How is a psychological trauma treated

Symptoms of mental trauma

How does a psychological trauma express itself?

Many of those affected notice very unusual experiences in themselves, often for the first time in their lives, such as severe confusion or automatically recurring memory images and are afraid of "going crazy". In reality, this is a completely normal reaction to the often completely "crazy" and abnormal situation that they have experienced.

However, like our body, our soul has strong self-healing powers. We can provide targeted support if we familiarize ourselves with the natural trauma process. This takes place in three phases: the shock phase, the impact phase of the trauma and the recovery phase.

Shock phase

Confusion, inability to remember important data, e.g. your own telephone or house number - these are all characteristics of the shock phase, which can last from an hour to a week. In an acute state of shock, the skin color is pale, the breathing is fast and shallow, the affected person has a dazed look, sometimes they think they are in another place. Measures to calm down and stabilize the circulation are indicated here. In general: medically necessary measures have priority over psychological first aid. Usually, however, there is a supplementary relationship here.

Exposure phase

This is followed by the impact phase of the trauma. It can last up to two weeks. Now the strongest excitement has subsided, but those affected are completely absorbed by the events. Again and again, as if under duress, they have to report on the incidents. There is strong self-doubt, often depression as well as feelings of hopelessness and powerlessness. Even with people who were previously rather optimistic, all the positive possibilities in life appear to be a long way off. Instead, many complain about their own mistakes. In alternation, tantrums and violent charges against possible perpetrators can occur, whether these claims are justified or not. Often during this time there are problems with falling asleep, overexcitability, wakefulness, increased nervousness, memory disorders, concentration difficulties, nightmares and reverberations of the traumatic event. When there are deaths, especially in their own families, some survivors experience severe depression and reproach themselves for having survived (so-called "survival guilt").

Recovery phase

After 14 days, sometimes only after four weeks, some of those affected begin to recover from the trauma. If more terrifying news or stressful life circumstances are added, the recovery phase is delayed and may even fail completely. At best, the permanent excitation now also drops. Not every thought of the traumatic event triggers the full horror again. The interest in normal life and in other people returns. The future plans are seen more positively. The traumatic event is still of central importance. It can take a long time before our view of the world and our understanding of ourselves are reworked in such a way that the traumatic incidents can be incorporated. For many, the trauma is an occasion to think carefully about their previous life and to rethink their future planning. But energies must be free for all of these steps. You will no longer be absorbed by the traumatic incidents when the recovery phase approaches.

What to do if the recovery phase does not take place?

Quite a few of those affected do not recover as quickly from the traumatic stress. This may be because they have suffered particularly serious physical and / or emotional injuries. A precise time schedule for healing cannot be determined in the case of mental injuries, or in the case of a physical wound.

If the consequences of the trauma last longer than a month, a condition often occurs that is characterized by the following appearance:

  • The starting point is a stressful event that was experienced in a state of objective or subjective helplessness. Stressful living conditions that existed over a long period of time can have a similar effect.
  • Recurring, sudden memories of the event, e.g. in nightmares or in so-called "flash-backs", in "reverberation memories", in which, like in a horror film, scenes of the traumatic event keep recurring. Sometimes only fragments emerge, such as smells, sounds, or body sensations that seem unrelated to the incidents.
  • Avoidance of anything that reminds or could remind of the trauma, e.g. fearful avoidance of trains and trams if a train accident caused the trauma or even talking about trains, trams or other means of transport. The fearful avoidance attitude can spread over time.
  • An increased excitability and frightfulness. Those affected cannot find peace and are shocked at all unusual occurrences, not only those related to the trauma. The autonomic nervous system, which regulates the vital functions of survival in humans, is on constant alert. It is as if an engine is running at full speed without moving a distance.

These features together form a disorder that we call psycho- or post-traumatic stress disorder (PTSD) describe.

Immediately after a traumatic event, these and other complaints, such as severe depression and self-doubt or overwhelming anger, are found in most sufferers. We're not talking about PTSD here yet. Anyone who barely escaped from a great danger will still feel a state of excitement all over their body after the rescue. The knees are trembling, many also feel a tremor in the jaw joint and in the pelvic region. This marks both the shock phase and the impact phase of the trauma. However, if recovery does not occur permanently, there is an increased risk of negative long-term consequences. So if longer than four weeks

  • Reverberation memories and nightmares persist
  • When the fear of anything reminiscent of the event continues or spreads
  • When the heightened excitability persists and you cannot calm down

then you should consider professional help from a psychotraumatologically trained specialist advisor or psychotherapist. You can also carry out auxiliary measures and exercises yourself, which you will find in the detailed self-help brochure NEW PATHS FROM TRAUMA, in order to further support your natural self-healing process or to get it going again. Often that also helps. In some cases, however, psychotherapy is highly recommended. It doesn't have to be nearly as complex as is often feared.

Info: trauma therapy

A study at the University of Cologne has shown that people who have suffered a severe trauma and belong to the risk group for long-term effects in terms of PTSD can be permanently stabilized and healed in an average of only 10 therapeutic sessions with a therapy method known as multidimensional psychodynamic trauma therapy (MPTT). It is a procedure that combines behavioral therapy and depth psychological principles. It specifically supports the natural self-healing process after trauma and removes its obstacles. Some techniques from the MPTT can also be used in self-experiments. The many years of experience with this scientifically proven procedure also give rise to the tips for self-help, which are given here in short form, in more detail in New ways out of trauma.

Which events often have negative long-term consequences?

You can use the following list like a "checklist" to take a closer look at yourself or your acquaintances and friends:

  • Danger to life and limb or subjectively experienced threat to life
  • Serious physical injury
  • To have been intentionally injured or harmed
  • Confrontation with disfigured or mutilated human bodies
  • Sudden or violent death of a loved one
  • Watching or finding out that someone close to us has been subjected to violence
  • Being exposed to or having experienced a toxin or infection
  • Causing death or serious injury to another person

The explosiveness of the last-mentioned incident is often misunderstood. Anyone who has caused the death of another person, for example in a traffic accident, is often treated like a perpetrator by others. At the same time, he tends to make violent accusations towards himself. Such influences can easily combine to form a "negative spiral" which leads to a "psychotraumatic stress syndrome".