What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

The terms "trauma" and "PTSD" (posttraumatic stress disorder) are often used interchangeably, but there is a difference.

Understanding the Difference Between Trauma and PTSD

What is Trauma?

Trauma is an emotional response to an overwhelming event which could include shock trauma or developmental trauma .

Shock trauma is a one-time event like a robbery, an accident or the devastating effect of a hurricane, to name just a a few examples of shock trauma.

Developmental trauma is ongoing trauma experienced during childhood due to stressful and traumatic events including physical and emotional abuse, physical or emotional neglect, violence, and chronic instability.

The effects of trauma can include (but are not limited to):

• Sadness
• Anxiety
• Depression
• Avoidance of people, places and things related to the trauma
• Anger
• Dissociation
• Confusion
• Exhaustion
• Numbing emotions and numbing yourself to your environment
• Nightmares

Symptoms from shock trauma and developmental trauma can persist for weeks, months, years or a lifetime.  

When symptoms of trauma persist and evolve over time, these symptoms can develop into posttraumatic stress disorder (PTSD) if the symptoms of trauma go untreated.

What is Posttraumatic Stress Disorder (PTSD)?

Even though PTSD and trauma are closely related, they are not the same.

Understanding the Difference Between Trauma and PTSD

"Post" in posttraumatic stress disorder refers to the physical, emotional and psychological impact after trauma occurs.

Whereas trauma is a response to an overwhelming event, PTSD is a more serious mental health condition.

The effects. of PTSD are divided into four categories:

• Re-experiencing symptoms: Flashbacks including emotional flashbacks, nightmares and frightening thoughts

• Avoidance: Avoiding people, places and things related to the traumatic event(s) and avoiding related thoughts and feelings

• Arousal/Reactivity: Getting easily triggered, having difficulty falling or staying asleep, problems calming down, getting easily frightened and experiencing intense anger

• Mood and Cognition: Problems remembering details of the trauma, a negative view of oneself and a lack of interest in hobbies or interactions that were pleasurable before

What is Trauma Therapy?

Trauma therapy includes a variety of therapy modalities including (but not limited to):

• EMDR (Eye Movement Desensitization and Reprocessing) Therapy

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

Understanding Trauma Therapy

• Somatic Experiencing (also known as Somatic Therapy)
  

• Clinical Hypnosis (also known as Hypnotherapy)

• Parts Work Therapy (also known as Internal Family Systems or IFS and Ego States Therapy)

Why is It Important to Seek Help in Trauma Therapy?

Whether you're experiencing unresolved trauma or PTSD, symptoms often get worse over time so seeking help in trauma therapy sooner rather than later is recommended.

Understanding the Importance of Trauma Therapy

Both trauma and PTSD symptoms can carry over intergenerationally, which means that your unresolved trauma can have a significant impact on your children and future generations (see my articles: What is Intergenerational Trauma?).

Getting Help in Trauma Therapy

If you have been struggling with unresolved trauma, you could benefit from working with a trauma therapist (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

After you have worked through your trauma, you can free yourself from your traumatic history so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have over 20 years of experience working with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Why is Past Trauma Affecting You Now?

One of the questions that I often hear from clients in my New York City psychotherapy private practice is, "Why is trauma from a long time ago still affecting me now?" (see my article: Reacting to the Present Based on Your Traumatic Past).

Getting Help in Trauma Therapy

Before discussing why past psychological trauma can still impact you now, let's first discuss the possible physical and emotional effects of unresolved trauma.

Possible Physical Effects of Unresolved Trauma

• Headaches
• Aches and pains throughout the body
• Tiredness
• Sweating
• Changes in appetite 
• Difficulty managing stress
• Sleep problems
• Memory problems
• Dizziness
• Changes in vision
• Long term health problems
• Fight response
• Fawn response
  
• Flight response
• Freeze response
  
• Substance Misuse and other addictive and compulsive behavior (e.g, gambling overspending, etc)

Possible Emotional Effects of Unresolved Trauma

• Anger/irritability
• Emotional numbing (an inability to feel strong emotions)
• Sadness and Grief
• Worrying
  
• Confusion
• Problems with knowing what you want
• Shame
  
• Fear
• Panic
  
• Hypervigilance: Being very alert to your surroundings because you fear something is going to happen
• A loss of a sense of who you are
• Flashbacks triggered by current situations
• Hypersensitivity to the comments and behavior of well-meaning people who are close to you

What Are Possible Day-to-Day Responses to Unresolved Trauma?

