What is Trauma?

The American Psychological Association defines trauma as an emotional response to experiencing or witnessing an event involving actual or threatened serious injury, sexual violence, or death.

Examples of traumatic events include:

  • Serious accident or serious injury
  • Natural disaster (e.g., tornado, hurricane, earthquake, fire, or flood)
  • Sudden life-threatening illness
  • Being attacked with a gun, knife, or other weapon
  • Attacked without a weapon, but with the intent to kill or seriously injure
  • Severely beaten, or witnessing severe physical violence
  • Sexual abuse as a child or adolescent
  • Rape or attempted rape
  • Physical force or the threat of physical force leading to unwanted sexual contact
  • Aggravated assault
  • Combat or being in a combat zone
  • Accidental death or murder of a close friend or family member
  • Suicide of a close friend or family member

Common Reactions to Trauma

People may react to trauma in different ways. Some common reactions to trauma include:

  • Fear and anxiety
  • Re-experiencing of the trauma
  • Increased arousal, impatience, difficulty sleeping
  • Avoidance
  • Guilt and shame
  • Anger and irritability
  • Grief and depression
  • Feeling detached from others, experiencing emotional numbness
  • Difficulty trusting others
  • Negative self-image
  • Difficulty with sexual relationships
  • Use of alcohol or other substances

These symptoms are considered part of a normal reaction to experiencing a trauma. For many people, these difficulties get better with time. If you are still experiencing difficulties more than a month after experiencing a trauma, then it may be time to seek counseling.

Posttraumatic Stress Disorder (PTSD)

Not everyone who experiences trauma goes on to develop PTSD. For many people, post-trauma reactions gradually decrease over time. However, for others, these difficulties endure and continue to cause significant distress in the months or even years following the traumatic event. 

A diagnosis of PTSD may be appropriate if symptoms last more than a month and cause significant distress or interfere with daily activities, relationships, or work performance. 

Specifically, PTSD is characterized by the following categories of symptoms: 

  1. Re-experiencing of the trauma through nightmares, flashbacks, and intrusive, unwanted thoughts about the traumatic event
  2. Avoidance of reminders of the trauma, or of places/situations that seem more dangerous since the trauma

  3. Increased arousal and reactivity - this may include being easily startled, frequently feeling on edge, scanning your environment for potential danger and exit strategies

  4. Negative changes in beliefs or mood

Prolonged Exposure (PE) Therapy for PTSD

  • Prolonged Exposure Therapy (PE) is a form of cognitive behavioral therapy that is specifically designed to treat PTSD
  • It is an evidence-based treatment, meaning that research studies have shown PE to be a highly effective treatment for individuals experiencing symptoms of PTSD

  • Because avoidance is a major factor in maintaining PTSD symptoms, PE is designed to help individuals approach trauma-related memories, thoughts, feelings, and situations in safe, structured, and gradual ways

  • This gradual exposure process helps reduce the distress associated with memories and reminders of trauma, and decreases PTSD symptoms

  • PE helps individuals process traumatic experiences in order to try to make sense of what they experienced and to re-evaluate beliefs (about self, others, and the world) that stem from traumatic experiences

  • Treatment is typically delivered over the course of 8-15 sessions, lasting 90-minutes each. On average, most individuals experience significant relief from PTSD symptoms and complete treatment in 10-12 sessions.
  • Recommended Workbook: I recommend that all of my clients participating in PE purchase the Reclaiming Your Life from a Traumatic Experience Workbook. This workbook provides additional step by step guidance through the PE treatment program, providing summaries of information discussed during therapy sessions and worksheets for recording important information between sessions.