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Trauma & Attachment Information

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What is Trauma?

Trauma is not defined by a specific event or type of experience. The same events can cause vastly different impacts depending on the person.

Trauma is the unique response and impact from an overwhelming experience.

Trauma is anything that causes overwhelm and pushes an individual or group beyond their coping abilities, resources and integration capabilities.

Trauma can be thought of as anything that is…

  • too soon
  • too much
  • for too long
  • lack of something needed – such as care, support or connection.

Trauma does not only occur from dramatic events; it often originates from a series of experiences or interpersonal dynamics that occur within relationship or organizations.

Overwhelm is impacted by:

Age when it OccursWhat is overwhelming to an infant is vastly different than to what overwhelms a young adult.

What happened Before Existing stress levels, health, resources, family dynamics, cultural/community factors, intergenerational factors, attachment, relationships and protective resources all matter.

What happened AfterThe support given, acknowledgment, comfort, care, validation, time to rest/heal, cultural/community relationship connections all have an impact.

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Types Experiences that may cause Trauma

Acute trauma

Often caused by an event that is sudden, shocking, short in duration and narrowly focused such as: a car accident, witnessing a disturbing event, disaster or an assault.   

Symptoms May Include:
Re-experiencing: Relive the traumatic event through distressing recollections, sensations, flashbacks & nightmares.

Avoidance: Emotionally numb; avoid places, people, memories & activities that are reminders of the trauma. Negative alterations in mood & cognition, feeling cut off from others, negative changes in mood, beliefs, ways of thinking & remembering.  Hyperarousal: difficulty sleeping & concentrating, jumpy, easily irritated & angered.

Chronic trauma

Exposure to repeated and prolonged overwhelming experiences such as ongoing abuse, war or conflict, racism, discrimination, bullying, medical/health challenges, domestic violence.  The symptoms may persist for several weeks, months, or years. Often within the context of specific relationships.  

Symptoms may include those for acute and also: 

Denial, rationalization, anxiety, depression, sadness, reactive to normal events, physical symptoms, guilt / shame, changes to self worth/self confidence, distorted perception of one’s environment, relationship & trust challenges, cognitive challenges, losing track time/sense of disconnection.    

Complex trauma

Exposure to multiple overlapping & overwhelming experiences that blend into one another without adequate support or security; often beginning in infancy or childhood that may impact development and learning.  Experiences are often invasive & interpersonal, and may involve family or close contacts such as:  emotional neglect & abandonment, abuse, intergenerational incidents, medical challenges, or long separations from caregivers.  Ruptures in the connection with predictable, consistent, stable, and nurturing caregivers can contribute to CPTSD.  

Symptoms may include all of the above and possibly:  dissociation, self harm/suicide, addictions, memory challenges,  isolation, health challenges, relationship challenges, persistent low self worth/shame.  

Attachment Styles

Attachment, or the attachment bond, refers to the emotional and physical connection formed between an infant and the primary caregiver.   The quality of attunment, security, and predictability of this bond as a child often impacts relationships and trust, relate to other people and create & respond to intimacy throughout the lifespan. 

With support, guidance, self compassion, self awareness and intention it is possible to shift from insecure toward more secure attachment as an adult.

Secure Attachment

The primary caregiver’s proactive, nurturing, attuned and predictable response to an infant’s emotional and physical needs, shows the infant that they are safe, important and understood most likely creating secure attachment.  When caregivers cannot be available because of life circumstances, other attuned caregivers combined with intentional repairs & reconnection can support secure attachment.  Those who have mostly secure attachment often feel self-confident, trusting, hopeful, able to manage conflict, respond to intimacy, and navigate the ups and downs of close relationships.  

Insecure Attachment

If the primary caregiver’s response was inconsistent, confusing, frightening, unreliable, or unpredictable than the infant’s emotional and physical needs were likely unmet; creating an insecure attachment   Infants with insecure attachment often become adults who have difficulty understanding their own emotions and the feelings of others which disrupts their ability to build relationships that are mutually satisfying.  Often these relationships feel frustrating and tumultuous with unmet needs and communication challenges.  There might be difficulty connecting with others authentically, intimacy challenges or a tendency toward detachment, hyper – independence, anxiety, fears, or worry in relationships.  The insecure attachment styles are:  ambivalent, anxious, or disorganized.  

Two people at a table talking about trauma counselling and how to build secure attachment through counselling in Nanaimo British Columbia

Building Secure Attachment

Experiences that occur between infancy and adulthood can also impact and shape relationships both by repairing attachment or by adding further layers of insecurity.   However, because the infant brain is immature and in the process of developing; the influence of the initial attachment bond has an immense impact.   Attachment tendencies occur on a continuum and it is most common that there is a blend of secure and insecure attachment. 

It is possible to build secure attachment in adulthood and to create trusting, satisfying, resilient and authentic relationships!

Responses to Trauma

When faced with a threatening & dangerous, perceived threatening situation or a reminder of a past threatening situation, the brain and body reacts automatically in order to increase the chances of survival.   These responses are evolutionary adaptations which occur immediately and instinctively without conscious choice or awareness.  These responses may stay activated or become reactivated within the nervous system long after the precipitating experiences are over.    This prolonged activation or reactivation becomes enmeshed with personality traits and preferences; functioning for long periods in these states is common and may cause troubling symptoms and maladaptive patterns.  

