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Psychological trauma is a type of damage to the psyche

Psyche (psychology)

In psychoanalysis and other forms of depth psychology, the psyche refers to the forces in an individual that influence thought, behavior and personality. The word is borrowed from ancient Greek, and refers to the concept of the self, encompassing the modern ideas of soul, self, and mind...

that occurs as a result of a traumatic event

Physical trauma

Physical trauma refers to a physical injury, generally of a considerably severe degree. A trauma patient is someone who has suffered serious and life-threatening physical injury with the potential for secondary complications such as shock, respiratory failure and death.-Common causes:Comprehensive...

. When that trauma leads to posttraumatic stress disorder, damage may involve physical changes inside the brain and to brain chemistry, which damage the person's ability to adequately cope with stress

Stress (medicine)

Stress is a biological term for the consequences of the failure of a human or animal to respond appropriately to emotional or physical threats to the organism, whether actual or imagined....

.

A traumatic event involves a single experience, or an enduring or repeating event or events, that completely overwhelm the individual's ability to cope or integrate the ideas and emotion

Emotion

An emotion is a mental and physiological state associated with a wide variety of feelings, thoughts, and behavior. Emotions are subjective experiences, often associated with mood, temperament, personality, and disposition. The English word 'emotion' is derived from the French word émouvoir...

s involved with that experience. The sense of being overwhelmed can be delayed by weeks, years, even decades, as the person struggles to cope with the immediate circumstances.

Trauma can be caused by a wide variety of events, but there are a few common aspects. There is frequently a violation of the person's familiar ideas about the world and of their human rights

Human rights

Human rights refer to the "basic rights and freedoms to which all humans are entitled." Examples of rights and freedoms which have come to be commonly thought of as human rights include civil and political rights, such as the right to life and liberty, freedom of expression, and equality before the...

, putting the person in a state of extreme confusion

Mental confusion

Confusion of a pathological degree, usually refers to loss of orientation and often memory...

and insecurity. This is also seen when people or institutions depended on for survival violate or betray

Betrayal

Betrayal is the breaking or violation of a presumptive social contract, trust, or confidence that produces moral and psychological conflict within a relationship amongst individuals, between organizations or between individuals and organizations...

or disillusion the person in some unforeseen way.

Psychological trauma may accompany physical trauma

Physical trauma

or exist independently of it. Typical causes of psychological trauma are sexual abuse

Sexual abuse

Sexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another, when that force falls short of being a sexual assault. The offender is referred to as a sexual abuser or molester...

, violence, the threat of either, or the witnessing of either, particularly in childhood

Childhood

Childhood is a broad term usually applied to the phase of development in humans between infancy and adulthood.-Age definition of a child:...

. Catastrophic events such as earthquakes and volcanic eruptions, war or other mass violence

Violence

Violence is the expression of physical or verbal force against self or other, compelling action against one's will on pain of being hurt. Variant uses of the term refer to the destruction of non-living objects . Worldwide, violence is used as a tool of manipulation and also is an area of concern...

can also cause psychological trauma. Long-term exposure to situations such as extreme poverty

Poverty

Poverty is the condition of lacking basic human needs such as nutrition, clean water, health care, clothing, and shelter because of the inability to afford them. This is also referred to as absolute poverty or destitution...

or milder forms of abuse, such as verbal abuse

Verbal abuse

Verbal abuse is a form of abusive behavior involving the use of language. It is a form of profanity that can occur with or without the use of expletives...

, can be traumatic (though verbal abuse can also potentially be traumatic as a single event).

However, different people will react differently to similar events. One person may experience an event as traumatic while another person would not suffer trauma as a result of the same event. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.

Symptoms of trauma

People who go through these types of extremely traumatic experiences often have certain symptoms and problems afterward. How severe these symptoms are depends on the person, the type of trauma involved, and the emotional support they receive from others. Reactions to and symptoms of trauma can be wide and varied, and differ in severity from person to person. A traumatized individual may experience one or several of them.

