By Ho Shee Wai

Director & Registered Psychologist

What is trauma?

Cambridge dictionary defines trauma as “severe and lasting emotional shock and pain caused by an extremely upsetting experience, or a case of such shock happening”. The American Psychological Association defines trauma as “an emotional response to a terrible event like an accident, rape, or natural disaster.” To put it simply, trauma is an extraordinary event that is beyond our normal ability to cope.

Types of traumas

There are different types of traumas. Trauma can be a single acute incident (e.g., car accident), or a repeated, prolonged, ongoing chronic situation (e.g., domestic violence or abuse), or complex where there is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature. Trauma can be something you experience personally, it can be something you witness, or it can be something pass on to you (e.g., Intergenerational family trauma).

Personal nature of trauma

Many people imagine trauma to be this huge event in their lives. That is true. I would label these as Big T trauma. However, sometimes small event can give us the “severe and lasting emotional shock and pain” and this experience can varied from individual to individual. This is what I would label as Small T trauma. For example, being scolded by a teacher in primary school can be something one brush off while it’s something that caused another to be scarred for life. Regardless whether it’s Big T trauma or Small T trauma, the impact and effect on the person is similar.

When will trauma occur?

Trauma typical happens when we feel:

• Frightened

• Under threat

• Humiliated

• Rejected

• Abandoned

• Invalidated

• Unsafe

• Unsupported

• Trapped

• Ashamed

• Powerless

Trauma reactions

Immediately after the trauma event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms like headaches or nausea. At its extreme, the person will experience Post-traumatic Stress Symptoms (PTSD) where there is re-experiencing, avoidance, negative cognitions and mood, and arousal.

Healing from traumas

Some people believe that given sufficient time, we can get over trauma. However, the reality is the healing from traumas has less to do with time but more to do with going through the process. We all know of example of people still trapped in the experience of the trauma 10, 20, or 30 years after the traumatic event.

Process of Healing

What is involved in the process of recovering or healing from trauma? You'll need to resolve the unpleasant feelings and memories you've long avoided, discharge pent-up “fight-or-flight” energy, learn to regulate strong emotions, and rebuild your ability to trust yourself and other people.

Effective treatment for trauma recovery

Given the whole definition of trauma (i.e., an extra-ordinary happening beyond our coping), this is not something that you can do with self-help strategies. You’d need professional counselling or psychotherapy treatment from a psychologist, counsellor, or psychotherapist with specialized training in trauma.

In terms of therapeutic approaches, EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation that can “unfreeze” traumatic memories. EMDR is the golden standard in the areas of trauma treatment.

Additional, Somatic Experiencing is a body–mind therapy specifically focused on healing trauma by helping clients draw their attention to their bodies, processing trauma related emotions like guilt, shame, anxiety, etc.

Helpful self-care

While you cannot do trauma recovery on your own, it is necessary for you to have some self-care to help you deal with your reactions while you are undergoing treatment.

Physical self-care

Part of the trauma recovery process requires you to discharge pent up “fight-or-flight” energy. We do that by either getting it out (e.g., physical exercise / activities) or calming it down (e.g., relaxation or mindfulness / meditation). It’s also important to take care of your physical health ensure you are paying attention to your diet, sleep, and avoid the use of state altering substances like alcohol of drug.

Social self-care

After a trauma, it’s natural and normal that you’d want to withdraw or isolate yourself. While it’s important to have “lick your wound” time, it is important to ensure that you still have the social connection and support during this period. Being social doesn’t mean you need to be talking about the trauma (unless you want to). Doing something “normal” can help take your mind off temporarily from the trauma and remind yourself that you are loved and not alone. Some people find it helpful to join support group where there are others who had gone through similar trauma and can understand. Others find it easier to find new friends who have no idea that they are going through the trauma and just relate to them as regular person.

Emotional self-care

With trauma, our emotional state can be quite volatile with mood swings, feelings of sadness, anxiety, irritation, or anger. Some people cope by shutting down all emotion and being numb. Be sensitive and aware of how your sensory can easily become overloaded. While it’s ok to be feeling what you are feeling, you do need to make space and time for you to take a break from the emotional rollercoaster. Journaling, grounding exercises, etc are some tools that can help.

Cognitive self-care

Trauma survivors are often flooded with negative thoughts like “I’m broken” or “I don’t deserve to be treated well” due to misplaced self-blame. Trauma can also shatter your core beliefs, like that the world is safe and that humanity is innately good. During this period, it’s important for you to hold on to what you can still believe in, start small, example, I can believe the sun will rise again tomorrow.

At any time during this process, you may find it useful to ask for professional help from a psychologist, counsellor or psychotherapist. There are some circumstances under which you should definitely get professional counselling help urgently:

• If you find yourself feeling suicidal or contemplating suicide

• If you find that your daily functioning continues to be so impaired that you cannot carry out your life tasks

• If post-trauma fears interfere with your ability to return to certain places or situations that remind you of the trauma