How these responses manifest is individually determined; often occurring on a continuum.  They all have related physical changes such as:  body tension, sleep disturbances, digestive shifts, tingling, numbness, constriction, racing heart, exhaustion, brain fog, sweatiness, pain, or lack of awareness of physical sensations.   

These are critical and important responses.  Symptoms may occur not because of the response itself, but because circumstances prevented the response from completing or perhaps support and care were lacking. 

Video: How the Brain Adapts to Adversity
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Video: How Your Attachment Styles Affect Your Relationships
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Video: 2-Minute Neuroscience: PTSD
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Types of Responses

Fight

Sympathetic Nervous System:  Urge to fight back when threatened or faced with danger to physical & emotional wellbeing in order to restore safety.  

Over time – physical challenges, angry outbursts, expecting the worse, defensiveness, mistrust, rigidity, combative, argumentative, emotional agitation, irritation.

Flight

Sympathetic Nervous System:  Urge to run away to escape any type of threat or danger to physical or emotional welling.  

Over time – physical challenges, worrying, procrastination, rushing, rigidity, avoidance, social anxiety, fidgety, restless, anxiety, hypervigilance.

Fawn

Sympathetic Nervous System:  Creating connection and attempting to appease the source of danger & threat, taking care of the source of danger & threat.  Over time – People pleasing, perfectionism, putting the needs of others first, fear of self expression, fear of belonging disconnection from self, low self confidence, lack of sense of self.

Freeze

Parasympathetic Nervous System:  Stuck scanning the environment and others for danger, leading to dissociating in response to the perceived threat or danger. 

Over time – spacing out, losing time, feeling unreal, brain fog,  numbness, difficulty making decisions, lack of connection with emotions & body sensations, feeling stuck, zoned out, feeling nothing, exhaustion.

Faint

Dorsal Vagel Branch of Parasympathetic Nervous System:  The body’s attempt to conserve blood flow to the brain to preserve life, reduce any activity in the body that might use too much energy, release pain relieving chemicals.  May progress to physical collapse, fainting or loss of consciousness.  

Over time:   Feeling tired or sleepy, numb, exhaustion, difficulty thinking clearly, feeling separated from life, memory challenges, wanting to curl up in a ball, disconnection from others, difficulty making decisions, zoned out, losing track of time, lost connection with self and identity. 

These are automatic & instinctual responses to danger & overwhelm that are part of our physiology and are critical for survival.   You make sense and it is possible to integrate and make shifts to support the flexibility of the nervous system.

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Stages of Therapy

There is no set timeline for these stages and there may be are lots of ups and downs with any health journey.  These stages suggest a general flow to the therapeutic process and provide an overall structure.  There is no requirement to move toward or through processing, if it doesn’t fit your goals or needs, the process is guided by you. Focusing on the first 2 stages may provide relief and positive shifts – mental health and wellness are possible in any of the stages and change can begin today!  

  • Acknowledgment

    Building secure therapeutic alliance based on dignity, care & respect; identify general goals; exploring hope for the future & supports for change; identifying strengths/resources/resiliency/supports; identifying symptoms; learning about the impacts of life experiences and education.

  • Security and Stabilization

    Building resources & tools, learning about trauma responses, self awareness resources; understanding emotions; communication & relationship skills; identify strengths; self care basics; practice using tools; create connections & support system; treatment planning; balancing stress & resiliency; creating positive moments; identifying security & safety.

  • Processing

    Building ability to stay present while acknowledging the past; making sense of the trauma response gently and slowly; awareness of body sensations, emotions, cognitions and meaning; Utilize EMDR & somatic modalities to process (intent is not to go into all the details or relive the past); build self compassion, self care and support.

  • Integration

    Build understanding of self and innate value; connect self awareness & compassion, integration of life goals; resiliency building, identify positive changes in life as a result of recovery process; steps toward satisfying and healthy relationships; restore a natural sense of wonder, awe and curiosity.

The goal of these stages is not to feel better about the distressing experiences, forgive others, or have positive feelings.  The intent is to support a sense of grounding and security in the present moment that supports self compassion and the capacity to manage the ups and downs of life with empowerment and resiliency.

ACES Study:
Adverse Childhood Experiences

This was the first study (1995 – 1997)  that explored the connection between experiences of abuse, neglect and dysfunction in the home on an adult’s overall physical, mental and emotional health.   This study by The Centers for Disease Control and Prevention (CDC) and Kaiser Permanente in the USA found a significant link between ACE (adverse childhood events) exposure and a higher likelihood of negative behavioral & mental health and physical health outcomes later in life, such as depression, addictions, anxiety, heart disease, diabetes and premature death.

https://www.cdc.gov/vitalsigns/aces/pdf/vs-1105-aces-H.pdf

A recent CDC survey ( 2019) in the USA found that 61 percent of adults had experienced at least one ACE and nearly 16 percent of adults have experienced four or more ACEs, and women and several racial and ethnic minority groups are at greater risk for experiencing a higher number of ACEs.

These results don’t suggest that if you have experienced Adverse Childhood Events that you will develop the related mental and physical health problems.  

The results do indicate that you may be at higher risk for these negative health outcomes, but more importantly it may be helpful and empowering to know that there are underlying contributing factors and that it is possible to improve your mental health with meaningful support. 

If you would like more information on the ACE Survey Questions: 

https://developingchild.harvard.edu/media-coverage/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean/

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