June is PTSD Awareness Month. While we experience and watch so many negative things happening in the world today, it is important to discuss the “T” in PTSD- trauma. Trauma infiltrates people’s lives and can make living in this world very difficult for those who hold it. To heal from traumatic experiences, it is important to know what trauma is, how it is expressed, and the lesser-known reactions to trauma. 

What is Trauma?

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According to author Jenni Schafer from the Meadows Ranch, trauma is “anything less than nurturing that alters your view of yourself and how you relate to the world.” What is traumatic to one person may not be traumatic to the next. Up to 20% of people who experience trauma will go on to develop PTSD. However, trauma victims without a PTSD diagnosis often display the same reactions to trauma as those with a diagnosis. Common symptoms of PTSD include:

• Avoidance behavior
• Shame
• Flashbacks/ Nightmares
• Difficulty regulating emotions

While these are common reactions to trauma, everyone can react to trauma in different ways. There are many lesser-known reactions to trauma that are often overlooked in impact. 

Lesser-Known Reactions to Trauma

When you think about the word “trauma,” you will probably think about an image commonly associated with it. Reactions to trauma are often depicted as intense flashbacks, horribly realistic nightmares, and having strong reactions to “triggers.” While these are true reactions to trauma, there are many more lesser-known reactions to trauma that can be just as damaging to the victim.

Dissociation

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We are taught about the “fight or flight” response to stress. This theory suggests that our bodies are flooded with hormones in the face of stress that tell us to either run away from the problem or stay and fight it. What is lesser-known about this theory is the next component of the “fight or flight” response- “freeze.”

The clinical term for this “freeze response” is called dissociation. Dissociation is the “state of disconnection” between your body and the outside world. Instead of fighting the stress, or fleeing from it, someone who “freezes” may do nothing in the face of trauma. Instead, they may separate themselves from the trauma mentally.  Everyone dissociates to a certain degree, even without the presence of trauma (i.e. “spacing out”). However, dissociation becomes a problem when those who experience trauma use it to detach themselves from stress. Dissociation occurs in trauma victims in different ways, including:

• Having memory loss that leaves large gaps in your timeline
• Feeling like  the world around you isn’t real
• Feeling like your body isn’t real
• Having “out-of-body experiences” where you observe yourself as a third party

Dissociation is a dangerous reaction to trauma because it prohibits the person experiencing it from living in the moment. Dissociation also leaves people at risk of self-destructive behaviors. If you are disconnected from your body, you are more likely to abuse it with things like substance abuse, eating disorders, or self-mutilation. Those experiencing dissociation needs to reach out for professional help to learn healthy coping mechanisms. 

Identity Disturbance

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Another lesser-known reaction to trauma is a disturbance in the victim’s identity. Like dissociation, identity disturbances occur when the victim separates themselves from their trauma. This can lead to a loss of sense of self. This is especially true in children who experience trauma early on. According to psychiatrist Grant Hilary Brenner, identity problems occur in trauma victims when “basic survival takes precedence over, and uses resources ordinarily allocated for, normal development of the self.” This is seen frequently in people with Borderline Personality Disorder, which is often comorbid with trauma and PTSD. Lacking a sense of self often causes extreme anxiety in a trauma victim because it makes it difficult for that person to see themselves in the world. They may have a hard time expressing their identity in ways that other people don’t. For example, we often express ourselves by:

• The way that we dress
• The things that we enjoy
• The opinions that we hold about various subjects

Someone with identity disturbances due to trauma may have difficulty establishing these things about themselves. It is more than just changing your mind about something, which everyone does. Rather, it is the dramatic swing from one sense of identity to the next, often changing from day today. When this happens, it can be hard for trauma victims to know who they are. 

Chronic Pain

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According to PTSD expert Dr. Matthew Tull, 20-30% of people with PTSD also exhibit symptoms of chronic pain. This can happen for several reasons. For people who have trauma related to physical injury, chronic pain is very likely. However, there are other, lesser-known reasons why someone with trauma can experience chronic pain. Trauma-related anxiety can lead to symptoms of hyper-arousal, leading to chronic pain. These symptoms include:

• Tense muscles due to hypervigilance
• Increased heart rate causing chest pain
• Loss of sleep leading to chronic headaches 

Pain can also be caused by disorders that are often comorbid with PTSD. Disorders like depression often lower physical activity. This can spiral into poor health practices, which increases the likelihood of chronic pain. To treat PTSD related pain, healing from your trauma is the most important step. 

Conclusion

Trauma can occur when a negative experience causes extreme psychological stress. Everyone diagnosed with PTSD has experienced trauma. However, people without PTSD also experience trauma, and it can be just as damaging. Everyone reacts to trauma differently, but there are common reactions to look out for. Lesser-known reactions to trauma, like dissociation, identity disturbance, and chronic pain, can be just as damaging as more commonly experienced symptoms. 

Talking about the lesser-known effects of trauma is important so that those who may not understand their symptoms can seek treatment. We must look beyond the symptoms that are good for entertainment and see this disorder in its entirety. Everyone deserves peace of mind, regardless of your diagnosis or symptoms. We must be open to discussing ALL of the symptoms of trauma to ensure treatment and healing for everyone affected. 

Written by Bethany Fischer, blogger at Safe Harbor International Ministries. For more articles, visit www.safeharborim.com/articles/

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