Traumatic experiences can have vast and long-term effects on an individual’s mental health. It can lead to mental health issues such as post-traumatic stress disorder (PTSD), depression, and anxiety. Trauma survivors often struggle to cope with the impact of trauma on their lives. Understanding trauma is essential for the journey towards healing.

Trauma can trigger a range of physiological responses as the body and brain react to a perceived threat or danger. Physiological responses could manifest as fatigue, exhaustion, sleep problems, hyperexcitability, somatic complaints, impairment of the immune system, loss of appetite.

Emotional reactions: Traumatic incidents could elicit anxiety related feelings such as shock, panic and fear.  It can also lead to guilt and self-blame and depression. Some people might experience helplessness and anger. 

Cognitive reactions: It is quite common to struggle remembering the details of the traumatic memory. Some people might also struggle with attention and concentration in the aftermath of trauma.

Interpersonal Reactions: After trauma, some people might feel lonely and distance themselves further from their loved ones. It might create a negative impact in friendships, relationships, and family ties.

What is Trauma?

Acute Stress Disorder (ASD): Traumatic events can lead to acute stress reactions, such as acute stress disorder (ASD), which is characterized by a set of distressing symptoms in the immediate aftermath of the trauma.  Acute Stress Disorder describes reactions that occur within 4 weeks following the traumatic event and last from 2 days to 1 month.

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop in individuals who have experienced or witnessed a traumatic event. PTSD is characterized by a range of symptoms that can persist for an extended period, often long after the traumatic event has occurred.

In short, the most important difference between the two disorders is duration of symptoms. 

Complex Post-Traumatic Stress Disorder (C-PTSD) is a psychological condition that can develop in individuals who have experienced prolonged and repeated traumatic events, often in the form of ongoing interpersonal trauma, such as childhood abuse, neglect, domestic abuse, war or multiple traumatic experiences during life. It can be seen as a disorder developing as a result of long-term trauma.

C-PTSD is considered a more severe and chronic form of post-traumatic stress disorder (PTSD), and it is associated with a broader range of symptoms that can affect a person’s mental and emotional well-being.

• Common traumatic experiences (e.g., physical or emotional abuse, natural disasters, accidents).
• Natural disasters
• Life threating accidents
• Physical and sexual Assaults
• War
• Violence
• Domestic violence
• Childhood abuse
• Sudden loss of a loved one
• Life threatening illness or injury
• Distinction between trauma and everyday stress. 

Stress is a normal physical response of the body to balance against events that cause a feeling of discrepancy between the tasks and the perception of being capable of meeting such demands. 

Psychological trauma is caused by unusual and unexpected events that make the individuals extremely frightened, terrified, and helpless. Many events occur in human life that cause distress and sadness, but not all of them cause psychological trauma. 

In traumatic experiences, continuity in daily life is unexpectedly disrupted or interrupted. Trauma occurs suddenly. Depending on how big the perceived threat is, it renders existing coping tools insufficient to a greater extent and makes an individual to struggle more with trauma related symptoms. It carries a clear or hidden threat to the existence of the individual, family, or community.

The Brain and Trauma

To understand why ASD or PTSD develops, it may be helpful to have a basic understanding of the brain. The Triune Brain Model was developed by neuroscientist Paul D. MacLean in the 1960s, and this model enabled understanding of cognitive functioning.

The brain can be divided into three main parts, from simple to complex structure:

1. Reptile Brain: It contains survival instincts. It manages body processes such as heart rate, breathing, and hunger.
2. Mammalian Brain (Limbic System): It contains the limbic system, which processes emotions such as joy and fear. It also regulates processes such as attachment and reproduction. 
3. Neomammalian Brain (Neocortex): It manages processes such as memory, self-regulation, learning, decision making and problem solving.

How trauma affects the brain is it shuts down all non-essential systems and switches to the “lower” brain system. This activates the sympathetic nervous system and helps release stress hormones, preparing you for “survival” mode: Fight-Flight-Freeze.

After a traumatic event, when the threat passes, your parasympathetic nervous system comes into play. This ensures that all three parts of your brain continue to function normally. In this way, you can process what you have experienced. However, in some people PTSD occurs and the brain remains in “survival” mode at all times. 

In the context of trauma, the role of amygdala in stress response that rapid threat detection and emotional processing can contribute to immediate survival by initiating defensive responses. However, the amygdala’s involvement in encoding traumatic memories and emotional reactions can also lead to long-term consequences, including the development of post-traumatic stress disorder (PTSD). In PTSD, the amygdala’s response to traumatic memories and cues remains heightened, leading to ongoing distress and re-experiencing of the trauma.

