluation And Management (TEAM)

The ability to recognize emotional trauma has changed radically over the course of history. Until recently psychological trauma was noted only in men after catastrophic wars. The women’s movement in the sixties broadened the definition of emotional trauma to include physically and sexually abused women and children. Now, because of the discoveries made in the nineties – known as the decade of the brain – psychological trauma has further broadened its definition.

Recent research has revealed that emotional trauma can result from such common occurrences as an auto accident, the breakup of a significant relationship, a humiliating or deeply disappointing experience, the discovery of a life-threatening illness or disabling condition, or other similar situations. Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.

Regardless of its source, an emotional trauma contains three common elements:

• it was unexpected;
• the person was unprepared; and
• there was nothing the person could do to prevent it from happening.

It is not the event that determines whether something is traumatic to someone, but the individual’s experience of the event. And it is not predictable how a given person will react to a particular event. For someone who is used to being in control of emotions and events, it may be surprising – even embarrassing – to discover that something like an accident or job loss can be so debilitating.

What causes emotional or psychological trauma?

Our brains are structured into three main parts, long observed in autopsies:

• the cortex (the outer surface, where higher thinking skills arise; includes the frontal cortex, the most recently evolved portion of the brain)
• the limbic system (the center of the brain, where emotions evolve)
• the brain stem (the reptilian brain that controls basic survival functions)

Because of the development of brain scan technology, scientists can now observe the brain in action, without waiting for an autopsy. These scans reveal that trauma actually changes the structure and function of the brain, at the point where the frontal cortex, the emotional brain and the survival brain converge. A significant finding is that brain scans of people with relationship or developmental problems, learning problems, and social problems related to emotional intelligence reveal similar structural and functional irregularities as is the case resulting from PTSD.

What is the difference between stress and emotional or psychological trauma?

Trauma is stress run amuck. Stress dis-regulates our nervous systems – but for only a relatively short period of time. Within a few days or weeks, our nervous systems calm down and we revert to a normal state of equilibrium. This return to normalcy is not the case when we have been traumatized. One way to tell the difference between stress and emotional trauma is by looking at the outcome – how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing the following:

• how quickly upset is triggered
• how frequently upset is triggered
• how intensely threatening the source of upset is
• how long upset lasts
• how long it takes to calm down

If we can communicate our distress to people who care about us and can respond adequately, and if we return to a state of equilibrium following a stressful event, we are in the realm of stress. If we become frozen in a state of active emotional intensity, we are experiencing an emotional trauma – even though sometimes we may not be consciously aware of the level of distress we are experiencing

What causes psychological trauma?

Psychological trauma can result from events we have long recognized as traumatic, including:

• natural disasters (earthquakes, fires, floods, hurricanes, etc.)
• physical assault, including rape, incest, molestation, domestic abuse
• serious bodily harm
• serious accidents such as automobile or other high-impact scenarios
• experiencing or witnessing horrific injury, carnage or fatalities

Other potential sources of psychological trauma are often overlooked including:

• falls or sports injuries
• surgery, particularly emergency, and especially in first 3 years of life
• serious illness, especially when accompanied by very high fever
• birth trauma
• hearing about violence to or sudden death of someone close

In addition, traumatic stress in childhood that influences the brain is caused by poor or inadequate relationship with a primary caretaker. Sources of this developmental or relational trauma include the following:

• forced separation very early in life from primary caregiver;
• chronic mis-attunement of caregiver to child’s attachment signals (“mal-attachment”) or reasons such as     physical or mental illness, depression or grief.

It is acknowledged that early life trauma creates a vulnerability for experiencing future traumatic responses.

For a fuller insights on the causes of psychological/emotional trauma see our adult trauma history questionnaire.*

Why can an event cause an emotionally traumatic response in one person and not in another?

There is no clear answer to this question, but it is likely that one or more of these factors are involved:

• the severity of the event;
• the individual’s personal history (which may not even be recalled);
• the larger meaning the event represents for the individual (which may not be immediately evident);
• coping skills, values and beliefs held by the individual (some of which may have never been identified); and
• the reactions and support from family, friends, and/or professionals.

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop symptoms of “vicarious” or “secondarytrauma. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

What are the symptoms of emotional trauma?

There are common effects or conditions that may occur following a traumatic event. Sometimes these responses can be delayed, for months or even years after the event. Often, people do not even initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from a more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

• Eating disturbances (more or less than usual)
• Sleep disturbances (more or less than usual)
• Sexual dysfunction
• Low energy
• Chronic, unexplained pain

• Depression, spontaneous crying, despair and hopelessness
• Anxiety
• Panic attacks
• Fearfulness
• Compulsive and obsessive behaviors
• Feeling out of control
• Irritability, angry and resentment
• Emotional numbness
• Withdrawal from normal routine and relationships

• Memory lapses, especially about the trauma
• Difficulty making decisions
• Decreased ability to concentrate
• Feeling distracted
• ADHD symptoms

The following additional symptoms of emotional trauma are commonly associated with a severe precipitating event, such as a natural disaster, exposure to war, rape, assault, violent crime, major car or airplane crashes, or child abuse. Extreme symptoms can also occur as a delayed reaction to the traumatic event.

Re-experiencing the Trauma
• intrusive thoughts
• flashbacks or nightmares
• sudden floods of emotions or images related to the traumatic event

Emotional Numbing and Avoidance
• amnesia
• avoidance of situations that resemble the initial event
• detachment
• depression
• guilt feelings
• grief reactions
• an altered sense of time Increased Arousal
• hyper-vigilance, jumpiness, an extreme sense of being “on guard”
• overreactions, including sudden unprovoked anger
• general anxiety
• insomnia
• obsessions with death

What are the possible effects of emotional trauma?

Even when unrecognized, emotional trauma can create lasting difficulties in an individual’s life. One way to determine whether an emotional or psychological trauma has occurred, perhaps even early in life before language or conscious awareness were in place, is to look at the kinds of recurring problems one might be experiencing. These can serve as clues to an earlier situation that caused a dysregulation in the structure or function of the brain.

Common personal and behavioral effects of emotional trauma:
• substance abuse
• compulsive behavior patterns
• self-destructive and impulsive behavior
• uncontrollable reactive thoughts
• inability to make healthy professional or lifestyle choices
• dissociative symptoms (“splitting off” parts of the self)
• feelings of ineffectiveness, shame, despair, hopelessness
• feeling permanently damaged
• a loss of previously sustained beliefs

Common effects of emotional trauma on interpersonal relationships:
• inability to maintain close relationships or choose appropriate friends and mates
• sexual problems
• hostility
• arguments with family members, employers or co-workers
• social withdrawal
• feeling constantly threatened

What if symptoms don’t go away, or appear at a later time?

Over time, even without professional treatment, symptoms of an emotional trauma generally subside, and normal daily functioning gradually returns. However, even after time has passed, sometimes the symptoms don’t go away. Or they may appear to be gone, but surface again in another stressful situation. When a person’s daily life functioning or life choices continue to be affected, a post-traumatic stress disorder may be the problem, requiring professional assistance.

NOTE: The above information is provided for informational purposes only.  It is not intended to diagnose or identify any person as having trauma related issues.  The sole purpose of this post is to provide information.

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Source: Trauma Evaluation And Management (TEAM)

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