After a traumatic experience, a person may re-experience the trauma mentally and physically, hence avoiding trauma reminders, also called triggers

Trauma trigger

A trauma trigger represents some form of experience that triggers a traumatic memory in someone who has experienced trauma. Triggers can be in the form of individual people, places, noises, images, smells, tastes, feelings, animals, films, scenes within films, dates, tones of voice, body...

, as this can be uncomfortable and even painful. They may turn to alcohol

Alcohol

In chemistry, an alcohol is any organic compound in which a hydroxyl group is bound to a carbon atom of an alkyl or substituted alkyl group. An important group of acohols is formed by the simple acyclic alcohols, the general formula for which is C_nH_2n+1OH...

and/or psychoactive substances

Psychoactive drug

A psychoactive drug, psychopharmaceutical or psychotropic substance is a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in changes in perception, mood, consciousness and behavior...

to try to escape the feelings. Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience.

Triggers and cues act as reminders of the trauma, and can cause anxiety and other associated emotions. Often the person can be completely unaware of what these triggers are. In many cases this may lead a person suffering from traumatic disorders to engage in disruptive or self-destructive coping mechanisms, often without being fully aware of the nature or causes of their own actions. Panic attack

Panic attack

Panic attacks are very sudden, discrete periods of intense anxiety, mounting physiological arousal, fear, stomach problems and discomfort that are associated with a variety of somatic and cognitive symptoms. The onset of these episodes is typically abrupt, and may have no obvious triggers...

s are an example of a psychosomatic response to such emotional triggers.

Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present. Upsetting memories such as images, thoughts, or flashback

Flashback (psychological phenomenon)

A flashback is a psychological phenomenon in which an individual has a sudden, usually powerful, re-experiencing of a past experience or elements of a past experience...

s may haunt the person, and nightmare

Nightmare

A nightmare is an unpleasant dream. Nightmares cause a strong unpleasant emotional response from the sleeper, typically fear or horror. The dream may contain a situation of extreme danger, or sensations of pain, bad events, falling, drowning, being raped, becoming disabled, losing loved ones,...

s may be frequent. Insomnia

Insomnia

Insomnia is a symptom of any of several sleep disorders, characterized by persistent difficulty falling asleep or staying asleep despite the opportunity. Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both"...

may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night.

Memory of the traumatic experience may become accessible only via the associated emotions: factual memories that place the event in temporal and spatial context may not be accessible. This can lead to the traumatic events being constantly experienced as if they were happening in the present, preventing the subject from gaining perspective on the experience. This can produce a pattern of prolonged periods of acute arousal punctuated by periods of physical and mental exhaustion.

In time, emotional exhaustion may set in, leading to distraction, and clear thinking may be difficult or impossible. Emotional detachment

Emotional detachment

Emotional detachment, in psychology, can mean two different things. In the first meaning, it refers to an inability to connect with others emotionally, as well as a means of dealing with anxiety by preventing certain situations that trigger it; it is often described as "emotional numbing" or...

, as well as dissociation or "numbing out", can frequently occur. Dissociating from the painful emotion includes numbing all emotion, and the person may seem emotionally flat, preoccupied, distant, or cold. The person can become confused in ordinary situations and have memory problems.

Some traumatized people may feel permanently damaged when trauma symptoms don't go away and they don't believe their situation will improve. This can lead to feelings of despair, loss of self-esteem

Self-esteem

Self-esteem is a term used in psychology to reflect a person's overall evaluation or appraisal of his or her own worth.Self-esteem encompasses beliefs and emotions...

, and frequently depression. If important aspects of the person's self and world understanding have been violated, the person may call their own identity into question.

Situational trauma

Trauma can be caused by man-made and natural disasters, including war, abuse, violence, earthquakes, mechanized accidents (car, train, or plane crashes, etc.) or medical emergencies.

Responses to psychological trauma

There are several behavioral responses common towards stressors including the proactive, reactive, and passive responses. Proactive responses include attempts to address and correct a stressor before it has a noticeable effect on lifestyle. Reactive responses occur after the stress and possible trauma has occurred, and are aimed more at correcting or minimizing the damage of a stressful event. A passive response is often characterized by an emotional numbness or ignorance of a stressor.