The Physiological Responses to Trauma

“Fight, flight, freeze, or fawn” response is a framework used to describe how individuals respond to perceived threats. It categorizes the various ways people react when they encounter situations that trigger their body’s stress response system. This framework acknowledges that not everyone responds in the same way to stress or danger although their response could be expected to be a part of flight-or-fight system. Here’s an overview of each response.

Fight: When there is a perceived threat, the body prepares to confront it with increased heart rate, blood pressure, and adrenaline and priming muscles for action. 

Flight: It is an instinctual response to escape from a threat or stressful situation by releasing stress hormones and activation of the cardiovascular system. The goal is to eliminate the perceived threat by removing one from the situation. 

The difference between the fight and flight response is whether the individual decides to confront or eliminate the threat.

Freeze: It is a survival strategy to reduce the likelihood of being targeted by the predator with temporary immobilization in the face of danger. The freeze response triggers the parasympathetic nervous system and might create sensations of numbness or disconnection.

Fawn: The fawn response could be considered as a less commonly acknowledged response which refers to appeasing or placating the aggressor as a means of survival. It usually develops in complex PTSD when there is long term abuse. The goal is to keep the peace or please the aggressor to eliminate threat.

The Long-term Effects of Trauma on the Brain

Neuroplasticity is the brain’s ability to learn, adapt and reorganize to adjust to environmental changes. It refers to brain’s capability of adapting by growing new neural pathways. It could be easily misconstrued that traumatized people won’t be able to go back to normal when the experience is too difficult to process and go back to daily life. 

Neuroplasticity allows people to go back to normal or even learn and grow after a traumatic experience no matter how sudden, unexpected or shocking the event is. Neuroplasticity offers hope, as it demonstrates the brain’s potential for recovery and healing. The brain can adapt and rewire itself to reduce the impact of traumatic experiences and improve mental well-being with early and right interventions such as psychotherapy.

How chronic exposure to trauma can rewire the brain.

Chronic exposure to trauma can rewire the brain, leading to long-lasting changes in its structure and function. This rewiring is a result of the brain’s adaptive response to prolonged stress and the need to cope with overwhelming and distressing experiences.

Trauma is closely linked to the development of several mental health disorders, including acute-stress disorder (ASD), post-traumatic stress disorder (PTSD), depression, and anxiety disorders. Traumatic experiences can trigger or exacerbate these conditions, and individuals who have experienced trauma are at a higher risk of developing them.

PTSD occurs after a traumatic event. However, not all individuals with traumatic experiences develop PTSD, it depends on the severity, duration, and the meaning of the event for the individual as well as the coping tools and social support network of the individual. 

Traumatic experiences, especially when they are severe or ongoing, can lead to hopelessness, helplessness, pessimism, and despair which are common thought patterns and feelings seen in the development of depression. 

Anxiety symptoms may include excessive worry, restlessness, panic attacks, and avoidance of situations or places which could be associated with trauma responses. The individual might also become fearful of experiencing another traumatic event and might start catastrophizing or expecting the worst in life. Such thinking strategies would exacerbate anxiety. 

Childhood trauma, which can include experiences such as physical, emotional, or sexual abuse, neglect, or witnessing violence, can significantly increase the risk of developing depression and anxiety later in life. Childhood trauma can affect brain development, particularly in regions associated with emotional regulation, such as the amygdala and the prefrontal cortex. The adverse experiences and stress associated with trauma can disrupt the healthy development of emotional regulation and coping mechanisms, becomes a risk factor for developing PTSD, C-PTSD, depression and anxiety in later life. 

Schema Therapy for the treatment of Complex PTSD (C-PTSD) or a difficult childhood

Schemas could be described as deeply ingrained patterns consisting of beliefs, emotions, behaviors, and attitudes developed in early life. They shape how we perceive and respond to our experiences.

In Schema Therapy, core needs refer to the fundamental emotional and psychological needs that individuals have, particularly during their early developmental years. During childhood, cognitive and emotional functions are still developing. Traumatic or adverse events, especially when repeated or severe, can disrupt healthy emotional and cognitive development, leading to the formation of maladaptive schemas. The difficulty might arise from parent’s lack of meeting core needs of a child such as love, safety, attachment, emotional support, supporting autonomy and helping with self-control as well as the right to play and discover. It can be also shaped by external factors such as parental illness and loss, disasters, and bullying. 

Maladaptive schemas are shaped by adverse experiences in our childhood as a response to unmet core needs and adverse experiences. They might be helpful in our childhood, but they turn into pervasive patterns shaping our experiences and not involve up to date coping tools in accordance with our later experiences. As a result, individuals might get stuck with similar situations in life and be unable to cope with them. 

Schema Therapy’s role in identifying and challenging these schemas.

The goal of Schema Therapy is to identify and challenge the maladaptive schemas, replacing them with healthier, more adaptive ways of thinking and behaving. This often involves exploring and understanding the origins of these schemas, processing associated emotions, and developing new coping strategies. 

