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By Dr. Ken Manges, PhD | Forensic Psychologist

Trauma 2

An Overview of the Effects of Emotional Trauma

Trauma is experienced by an individual as physically or emotionally harmful or threatening as a result from an event, series of events, or set of circumstances. Trauma can have lasting adverse effects on an individual’s functioning and emotion, social, physical, or spiritual well-being (Substance Abuse and Mental Health Services Administration [SAMHSA], 2005).

Emotional trauma can result from events with or without physical damage. Emotional trauma typically contains three common elements: (1) the event was unexpected; (2) the individual was unprepared; and (3) there was nothing the individual could do to prevent the event from happening. Not all persons respond to the same event in the same way. Research suggests that 33% of persons who witness the same event do not get diagnosed with Post Traumatic Stress.

It is unpredictable how a given individual will react to a particular event although a person’s pre trauma emotional history may give us a clue if the person will be traumatized. When there is a history of trauma there is an increased likelihood for re-traumatization.

Therefore, it is not the event itself that determines whether something is traumatic to someone, but the individual’s experience of the event.

There are several potential causes of emotional trauma. The events that are typically thought of to be traumatic include physical assault such as rape, domestic abuse, and molestation; natural disasters; serious automobile accidents; and experiencing or witnessing injury or fatalities. Emotional trauma can also result from events that are often overlooked such as sports or work injuries, serious illness, birth trauma, and hearing about violence to or sudden death of someone who was significant to the survivor.

In regard to emotional trauma in childhood specifically, forced separation very early in life from their primary caregiver, mal-attachment of caregiver with a and/or physical or mental illness would be elements to consider when diagnosing emotional trauma etiology. It is recognized that when trauma occurs early in life a vulnerability for experiencing traumatic responses in the future is a likely result.

In addition, there are also several symptoms of emotional trauma involving emotional, physical, and cognitive responses. These responses can sometimes be delayed for months or even years after the initial traumatic event. Emotional symptoms may include depression, panic attacks, anxiety, fearfulness, and withdrawal from normal routine and relationships. Persons may show no external symptoms after an event but later will respond atypically with extreme emotional distress to what would otherwise be considered minor.

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Physical symptoms may over or under eating, no need or an increased need for sleep, low energy or excessive “manic” energy levels, and complaints of pain. These extremes adversely affect the person’s routine and they can become less able to perform work, pay attention at school or have disrupted interpersonal/intimate relationships.

Cognitive symptoms may include memory lapses, feeling distracted, decreased ability to concentrate, and difficulty making decisions. Some may exhibit what are termed “pseudo seizures.” A seizure in the absence of identifiable lesions in the brain.

In addition, re-experiencing the trauma commonly referred to as a flashback, as well as, emotional numbing and avoidance of a situation that reminds the person of the event are symptoms of emotional trauma. Post traumatic stress disorder, was originally diagnosed with war veterans and became a popular term of art after Viet Nam, was actually diagnosed under a different name during the Civil war and is now know to occur in response to a severe triggering event such as exposure to rape, child abuse, major car or airplane crash, or natural disaster.

Emotional trauma can create lasting effects on an individual’s life in numerous ways. There are typically recurring problems an individual may experience that effects their personal life, work life, their behavior, and/or their interpersonal relationships. Common personal and behavioral effects of emotional trauma include substance abuse, self-destructive and impulsive behavior, dissociative symptoms, compulsive behavior patterns, and an inability to make healthy professional or lifestyle choices.

Common effects of emotional trauma on interpersonal relationships include inability to maintain close relationships or choose appropriate friends, social withdrawal, hostility, feeling constantly threatened, and arguments with family members, employers or co-workers. Briefly, traditional approaches to the treatment of emotional trauma include talk therapies, cognitive-behavioral therapy, flooding (total immersion) in the reliving of the event and systematic desensitization. Recent developments include new, effective forms of psychotherapy and somatic therapies such as eye movement desensitization/reprocessing and somatic psychotherapies (Santa Barbara Graduate Institute Center, 2012).

Past Research

Extant research has explored the relationship between emotional trauma and several topics such as children’s exposure to violence and physical injury. In a study conducted by Singer, Flannery, Guo, Miller, and Leibbrandt (2004), the authors found that emotional trauma was related both significantly and positively to recent and past exposure to violence in children. Recent violence exposure was associated with increased emotional distress including witnessing violence at school, being a victim of violence in school or in the neighborhood, being a witness or victim of home violence, and being sexually abused. Past violence victimization, witnessing of violence, and sexual abuse were also associated with emotional trauma symptoms.

In addition, studies have also examined the relationship between emotional trauma and physical injuries. In a study conducted by De Sousa, Sonavane, Kurvey, Kukreja, and Shah (2013), the authors examined the emotional trauma resulting from physical hand injuries. The results revealed that the commonly reported emotional effects of hand injuries included post-traumatic stress disorder and associated depression. Also, other significant emotional responses included appearance related concerns and body image issues, avoidance of work, pain, sleep disturbances, and impairments in social functioning.

Furthermore, in a study conducted by Schneider et al. (2012), the authors examined the lives of survivors from a large fire both with and without burn injuries. Results showed that survivors experienced emotional impairments in the four outcome measures studied: post-traumatic stress symptoms, depression symptoms, employment, and quality of life. Survivors with burn injuries experienced worse outcomes than survivors without burn injuries in the outcome measure of employment. However, survivors without burn injuries experienced worse outcomes than survivors with burn injuries in the outcome measures of post-traumatic stress symptoms, depression symptoms, and quality of life.

Studies from Vietnam veterans showed medics and photographers who were exposed to horrific war events but did not carry weapons experienced a similar rate of Post Traumatic Stress as did the soldiers who were returning fire.

Summary

In conclusion, emotional trauma is one of the main forms of trauma experienced by both adults and children which can result from various events such as rape, natural disasters, automobile accidents, sports or work injuries, and serious illness. Symptoms of emotional trauma involve emotional, physical and cognitive responses such as depression, anxiety, eating and sleep disturbances, memory lapses, and decreased ability to concentrate. Emotional trauma can create lasting effects on an individual’s personal life, their ability to perform work, and/or their interpersonal/intimate relationships. Traditional and newer treatment approaches exist such as talk therapies, cognitive- behavioral therapy, eye movement desensitization/reprocessing, and somatic psychotherapies.

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Dr. Kenneth Manges, is a Forensic Psychologist and vocational expert who offers consultation and comprehensive evaluations. His analyses have been recognized for their clarity and scientific rigor. He offers reasonably certain opinions about the psychological impact of physical injury or emotional trauma as they effect earning capacity and the impact of loss on future work and quality of life.  Well regarded in the litigation arena, he is a trusted and respected authority and offers evaluations that have been consistently upheld in both state and federal courts.