Those who are able to be proactive can often overcome stressors and are more likely to be able to cope well with unexpected situations. On the other hand, those who are more reactive will often experience more noticeable effects from an unexpected stressor. In the case of those who are passive, victims of a stressful event are more likely to suffer from long term traumatic effects and often enact no intentional coping actions. These observations may suggest that the level of trauma associated with a victim is related to such independent coping abilities.
There is also a distinction between trauma induced by recent situations and long-term trauma which may have been buried in the unconscious from past situations such as childhood abuse. Trauma is often overcome through healing; in some cases this can be achieved by recreating or revisiting the origin of the trauma under more psychologically safe circumstances, such as with a therapist

Psychotherapy

Psychotherapy or personal counseling with a psychotherapist, is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living.It aims to increase the individual's sense of their own well-being...

Trauma in psychoanalysis

French neurologist Jean-Martin Charcot

Jean-Martin Charcot

Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis .His work greatly influenced the...

argued that psychological trauma was the origin of all instances of the mental illness known as hysteria

Hysteria

Hysteria, in its colloquial use, describes a state of mind, one of unmanageable fear or emotional excesses. The fear is often caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part or most commonly on an imagined problem with that...

. Charcot's "traumatic hysteria" often manifested as a paralysis that followed a physical trauma, typically years later after what Charcot described as a period of "incubation".

Sigmund Freud

Sigmund Freud

Sigmund Freud , Sigismund Schlomo Freud , was an Austrian neurologist who founded the psychoanalytic school of psychology...

, Charcot's student and the father of psychoanalysis

Psychoanalysis

Psychoanalysis is a body of ideas developed by Austrian physician Sigmund Freud and continued by others. It is primarily devoted to the study of human psychological functioning and behavior, although it also can be applied to societies.
...

, examined the concept of psychological trauma throughout his career. Jean Laplanche

Jean Laplanche

Jean Laplanche is a French author, theorist and psychoanalyst. Laplanche is best known for his work on psychosexual development and Sigmund Freud's seduction theory, and has written more than a dozen books on psychoanalytic theory...

has given a general description of Freud's understanding of trauma, which varied significantly over the course of Freud's career: "An event in the subject's life, defined by its intensity, by the subject's incapacity to respond adequately to it and by the upheaval and long-lasting effects that it brings about in the psychical organization".

Trauma and stress disorders

In times of war, psychological trauma has been known as shell shock or combat stress reaction

Combat stress reaction

Combat stress reaction, in the past commonly known as shell shock or battle fatigue, is a military term used to categorize a range of behaviours resulting from the stress of battle which decrease the combatant's fighting efficiency. The most common symptoms are fatigue, slower reaction times,...

. Psychological trauma may cause an acute stress reaction

Acute stress reaction

Acute stress over reaction is a psychological condition arising in response to a terrifying event...

which may lead on to posttraumatic stress disorder (PTSD). PTSD emerged as the label for this condition after the Vietnam War

Vietnam War

The Vietnam War or the Second Indochina War was a Cold War military conflict that occurred in Vietnam, Laos, and Cambodia from 1959 to 30 April 1975...

in which many veterans returned to their respective countries demoralized, and sometimes, addicted to drugs. Psychological trauma is treated with therapy and, if indicated, psychotropic medications.

Following traumatic events, persons involved are often asked to talk about the events soon after, sometimes even immediately after the event occurred in order to start a healing process. This practice may not garner the positive results needed to recover psychologically from a traumatic event.

Victims of traumatic occurrences who were debriefed immediately after the event in general do fare better than others who received therapy at a later time, though there is also evidence to suggest forcing immediate debriefing may distort the natural psychological healing process.

Psychological trauma

Symptoms of trauma

Situational trauma

Responses to psychological trauma

Trauma in psychoanalysis

Trauma and stress disorders

See also