The therapeutic process and its benefits

Schema Therapy is an effective, evidence-based psychotherapy approach designed to help with long term, pervasive mental health challenges. It is particularly helpful for people who had a difficult childhood for any reason or any childhood trauma as well as people with C-PTSD. 

Cognitive Behavioral Therapy (CBT) for PTSD 

CBT is an evidence-based, short-term psychotherapy approach which is found helpful treating PTSD. CBT techniques helps to reduce PTSD related symptoms with cognitive and behavioral strategies. Cognitive techniques support with the traumatic memory, associated shame and guilt, and helps to readjust distorted world views after trauma. Behavioral strategies bring relief in managing the reminders of the traumatic event, as well as reducing any avoidance behaviors associated with the event. 

Coping and Healing

Trauma is a sudden, overwhelming, life-changing experience which individuals’ existing coping tools might struggle to respond well to manage what happened, and as a result, life after trauma could get disrupted.

Although self-help strategies such as meditation, mindfulness, journaling, seeking social support are ways of coping with traumatic experiences, it might not be always sufficient. Because trauma shatters how individuals perceive the world, it might become vital to have a safe place to process what happened with an expert to be able to move forward which could be provided by psychotherapy. 

It’s important to choose the right therapist with expertise in trauma, PTSD and C-PTSD. People who receive help after a traumatic event are less likely to develop PTSD and more likely to recover from any trauma associated mental health problem. 

Conclusion

Traumatic experiences might bring long lasting, negative changes into an individual’s mental health such as depression, anxiety and PTSD, as well as behavioral changes and interpersonal difficulties with their families, friends and romantic relationships. It’s important to explore the impact of trauma in an individual’s life to manage the difficulties arose, process what happened and develop adaptive coping tools. 

Your well-being matters and everyone has the strength to move forward in life no matter how challenging the traumatic experience was. Seeking professional support can be a crucial step toward healing and reclaiming a sense of control over your life. 

The modern world is marked by high levels of stress and pressure. It is not a big surprise considering work demands, social expectations, financial burdens, and the constant connectivity enabled by technology. This has led to a rise in mental health issues like anxiety and depression.
As a result, there has been a growing awareness of mental health issues. People are now more open to discussing their mental health concerns and seeking help without feeling ashamed or judged.
Psychotherapy plays a crucial role in helping individuals cope with the challenges of modern life and achieve better mental health. However, psychotherapy is not only about addressing mental health issues but also about personal growth and self-improvement. Many people seek psychotherapy to have better communication skills, become more assertive, manage stress, and improve well-being and life quality.

What is CBT? (Cognitive Behavioural Therapy)

Cognitive Behavioral Therapy (CBT) is a widely used form of psychotherapy that focuses on helping individuals identify and change unhelpful thought patterns and behaviors. It is based on the idea that our thoughts, feelings, and behaviors are all connected. If individuals manage to alter negative thought patterns and behaviors, they can overcome various mental health issues.
CBT has been shown to be effective in treating a wide range of mental health conditions, including depression, anxiety disorders (such as generalized anxiety disorder, social anxiety disorder, and panic disorder), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and eating disorders.

CBT starts by helping individuals become aware of the content of thoughts which are often distorted or have negative thought patterns when they struggle with mental health issues. These thought patterns are known as cognitive distortions. Through cognitive restructuring, individuals learn to challenge and replace these distortions with more balanced thoughts. This process
aims to change the way individuals perceive and interpret situations. In addition to working on thoughts, CBT also addresses behaviors. Individuals learn to identify problematic behaviors and develop strategies to modify them. This may involve setting specific goals and practicing new behaviors.

CBT is typically considered a short-term and time-limited therapy. It often involves a specific number of sessions, and treatment goals are typically well-defined. This contrasts with some other therapeutic approaches that may be more open-ended in terms of duration.
CBT tends to focus primarily on the present and future rather than delving extensively into the past. While past experiences are considered, the main emphasis is on understanding and addressing current thoughts, emotions, and behaviors to bring about change. Many other psychotherapeutic approaches would heavily emphasize on childhood and past experiences.

Understanding Schema Therapy:

Schema Therapy is an integrative therapy approach developed for the treatment of long term, recurrent, resistant, or chronic emotional and interpersonal problems. Schemas are enduring and self-defeating beliefs and patterns of behavior that develop early in life and can impact a person’s self-concept, relationships, and overall well-being. Schema therapy aims to identify
these schemas, understand their origins, and work to modify them, leading to healthier, more adaptive ways of thinking and behaving.