Unresolved trauma can impact your day-to-day living in terms of:

• Taking care of yourself
• Difficulty trusting others even when you have no objective reason to mistrust these particular people
• Difficulty maintaining romantic relationships, friendships and familial relationships
• Difficulty in school and college
• Difficulty setting goals
• Difficulty maintaining a job and getting along with managers and colleagues
• Difficulty making decisions
  
• Lack of motivation
• Difficulty with change
• Difficulty with how to manage free time 

Why Does Trauma That Happened a Long Time Ago Affect You Now?

Unresolved trauma remains stored in your mind and body.  

Regardless of when the trauma originally occurred, the impact can last for years if the trauma remains unresolved and untreated.

Everyone experiences unresolved trauma in their own way and symptoms can change over time.

You might not experience a noticeable impact of the trauma until it gets triggered later in life and, at that point, you might not understand what you're reacting to when you experience symptoms.

Even if the trauma occurred decades ago and the current situation doesn't appear to be related to what happened in the past, you could experience emotional and/or physical symptoms now based on what happened in the past (see Example #3 below).

Examples

#1. As a child, you grew up in a household where your parents would often have loud arguments at night which made you feel scared. As an adult, you live next door to a couple who has loud arguments and you feel scared because your neighbors are triggering your earlier experience.

#2. You were traumatized during combat by a nearby explosion and after you leave the military, you react physically and/or emotionally when a car backfires near you.

#3. When you were a child, you were in a situation where you were scared and helpless and then, as an adult, you're in a plane where there's a lot of turbulence which triggers your childhood feelings of fear and helplessness.

    

    Note: In Example #3 the two situations are different, but what gets triggered, fear and helplessness, is the same.

There are many other obvious as well as subtle triggers that can impact you long after the original trauma occurred.

Shock Trauma vs Developmental Trauma

Psychological trauma is usually categorized as either a one-time trauma, also known as a shock trauma, or developmental trauma, also known as childhood trauma.

Shock trauma tends to be incidents that occur once, such as a tornado, a car accident, a robbery, and so on (see my article: Understanding Shock Trauma)

Developmental trauma, which is trauma that tends to be ongoing during childhood (see my article: How Developmental Trauma Affects How You Feel About Yourself).

Developmental trauma usually tends to be of a more serious nature because it's ongoing.  However, a shock trauma can also trigger symptoms related to developmental trauma.

For instance, if a person is beaten up and robbed, which is a one-time trauma, that one-time incident can trigger symptoms related to being physically and emotionally abused as a child.

So, even when it appears that there aren't layers of trauma involved with a one-time incident, a trauma therapist needs to explore whether there are underlying traumas that are getting triggered, similar to Example #3 above.

Intergenerational Trauma

In addition, psychological trauma can get unconsciously passed on from one generation to the next (see my article:  What is Intergenerational Trauma?).

Getting Help in Trauma Therapy

Unresolved trauma can get worked through in trauma therapy (see my article: What is Trauma Therapy?).

Getting Help in Trauma Therapy

There are now many different types of trauma therapy, such as:

EMDR Therapy (Eye Movement Desensitization and Reprocessing)

AEDP (Accelerated Experiential Dynamic Psychotherapy)

Somatic Experiencing

And other modalities that were developed specifically for trauma that can help you to work through trauma (see my article: Why Experiential (Mind-Body Oriented) Therapy is More Effective Than Regular Talk Therapy).

Rather than struggling on your own, seek help from a licensed mental health professional who is a trauma therapist.

