13 Common Reactions to Trauma
By Melvin Hayden
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At some point, most of us will live through a terrifying event. It could be a car accident, a natural disaster, a medical emergency, a fire or perhaps trauma inflicted by another person in the form of assault, abuse, combat or robbery. Trauma can also come from seeing another person be seriously hurt or killed or learning about something awful that happened to a person we love.
Whatever the source, trauma leaves its imprint on the brain. For example, research studies consistently show that Post-Traumatic Stress Disorder (PTSD) is linked to greater activity in brain areas that process fear and less activation in parts of the prefrontal cortex. Two traumatic events from my own life stand out in this context. The first happened in the middle of my graduate education, the second after I had specialized in the study and treatment of Post-Traumatic Stress Disorder (PTSD). My experience after the second event was very different since I had learned a lot about what to expect after a trauma, even if a person does not go on to develop PTSD. While everyone's reaction to trauma is unique, there are common reactions, and knowing what they are can be helpful as we recover.
Part of what is helpful about knowing the common reactions is recognizing that all of these problems are tied to trauma and these feelings can be managed. Maybe what your experiencing is one problem with many faces. It can also be useful to realize that as the recovery process unfolds, these experiences are likely to improve, which can instill hope. In fact, a discussion of these reactions is part of Prolonged Exposure therapy, the best-tested treatment for PTSD. As therapists, we point out during that discussion that these reactions are very common among trauma survivors, whether a person develops PTSD or not. Below are some of the common reactions to a traumatic event.
Re-experiencing the Trauma
Many people find that the mind returns over and over to the upsetting memory, almost as if it’s on instant replay. It might feel like the brain is trying to make sense of the experience or figure out if we should have responded differently. Whatever the cause, it can be extremely distressing to relive a nightmarish experience repeatedly, even as we try our best to get the memory out of our heads.
Perhaps the most common emotional reaction to a trauma is feeling fearful and anxious. It makes perfect sense that we would be afraid after something scary happened. In fact, like so many of these reactions, it's a sign that our nervous system is functioning as it should. Nevertheless, the fear following a trauma can be as bad or worse than the emotions we felt at the time of the trauma, and almost certainly lasts longer. You may feel like the fear is subsiding when something triggers a reminder of the trauma, and the intense fear returns. Thankfully like the rest of these reactions, most people find that they do decrease over time.
If the trauma involved someone close to us being injured or killed, we may blame ourselves and feel guilty that we didn't somehow prevent it. Combat veterans might feel guilty about actions they took in the course of their duties that resulted in the deaths of their comrades. Or we might feel responsible for being attacked or hurt as though we somehow caused it.
Sometimes rather than feeling strong emotions, we feel shut down emotionally, as though we're made of wood. We might not have the positive emotions we know we "should" when good things happen in our lives. Part of the numbing response can come from the body and mind's self-protective efforts in the face of overwhelming emotions.
Trying not to Think About the Event
By definition, a traumatic event is not a pleasant memory, so it makes sense that we would want to avoid thinking about it. As mentioned above, the mind tends to replay the traumatic memory, so it can be difficult to keep it out of our minds for long. With time most people find that it becomes less painful to remember the trauma.
Avoiding Things Related to the Event
Sometimes we avoid people, places or things related to our trauma because they trigger the painful memory. For example, we might avoid TV shows that remind us of the event. Other times we might avoid things because they feel dangerous, like a section of a city where we were assaulted. It's common to want to avoid being in crowds after a trauma, even if the traumatic event wasn't caused directly by another person (such as an earthquake).
Difficulty Trusting People
When we've been attacked by another person, it can be hard to know whom we can trust—especially if we were caught off guard. We might start to suspect everyone and start to think "if that person could hurt me, why not this person?" From there, we may begin to avoid others to protect ourselves.
Believing the World is Extremely Dangerous
Immediately after a trauma, the mind is likely to see the world as very dangerous. Whereas we might have underestimated the danger in the world before the trauma, we might overestimate danger in the aftermath of a trauma. After all, our most recent experience of the world is as a very threatening place. Over time our beliefs tend to shift toward the middle, recognizing that the world can be quite dangerous at times, and that at other times it's relatively safe.
Blaming Yourself for the Trauma
As mentioned above, it's common to feel guilty after something terrible happens to you, as though you're to blame that it happened. The mind may cast about ways that you could have avoided the trauma such as:
"If only I'd left work a few minutes earlier."
"I shouldn't have been out at that hour."
"I should have seen that he was coming for me."
"Why wasn't I more careful?"
It's easy to use the advantage of hindsight to see the "mistakes" we made. In reality we almost certainly overstate our own responsibility for the traumatic event, and as a result feel unnecessary guilt. All the same, it's a common response after a trauma.
So many trauma survivors I've treated have talked about how they "should have" had a different response to the trauma, which was something I thought as well for both of my incidents. It's another example of "Monday Morning Quarterbacking"—second guessing split-second decisions made under a high degree of stress. Perhaps we can think of a better reaction when we have hours or days to mull it over, but life is lived in real time.
Seeing Yourself as Weak or Inadequate
It's not uncommon after a trauma to start to see ourselves as being "less than" in some way. Maybe we tell ourselves we're weak for "letting it happen." I remember thinking after getting mugged that if I'd been a more intimidating presence that my wife and I wouldn't have been targeted. I ignored of course, the fact that he had a gun. As with many trauma-related beliefs, we often are more critical of ourselves than we need to be.
Criticizing Yourself for Reactions to the Trauma
In addition to beating ourselves up for having experienced the trauma, we might also be upset with ourselves for being upset. As one person asked me, "How come everyone else has gotten over it and I can't?" There's an irony in how common it is to believe after a trauma that "nobody else would have the same kinds of struggles I'm having," given how many people feel this way.
Seeing Danger Everywhere
When your nervous system is highly attuned for danger, it's going to be set to detect any possible threat, which probably means you'll have a lot of false alarms. You might see your assailant walking toward you, and realize as your heart pounds out of your chest that it's really just your friendly neighbor. You might be startled by a movement out of the corner of your eye, and then realize it's your own reflection. I remember literally jumping at the movement of my own shadow in the streetlights one night, thinking it was someone walking up behind me.
Sleep is a vulnerable state, and when the brain and body are revved up, we're likely to have a hard time sleeping. It's as though the mind is saying, "Danger! This is no time for sleeping!" The nightmares that are common can also interfere with sleep and can make us reluctant to go to bed.
If you've been through a trauma you may have had many or few of these experiences, or you may have had ones that aren't listed here. It's important to keep in mind that everyone's reaction is different, and to allow room for your own reaction to be exactly what it is.
While these reactions are common, most people will find that they gradually subside over a period of days to months. If you find that you're struggling to recover from your trauma, don't hesitate to seek professional help. There are highly effective treatments for post-traumatic struggles, including PTSD and depression that greatly help most people who receive them.
I also want to note that not all post-traumatic reactions are bad. In fact, one of the common reactions at some point following a trauma is post-traumatic growth—a topic I'll pick up in a later post.
If you've recently been through a terrifying event, consider talking with someone close to you about your experiences, including any of these common reactions. Print and share this post if it might help your discussion. Confiding in people who care about us is invaluable as our minds and bodies heal. If someone you care about has recently gone through an horrific event, consider offering your support if you haven't already. At the worst times in our lives, we need the best from one another.