cont. from

Summary

Psychological effects are likely to be most severe if the trauma is:

• Human caused
• Repeated
• Unpredictable
• Multifaceted
• Sadistic
• Undergone in childhood
• And perpetrated by a caregiver

Who Are Trauma Survivors?

Because violence is everywhere in our culture and because the effects of violence and neglect are often dramatic and pervasive,

• most clients/patients/recipients of services in the mental health system are trauma survivors.

Because coping responses to abuse and neglect are varied and complex,

• trauma survivors may carry any psychiatric diagnosis and frequently trauma survivors carry many diagnoses.

And, because interpersonal trauma does not discriminate,

• survivors are both genders, all ages, all races, all classes, all sizes, all sexual orientations, all religions, and all nationalities. Although the larger number of our clients are female, many men and boys are survivors of childhood abuse and trauma. Under-recognition of male survivors, combined with cultural gender bias has made it especially difficult for these men to get help.

What are the Lasting Effects of Psychological Trauma?

There is no one diagnosis that contains all abuse survivor clients; rather individuals carrying any diagnosis can be survivors. Often survivors carry many diagnoses.

Abuse survivors may meet criteria for diagnoses of:

• substance dependence and abuse,
• personality disorders (especially borderline personality disorder),
• depression,
• anxiety (including post traumatic stress disorder),
• dissociative disorders, and
• eating disorders, to name a few.

PTSD is the only diagnostic category in the DSM that is based on etiology. In order for a person to be diagnosed with PTSD, there had to be a traumatic event. Because most diagnoses are descriptive and not explanatory, they focus on symptoms or behaviors without a context: they do not explain how or why a person may have developed those behaviors (e.g., to cope with traumatic stress).

For purposes of identifying trauma and it adaptive symptoms, It is much more useful to ask "What HAPPENED to this person" rather than "what is WRONG with this person."

Symptoms as Adaptations

The traumatic event is over, but the person's reaction to it is not. The intrusion of the past into the present is one of the main problems confronting the trauma survivor. Often referred to as re-experiencing, this is the key to many of the psychological symptoms and psychiatric disorders that result from traumatic experiences. This intrusion may present as distressing intrusive memories, flashbacks, nightmares, or overwhelming emotional states.

The Use of Maladaptive Coping Strategies

Survivors of repetitive early trauma are likely to instinctively continue to use the same self-protective coping strategies that they employed to shield themselves from psychic harm at the time of the traumatic experience. Hypervigilance, dissociation, avoidance and numbing are examples of coping strategies that may have been effective at some time, but later interfere with the person's ability to live the life s/he wants.

continue: Changes Resulting From Psychological Trauma in Childhood

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Reviewed: 04/2006