Once you have worked through your trauma, you can live a more meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

With over 25 years of experience as a trauma therapist, one of my specialties is helping clients to work through unresolved trauma.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW.- NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Before and After Psychological Trauma

Many clients who start psychotherapy to deal with unresolved psychological trauma talk about life before and after their trauma.  Psychological trauma often changes a person's self perception as well as his or her perception of the world.  Whereas the person might have been self confident and the world around him or her made sense before the trauma, after experiencing trauma, self doubt and a feeling that the world is a precarious place can set in (see my article: Trauma Often Creates Negative Expectations For the Future).

Before and After Psychological Trauma

Assuming that a client was functioning at a high level before the trauma, one of the goals of trauma therapy is to help a client to get back to his or her former level of functioning.  If the client has other underlying trauma, like unresolved childhood trauma (also called developmental trauma), resolving these underlying issues is usually a goal of therapy (see my article: Working on Developmental and Shock Trauma in Therapy).

Fictional Clinical Vignette
The following fictional clinical vignette demonstrates this before and after effect of psychological trauma and how trauma-informed psychotherapy can help:

Cassie
Cassie started psychotherapy due to her recurring nightmares about her friend's fatal accident, which occurred more than a year ago.

Cassie explained to her psychotherapist that her friend, Nina, drowned while they were on vacation in New England on a beach that had no lifeguards.  They had been to this beach many times before.  They especially enjoyed that there were relatively few people on the beach early summer.

She told her therapist that Nina, who was a stronger swimmer, went for a swim while Cassie napped on their blanket.  Suddenly, Cassie was woken up when she heard Nina calling for help before she disappeared underwater.  Cassie said she ran into the water to try to save her friend but, she couldn't find her.

In a panic when she couldn't find Nina, Cassie ran back to the blanket to call the police on her cellphone.  Minutes later, help arrived, but they were unable to find Cassie.  The rescue team searched into the night and the next morning, but there was no sign of Nina.

A day later, the police came to the bed and breakfast where Cassie was staying and informed her that Nina's body washed up on the shore.  They told her that Nina was probably overcome by a strong undertow.

Cassie told her psychotherapist that she was devastated and, since that day, she had nightmares almost every night.  She said these recurring dreams were mostly the same:  She was in the water frantically trying to find Nina, calling her name, diving under the water to try to find her, yelling for help, but no one came (see my article: Understanding Shock Trauma).

She said she would wake up panting and in a cold sweat, and the effect of the nightmares tended to stay with her for the rest of the day.

Cassie said she kept replaying in her mind the minutes after Nina told her that she was going for a swim.  She remembered having the thought that Nina shouldn't swim by herself, especially because the water was rough, but she didn't say anything to Nina about this.  She assumed that Nina would be alright because she was such a good swimmer.

Now, all she could do is berate herself for not saying something to Nina or going with her for a swim so Nina wouldn't be alone, "Why didn't I tell her not to go in the water. I should have, at least, gone with her.  Why didn't I do it?"

Cassie said that, before her friend's fatal drowning, she was feeling optimistic about her life, looking forward to starting a new career, happy to be in a new relationship, and making plans for the future.  But, after Nina died, her whole world changed.

Even though she started her new career and stayed in her relationship, Cassie felt like she was just going through the motions.  On the surface, she tried to appear "normal" (her word), but beyond the facade she was trying to maintain, she felt confused, sad, and guilty.

Cassie was aware that her perception of herself and the world around her had changed dramatically since her friend's death, and she was tired of pretending that she was alright.  And, most nights, she was afraid to go to sleep because she dreaded her recurring nightmares.

When her psychotherapist asked Cassie about her family background, she described a loving family with no major traumatic incidents when she was growing up.  She felt emotionally supported by her family and her boyfriend, but she felt no one really understood what she was going through.

Based on Cassie's information about her family background and her description of the traumatic incident when Nina died, her psychotherapist concluded that there was no developmental trauma, so their work would be focus on helping Cassie to overcome the shock trauma related to the Nina's drowning.

