DETOX / RESIDENTIAL INPATIENT / AFTERCARE
Treating Unresolved Trauma
Some trauma can stay with us for the rest of our lives. It can affect everyday activities and responses in ways we do not even recognize. It can even lead to causing physical pain from the stress that is carried subconsciously. While the trauma itself cannot be treated because it happened in the past, the effects and symptoms can be managed if not wholly treated. The first step is to understand what it is and the symptoms of unresolved trauma so that you can better understand the long-term effects.
Trauma is defined as a state of arousal when the threat or perception of a severe threat overwhelms a person’s ability to cope; either with the situation or in general. Unresolved trauma, especially trauma that occurs in childhood, often has long-lasting impacts on a person both mentally and physically. It has these long-term effects on the human body because it sends the body into ‘fight or flight’ mode. This means that the brain kicks into survival mode and has a large amount of adrenaline pumped into the brain. Increased stress hormones can lead to an elevated immune response, which has been proven to be associated with poor health and increasing pulmonary, auto-immune, and cardiovascular disease. Overwhelming stress also negatively impacts the hypothalamic-pituitary-adrenal axis. This axis helps control the body’s reaction to stressful situations and trauma. Over time the stress response can cause lasting changes to areas of the brain including the amygdala, hippocampus, and prefrontal cortex. Trauma is also associated with increased cortisol and norepinephrine response to stressors. Trauma can lead to stress disorders as well.
Trauma can disrupt multiple systems in the body, not just cause issues in the brain. Trauma disrupts the connections between the various systems in the body. The greater the severity and frequency of the trauma, the more severe the issues that follow. Chronic conditions develop slowly over time so they are harder to track back to past trauma that occurred, but the physiological effects of trauma can be seen in many clients.
There are three types:
- Acute trauma– stems from a single incident
- Chronic trauma– stems from repeated and prolonged stressful situations or events
- Complex trauma– stems from exposure to varied and multiple traumatic events. These events are often invasive and interpersonal.
The symptoms can vary from person to person. The triggers for these symptoms will also vary because not one traumatic event is the same, and not everyone will react the same way to the same situation. The common symptoms are listed below:
- Night Terrors
- Poor Concentration
- Mood Swings
- Racing Heartbeat
Recovering from trauma is not a one-size-fits-all situation. Everyone will have their own steps and own way of moving through traumatic events. There are some common approaches to help with the treatment of trauma and the symptoms that can be debilitating for someone’s activities of daily living.
One of the main therapies used for the treatment is cognitive-behavioral therapy (CBT). CBT is a talk-based therapy in which the therapist is used as a sort of ‘bounce back wall’ to help sort out any issues the client may be experiencing. CBT’s main principles are based on the idea that psychological problems are caused partly by faulty or unhelpful ways of thinking and learned patterns of unhelpful behavior. It is believed that through CBT, clients can learn better coping mechanisms and change unhelpful thought patterns in order to have relief from symptoms and be able to function with ‘untreatable’ issues. This form of therapy is backed up by ample scientific evidence and methods that have been developed over decades. This form of therapy is client-lead and helps the client build up their confidence in rational thinking and decision-making. Client self-determination is key for CBT, and the therapist and client work together to develop an understanding of the problems surrounding the client and a manageable treatment strategy using short term micro-goals. This therapy has been proven to help and the symptoms surrounding traumatic events because of the emphasis on coping mechanisms and helping the client take charge of their life and their own thoughts and behaviors.
Another therapy that is recommended for trauma is exposure therapy. CBT has bits of this in the form of facing the client’s fears, but exposure therapy directly exposes the client to memories or triggers. This is to slowly lessen the effects of the triggers, or make it so that the memory does not hold the same power over the client. Exposure therapy has to be done carefully so as not to worsen the condition of the trauma. This is done by a process of intervention and guided discovery so that the client is helped, not harmed. Exposure therapy also focuses on coping mechanisms for the client as a way to manage the symptoms of trauma. Exposure therapy is usually done long-term and gradually.
There are only four medications that have received a conditional recommendation for the use in the treatment of trauma. These four medications are sertraline, paroxetine, fluoxetine, and venlafaxine. Many professionals suggest the use of medication with a combination of therapy and not just medication alone. It is best practice to have routine appointments with a therapist while starting new medications to ensure that the transition is going smoothly and there are no negative side effects, or to see if the dosage needs to be adjusted.
Treating unresolved trauma is handled much like a fresh traumatic incident would be. It is recommended that trauma be treated as soon as possible, but that is not always possible. Long-term trauma causes a plethora of other issues to the body as discussed above. In combination to help heal from anything unresolved, a client will need to look at the physical and mental issues that can arise from unresolved trauma and treat those as well. Healing from unresolved trauma included all of the symptoms that come from it as well.
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