Schema Therapy takes a holistic approach to understanding and treating individuals by considering the interplay between thoughts, emotions, behaviors, and relational dynamics. It aims to create lasting and comprehensive change in clients’ lives.
Schema Therapy’s unique combination of cognitive, emotional, and relational elements makes it well-suited for individuals with deep-seated emotional and interpersonal issues, especially those associated with long term, chronic or recurrent mental health conditions. It is also useful for individuals wanting to understand and address the root causes of their struggles. It seeks a
unique balance between understanding the root causes and doing past work but also focusing on enabling change in the present.

When Schema Therapy is recommended

Chronic Depression: For individuals who experience recurrent or chronic depression that has not responded well to other treatments, Schema Therapy can be an effective option. It helps to identify and address the underlying schemas and modes that contribute to depressive episodes.
Complex Trauma (cPTSD): Schema Therapy is useful for individuals who have experienced complex trauma, such as childhood abuse or neglect. It helps them process the emotional wounds from their past and develop healthier coping mechanisms.
Recurrent Relationship Problems: Individuals who struggle with recurrent relationship problems, including difficulties with intimacy, trust, and communication, may find Schema Therapy helpful.
Low Self-Esteem: Schema Therapy is recommended for individuals with self-esteem issues. It helps clients develop a more positive and coherent self-concept.
Interpersonal Difficulties: When individuals have ongoing interpersonal difficulties, such as intense anger, difficulty asserting themselves, people pleasing or excessive need for approval, Schema Therapy can assist in addressing these issues.
Individuals Interested in In-Depth Self-Exploration: Some individuals may choose Schema Therapy because they are interested in deep self-exploration and gaining a better understanding of their core beliefs, emotional responses, and interpersonal patterns.

Why Choose a Specialist in Both CBT and Schema Therapy?

A therapist trained in both CBT and Schema Therapy has a comprehensive understanding of these two evidence-based approaches. This means they can provide a more nuanced and holistic assessment of your issues, incorporating the strengths of both modalities to tailor a treatment plan that addresses your unique needs.
With a therapist who is well-versed in multiple modalities, you have the flexibility to explore a wider range of therapeutic techniques and strategies, allowing for greater adaptability as your needs evolve over the course of treatment.

CBT is a short-term, goal-based approach which focuses on reducing symptoms and recovery from the mental health issues. On the other hand, Schema Therapy focuses on the root causes of the issues which are often embedded in childhood and early life experiences. The purpose of it is finding out the origins, and the link between current struggles with the goal of a life transformation where the individual no longer struggles with such issues and reducing the risk of the problem becoming recurrent or long term.
Many clients benefit from a combination of short-term, symptom-focused therapy and longer-term therapy. This approach helps them manage current symptoms while also addressing the root causes of their issues for long-term healing and relapse prevention.
Different modalities offer diverse coping strategies, equipping clients with a more extensive toolkit for managing stress, triggers, and life challenges.
Some mental health issues are multifaceted and deeply ingrained, such as personality disorders or complex trauma. A combined approach can address these complex issues more effectively by using a variety of therapeutic techniques.

The Importance of Choosing the Right Therapist in London:

In the UK, the primary regulatory bodies for psychotherapists and counselors include the UK Council for Psychotherapy (UKCP) and the British Association for Counselling and Psychotherapy (BACP). Registration with these bodies demonstrates that the therapist meets certain professional standards and ethical guidelines.
Depending on your needs, find a therapist who specializes in the type of therapy and issues you are dealing with (e.g., cognitive-behavioral therapy, Schema Therapy, depression, anxiety, relationship problems, etc)

What to Expect in Your Sessions with Our Therapist in London:

The initial consultation.
The first psychotherapy session, often referred to as the initial assessment or intake session, is
a crucial step in beginning the therapeutic process. The initial session is an opportunity for both
you and the therapist to assess whether you are a good fit for each other and whether the
therapist’s approach aligns with your needs and goals. It’s to understand the issues and assess
the fit. It is also different than a regular therapy session which you and the therapist will work on
the issues.

Setting goals and therapy timelines.
Setting goals in psychotherapy is an important part of the therapeutic process. Goals help you
and your therapist focus on what you want to achieve and provide a framework for your
sessions. It would enable you to know what you are working on and provide guidance for the
direction to take. It also factors in how many sessions you would need depending on your
expectations from therapy.

The welcoming and confidential environment.
Psychotherapy is safe and secure environment where you can openly explore your concerns
and work toward personal growth and well-being. Confidentiality is a fundamental principle in
ensuring your safety, and your personal information and discussions are kept confidential.

Conclusion:

Taking the first step can be challenging, as it might be anxiety inducing to meet a new therapist and open up about your struggles. However, it’s a courageous and empowering act that can set
you on a path to a happier, healthier, and more fulfilling life.
No matter where you are on your path to mental well-being, let’s create a safe and nurturing space where you can share our struggles, and be listened with empathy, and work towards a more balanced, and healthier state of mind.