Cassie's psychotherapist provided her with psychoeducation about trauma and explained that what she was experiencing were common reactions to a traumatic incident.  She also explained that trauma therapy, EMDR therapy in particular, could help Cassie to overcome her traumatic symptoms (see my articles: How EMDR Therapy Works: EMDR and the Brain and EMDR Therapy: When Talk Therapy Isn't Enough).

After they completed the preparation phase of EMDR therapy, Cassie and her psychotherapist worked on the traumatic memory of her friend's death, how helpless Cassie felt, and the guilt that remained with her.

Before and After Psychological Trauma

During the course of their EMDR work, Cassie revealed that, although a part of her wanted to feel better, another part of her felt she didn't deserve to feel better.  She was surprised at how strong the part was that felt she was undeserving.

Cassie's psychotherapist normalized this part that felt undeserving by informing Cassie that it wasn't unusual to feel this way under the circumstances.  She also explained to Cassie that they needed to do Ego States therapy (also known as Parts Work) to work with this particular part of her or it would create an obstacle to their work.

Cassie and her psychotherapist did Ego States work for the next couple of months to help soften this punitive part that felt Cassie was undeserving of feeling better.  After that, they were able to resume EMDR therapy and it went more smoothly.

The trauma therapy was neither quick nor easy, but her psychotherapist knew that experiential work, like EMDR therapy and Ego States work, is usually more effective and works faster than regular talk therapy (see my article: Why Experiential Therapy is More Effective to Overcome Trauma).

By the time Cassie completed therapy, she still felt sad about her friend's death, but she no longer felt responsible and guilty.  She regained her former self confidence and positive outlook on life.  She also felt worthy of making plans for the future and enjoying her life.  She also stopped having the recurring nightmares.

Conclusion
Most clients, who experience psychological trauma, report that they notice a difference in how they feel about themselves and the world around them after a traumatic experience.

It is as if there were a line that divides their experiences before the trauma vs. after the trauma.

As is often the case in trauma work, there can be a certain amount of ambivalence about getting better when an aspect of a client feels that s/he doesn't deserve to feel better.  This can present an obstacle to doing trauma work if it is not dealt with.

Fortunately, Ego States work, which involves the therapist and client dealing with this particular aspect of the client, helps to overcome this ambivalence so that regular trauma processing in therapy can resume and resolve the trauma.

Getting Help in Therapy
Psychological trauma doesn't usually resolve on its own, and ignoring it or hoping it will get better on its own usually makes the symptoms get worse over time.

If you're struggling with unresolved trauma, you could benefit from getting help in trauma therapy with an experienced trauma therapist who uses experiential therapy, like EMDR therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs and How to Choose a Psychotherapist).

After you have resolved your traumatic experiences in psychotherapy, you can live a more meaningful and fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples, and I have helped many clients to overcome unresolved trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Working on Developmental and Shock Trauma in Trauma Therapy

Shock trauma and developmental trauma are different types of traumatic experiences.  

In this article, I will define both shock and developmental trauma, discuss how clients often suffer with one or both, and provide a fictional clinical vignette to demonstrate how trauma therapy can help a client with both types of trauma to overcome his traumatic symptoms (see my articles: Understanding Shock Trauma and Overcoming Developmental Trauma).

Many People Experience Both Developmental and Shock Trauma

Shock Trauma vs. Developmental Trauma in Trauma Therapy
Whereas shock trauma usually involves a one-time traumatic event like a tornado, a car accident, being mugged, and so on, developmental trauma is chronic childhood trauma of neglect or abuse (or both) which occurs over time.

A one time experience of shock trauma with no other underlying issues and a high level of functioning  prior to the trauma is easier to resolve than chronic developmental trauma.  Under these circumstances, shock trauma without other layers of shock or developmental trauma can resolve relatively quickly with trauma-informed therapy.

Generally speaking, complex developmental trauma with layers of psychological trauma, will take longer to resolve because there is more than one traumatic experience.  There might be numerous traumatic experiences throughout childhood and also in adulthood.

Whereas it is easier to find a particular target memory in trauma therapy to work on for shock trauma because it is a one-time event, developmental trauma usually involves multiple memories over time.

