Trauma is caused by an event or experience that is so threatening or overwhelming that a person cannot cope. In response to perceived danger and stress, the body triggers an involuntary reaction called the stress response. This is often referred to as the fight-flight-or-freeze response and has been an essential part of human survival for hundreds of thousands of years.
When the stress response is triggered, the body is flooded with a variety of hormones, blood distribution to large muscle groups changes and core functions such as heart rate decrease or increase, depending on the response. While this reaction may keep us safe in the moment of danger, possibly giving us the extra speed to get away, enhanced reaction times to respond to attacks, or desensitised pain reactions, it can cause a range of adverse consequences in the long term.
While it is incredibly difficult to produce an accurate statistic, it is thought that around 20% of people who experience trauma may go on to develop Post Traumatic Stress Disorder (PTSD). The prevalence of trauma varies widely among individuals who experience a traumatic event, and not everyone who experiences a traumatic event develops PTSD or other trauma-related conditions. They might live with certain consequences that make relationships, employment, or anything related to the traumatic experience difficult but not meet the diagnostic criteria for PTSD. The impact of a traumatic event differs based on various factors, such as the nature of the event, genetics, individual resilience, available support systems, and personal coping mechanisms.
Trauma and Change
Trauma can be life-changing, profoundly impacting those who experience it in various ways. When someone experiences a traumatic event, it can shatter their sense of safety, trust, and stability. The emotional and psychological effects of trauma can be long-lasting and pervasive, often extending well beyond the initial event itself.
Trauma can have a life-changing influence on beliefs and perspectives. Traumatic experiences can challenge deeply held beliefs about oneself, others, and the world, leading people to question their own vulnerability, the reliability of others, and the fairness of life. The experience and change it evokes in a person can lead to a significant shift in core values, priorities, the things they enjoy, and general outlook on life.
Trauma can also catalyse personal growth and resilience. Many people who have experienced trauma embark on a journey of healing and self-discovery. Through therapy and support networks, as well as drawing on innate strength and self-reflection, they develop coping mechanisms, gain insights into their own resilience, and find new meaning and purpose in life. This can often lead trauma survivors to develop a heightened appreciation for life, greater empathy, and a renewed sense of purpose, which can shape their future choices and actions. However, this happens through a process of change that can be deeply challenging and confusing, with elated highs and demoralising lows.
The Non-Linear Process of Change
Recovering from trauma is a unique and personal experience. It does not follow a predictable path or timetable. While some may experience immediate relief and progress, others may face ongoing challenges and setbacks that impede recovery and interrupt daily life. With trauma, in particular, healing occurs in layers, as individuals gradually confront and process different aspects of their traumatic experiences. Peeling off one layer can bring profound realisation and acceptance but also cause a wave of renewed pain, sensitivity, vulnerability and fear that makes it feel as if healing might be going backwards and the capacity to cope has greatly diminished.
The non-linear and complex process of change involves fluctuations in emotions, memories, and behaviours. One day, a survivor may feel empowered and hopeful, while the next, they may be overwhelmed by triggers and emotional turmoil. This unpredictability can be frustrating and discouraging, both for the individual and their support system.
The change process is often understood in therapy as a wheel with six stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination. The stages represent the progression individuals go through when making behaviour changes; however, the process is not always cyclical, with individuals often oscillating between two or three stages, particularly preparation and maintenance. Each stage requires different support strategies and actions to empower movement to the next stage and ultimately reach the maintenance stage, where the behaviour change becomes a long-term habit.
In the pre-contemplation stage, individuals may not recognise the need for change. In the contemplation stage, they start considering the possibility of change but may still feel ambivalent or hesitant. The preparation stage signifies readiness to take action and involves small steps toward behaviour change.
Once individuals enter the action stage, they have made a change and are committed to continuing the process. The maintenance stage follows, where individuals have sustained their behaviour change for an extended period and focus on preventing relapse.
Change can be difficult for everyone, but for trauma survivors, it can feel like giving up something that makes them feel safe. Trauma creates deep-rooted habits and behaviours that serve as defences against fear and terror. These habits are difficult to untangle from the trauma itself, making change a challenging process. Trauma survivors benefit from smaller and more structured changes, with better support systems in place. It is important to respect the survivor’s pace of change, allowing time for preparation and discussing the pros and cons. Change should be approached in small increments, finding the smallest achievable steps while being mindful of overwhelming emotions, while understanding and respecting the role that the habit played in the survivor’s life, gradually finding alternative ways to meet those needs.
Dealing with Change
It is essential to approach trauma recovery with patience, empathy, and flexibility. Healing requires creating a safe and supportive environment that allows for self-expression and exploration of emotions. Professional help, such as therapy or counselling, can provide valuable guidance and tools for navigating the complexities of trauma.
The non-linear process of change reminds us that healing is not a linear destination but a personal journey. It requires self-compassion and understanding, as well as a recognition that progress can be measured in small steps. By acknowledging the non-linear nature of trauma recovery, we can offer the necessary support and validation, fostering resilience and growth in those who have experienced trauma.
Endnotes
- Schein, J. PTSD STATS, PTSD UK |. Available at: https://www.ptsduk.org/ptsd-stats/ (Accessed: 25 June 2023).
- Cherestal, & Herts, K. L. (2021). Trauma―Focused Treatment for PTSD With Comorbid Psychosis: A Case Report. Clinical Case Studies, 20(3), 201–216. https://doi.org/10.1177/1534650120980069
- St Cyr, Liu, J. J. W., Cramm, H., Nazarov, A., Hunt, R., Forchuk, C., Deda, E., & Richardson, J. D. (2022). “You can’t un-ring the bell”: a mixed methods approach to understanding veteran and family perspectives of recovery from military-related posttraumatic stress disorder. BMC Psychiatry, 22(1), 37–37. https://doi.org/10.1186/s12888-021-03622-3