In addition, if developmental trauma occurs early in childhood, the client might not have coherent memories of what happened due to the way traumatic memories are stored in the brain.

A person with preverbal (before the individual develops language) developmental trauma might only have access to conscious memories of one sense and no other senses.  For instance, he might only have a memory of a sound with no other sense of the memories (no visual, tactile, auditory, olfactory experiences are available).

This also occurs sometimes in shock trauma.  For instance, a client who was hit by a car and who never saw the car coming before he was hit, might only have a vague memory of hearing the siren of the ambulance.  Even so, in most cases, shock trauma is easier to resolve in trauma therapy than developmental trauma when it is a one-time event.

An experienced trauma-informed psychotherapist can work with whatever experiences a client brings to therapy, even if it is only a partial memory or a vague sense of what occurred.

There are also frequently cases where people come to trauma therapy to deal with shock trauma and they also have underlying developmental trauma.  So, it's not an either/or situation--it can be both shock and developmental trauma.

A Fictional Clinical Vignette:  Working on Developmental and Shock Trauma in Therapy
The following fictional clinical vignette is an example of a combination of shock and developmental trauma to illustrate how trauma therapy can help:

Ron
Ron began psychotherapy 17 years after the 9/11 World Trade Center attack.  He explained to his psychotherapist that he had been on the 10th Floor of the North Tower in the World Trade Center early in the morning on 9/11 when the terrorist attack occurred.

Working on Developmental and Shock Trauma in Therapy

He had vivid memories of feeling the impact of what he later learned was a plane as it crashed on the upper floors of the North Tower, his fear and confusion about what was happening, and how he and his colleagues ran down the stairs to safety shortly after the attack.

Afterwards, as he and his colleagues stood outside the North Tower, they were shocked to see a fire on the upper floors and the sound of fire trucks racing to the scene.  They were also shocked and upset to see people jumping from the Tower.

As he walked away from the building to safety, he tried to call his best friend, Joe, who worked on the 95th Floor of the North Tower, but there was no cellphone service.  So, he and several colleagues continued to walk north to the Brooklyn Bridge so they could get away from the scene and walk home to Brooklyn.

Less than 20 minutes later, Ron remembered hearing another crash.  The impact of the crash was so strong that the walkway shook and the bridge swayed.  When he turned around, he saw that the South Tower was also on fire.

Still not knowing what had happened, he stopped a police officer on the bridge, who told him that both towers were hit by planes and it appeared to be a terrorist attack.  Before Ron could ask any more questions, the police officer, who had been listening to his radio, began to run in the direction of the World Trade Center.

During his psychotherapy session, Ron told his psychotherapist that he and his colleagues, not knowing what else to do, continued to walk over the bridge with many other people who were trying to get away in a scene that felt surreal to him.

Less than an hour later while still on the Brooklyn Bridge, Ron and his colleagues heard and felt a tremendous crash, which they initially thought was an earthquake.  They looked in the direction of the Towers and saw that the South Tower was collapsing in on itself.

Ron and his friends felt momentarily paralyzed in place as they stood in shock, not quite believing what was happening.

Throughout it all, Ron kept trying to call his friend, Joe, but neither Ron's nor his companions' cellphones had a signal.

By the time Ron got home, he turned on his TV and heard that the North Tower had also collapsed.  He also discovered more details about the terrorist attack.

Since his office was closed for the rest of the week, Ron watched news coverage non-stop for rest of the week.  Every so often, he continued to try to reach Joe by phone, but his calls kept going to voicemail.

A few days later, he received a call from Joe's sister to let Ron know that Joe never came home.  The family was hoping that he would turn up, but they feared that he was trapped and killed at the World Trade Center site.

As Ron spoke to his psychotherapist about the events of that day and the following weeks, he was surprised at how emotional he still felt after almost 17 years.  He told his psychotherapist that he eventually learned from Joe's family that he was dead, which was a terrible loss.

He explained to his therapist that he "powered through" during the next several months without the help of therapy.  He thought he was managing, but he was surprised that he recently began having nightmares about the events on 9/11.

His psychotherapist provided Ron with psychoeducation about how people can develop traumatic symptoms many years after a traumatic event.

In subsequent psychotherapy sessions, Ron's psychotherapist asked him about his family history, and Ron revealed that his father was emotionally abusive throughout Ron's childhood, which left Ron feeling that he was powerless and unlovable.  He said that he continued to feel that way as an adult.

Ron also told his psychotherapist that he also felt powerless on 9/11 because initially he didn't know what was happening and he couldn't reach his friend, Joe.

Ron's psychotherapist provided Ron with additional psychoeducation to inform him that he was suffering with both shock and developmental trauma.  She explained to Ron that his earlier childhood trauma might have made him more vulnerable to the shock trauma that occurred as a result of 9/11, especially since he felt powerless as it related to both the shock and developmental trauma.

She recommended that they use EMDR therapy to work on the shock trauma first and then they would work on the chronic developmental trauma (see my articles: How EMDR Therapy Works: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

After the preparation phase of EMDR therapy, Ron and his psychotherapist talked about which 9/11 memories were the most disturbing and agreed to work on those memories first.  After a few months, they completed the EMDR processing of the 9/11 memories, including the loss of his friend, Joe.

Then, they proceeded to use EMDR therapy for the developmental trauma, which was more complex since it was ongoing throughout Ron's childhood and he continued to feel the emotional impact of his father's abuse as an adult.

Ron came to his psychotherapy sessions every week and worked hard in therapy and between sessions for the next several months.  The work was neither quick nor easy, but by the time Ron completed therapy, he was no longer was having nightmares, he no longer felt powerless or unlovable, he grieved the loss of his friend, and he no longer was affected by his childhood trauma.

Conclusion
Whereas shock trauma is usually related a one-time event, developmental trauma is childhood trauma that occurs over time, like physical abuse or emotional neglect.

People who experience developmental trauma are often more susceptible to developing shock trauma if they are exposed to a shocking or traumatic event.

It's not unusual for trauma-related symptoms to show up many years after the trauma, which can be confusing for anyone who experiences this.

Getting Help in Therapy
EMDR therapy is an effective type of trauma therapy to assist clients to overcome traumatic symptoms in both shock and developmental trauma (see my article: The Benefits of Psychotherapy).

Although EMDR therapy tends to be faster and more effective than regular talk therapy to overcome trauma, when there is complex developmental trauma, it can take time to overcome the traumatic symptoms.

If you have been suffering on your own with traumatic symptoms related to shock trauma, developmental trauma or both, you owe it to yourself to get help from a licensed mental health professional who is a trauma-informed psychotherapist (see my article: How to Choose a Psychotherapist).

Once you have worked through your traumatic symptoms, you have a chance to live a fuller, more meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma-informed psychotherapist who works with individual adults and couples.

I have helped many clients to overcome the both shock and developmental trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Psychotherapy for Shock Trauma

In my last blog post, Understanding Shock Trauma, I discussed shock trauma, including the types of traumatic events that can cause shock trauma and its symptoms. In this blog post, I will discuss psychotherapy and shock trauma and the treatment modalities that I find most effective in my psychotherapy private practice in New York City.

Psychotherapy for Shock Trauma

Psychotherapy for Shock Trauma - Initial Phase: Assessment and Developing Resources
When clients come to me to be treated for shock trauma, I assess each client with regard to the nature of the trauma and their internal and external resources. Before any processing of the trauma can begin, clients must have adequate internal and external resources or the trauma processing could be overwhelming for them.

What are Internal and External Resources?
When I refer to internal resources, I'm referring to a person's coping abilities. If the client doesn't have sufficient coping abilities, I assist them to develop them. Internal resources can be any of the following: an ability to meditate or calm oneself by taking calming breaths, visualizations of relaxing places, visualizations of supportive people in their lives, memories or associations of times in their lives when they felt good about themselves (confident, powerful, competent) and so on.

External resources can include friends, family, loved ones, mentors, coaches, or pets. If a client is in recovery for substance abuse or some other form of addiction, it could include 12 Step meetings, peers in 12 Step meetings, and sponsors.

Psychotherapy Treatment Modalities:
When dealing with trauma, I usually use mind-body oriented psychotherapy such as Somatic Experiencing, clinical hypnosis, or EMDR, depending upon the needs of the client. Sometimes, depending upon the needs of the client, I might use a combination of these treatment modalities. The treatment plan is a collaborative effort with the client.

Psychotherapy for Shock Trauma - Processing the Trauma:
Once the client has developed adequate resources, I titrate the trauma work so that it is performed in manageable pieces. (Titration means in manageable doses.) When dealing with the trauma, we're dealing with the reptilian brain (see prior blog post about the triune brain). The reptilian brain processes about 7x slower than the neo-cortex, so trauma work is, by necessity, slower than other types of work that is done in psychotherapy. If the therapist goes too quickly, the reptilian part of the client's brain will be overwhelmed and it will be to0 much for the client.

I help the client to move gently back and forth between manageable emotional activation related to the trauma and a calm emotional state so that the trauma work remains in a tolerable range.

The client is the best judge in terms of what he or she experiences in trauma work, so the client is in charge, and I am guided by his or her feedback during sessions.

Psychotherapy for Shock Trauma - The Goal of Treatment:
Using one of the mind-body oriented psychotherapy treatment modalities, the goal is for the client to process the trauma and to discharge the trauma-related "stuck" energy which is being held in the body so that the client can return to at least as good a level of his or her former level of overall functioning or better.

The discharge of "stuck" energy can come in many forms, including breathing out stressful energy, perspiring, yawning, experiencing tingling, and other forms of discharge. The client often senses when he or she has discharged the trauma-related energy that has been "stuck" in the body because there is a sense of calm or relief for the particular piece of trauma work that has been worked on.

Psychotherapy for Shock Trauma - Developing Self Compassion:
Many clients who begin trauma work blame themselves for what happened to them. They get caught up in negative cycles of self talk where they berate themselves, telling themselves that they should have known better or they shouldn't have gone to a particular place, etc. This only exacerbates their trauma symptoms.

During treatment, I help clients to realize that they're not to blame for what happened to them or for their trauma symptoms. Helping clients to develop self compassion is also part of the way I work with traumatized clients from the beginning so they don't get caught in negative cycles of self blame.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I work with individual adults and couples.

I have helped many clients to overcome traumatic events in their lives, including shock and developmental trauma, so that they can go on to lead productive and meaningful lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Understanding Shock Trauma

What is Shock Trauma?
As opposed to developmental trauma, which develops over time when traumatic events overwhelm a child, shock trauma occurs usually from an overwhelming one-time event. Shock trauma can occur to an adult or a child. It can occur from experiencing the traumatic event or witnessing it. The traumatic event is usually sudden, unexpected and has a distinct beginning and end.

Understanding Shock Trauma

Many people describe their experience of shock trauma as if their whole world has been turned upside down. They describe it as if the rug has been pulled out from under their feet. Often, their perspective of their internal world and the world around them changes and they feel unsafe and that life is very unpredictable.

As with any overwhelming event, the trauma is not in the event itself, but in the way the person experiences the event. As a result, two people can experience the same event and one person might become traumatized while the other person does not.

What Type of Events Cause Shock Trauma?
There are many different types of events, which can cause shock trauma, including:

• accidents
• natural disasters
• acts of war
• assaults
• falls
• invasive medical procedures, and so on

Understanding Shock Trauma

What Are the Symptoms of Shock Trauma?
Each person has his or her own individual experience with regard to shock trauma. These symptoms can include:

• anger
• anxiety
• panic attacks
• depression
• a sense of helplessness
• a sense of hopelessness
• a need to be vigilant all or most of the time
• flashbacks
• nightmares
• isolation
• loss of interest in activities that used to be pleasurable
• exhaustion

In my next blog post, I will discuss psychotherapy for shock trauma and the treatment modalities that I find most effective in my psychotherapy private practice in NYC.

About Me

I am a licensed psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist in New York City.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

See my article:  Psychotherapy For Shock Trauma