Trauma and our society
As Bob Dylan once noted some years ago in his popular song, “The Times Are A-Changin’,” and it appears that in the twenty-first century, they are a-changin’ rapidly and drastically in relation to many core beliefs about mental health and illness. In fact, society seems to be moving from what has been termed “The Age of Anxiety” into what might now be called “The Age of Trauma.”
It is not that trauma itself is new, because it is not new at all—think of Noah and the great flood or Moses killing all of the worshippers of the Golden Calf. However, what is new is that the eyes of both science and humanity have begun to focus their attention on the specific topic of trauma and to employ observational tools that are more sophisticated than ever. The results of analysis to date so far have been astonishing and staggering.
Already the artificial distinction between the “mind” and the “body” has been thrown out as simple and artifacial and experts have come to view the mind and the body as one and the same phenomenon. For example, the role and function of the central nervous system, neurology and the endocrine system are being intimately and slowly unraveled to reveal their contributions to human development and behavior. Traumatic stress is now a source-term for most studies of emotional and behavioral development, deviation and pathology.
Traumatic experience has been made more real to many people by the fact that now most of the pathways within the brain, the nervous system and the endocrine system can be traced. Powerful conceptual models have been developed that explain memory, posttraumatic stress, emotional modulation, concentration, and interpersonal behavior. As a result, new therapies have been developed to access the frontal and lower brain centers and the right hemisphere functions, since these structures are intimately involved in traumatic reactions.
Somatically-based therapies (e.g., EMDR and Somatic Experiencing) are also merging, and these therapies help to release constrictions and the body memory of the stored traumatic events in a person’s life. Such therapies can relieve the pain that is directly or indirectly associated with past traumatic events, such as pain induced by past physical, sexual or emotional abuse that occurred in childhood or adulthood.
Electronic bio-measurements provide some measure of autonomic nervous system activity. For example, using heart rate variability measures, it is now possible to monitor the individual’s arousal (sympathetic) responses as well as their relaxation (parasympathetic) responses, and thereby capture the relationship between these two ends of the scale. Likewise, measurements of carbon dioxide utilization and cortisol levels can provide other measures of autonomic variability and set points.
Finally, understanding of the concepts of traumatic experience—which chronically affects 5 percent of men and 10 percent of women—can free the individual from the shameful shackles of being viewed as personally responsible for their condition or as defective as an individual. The reason for this is that traumatic stress—unlike any other psychiatric condition—is caused by events that occur outside the individual, even though its effects linger within the person.
The study of traumatic stress has also gained depth and breadth in that far more subtle forms of trauma (sometimes known as small t’s) are being extensively studied by researchers, in contrast to horrific single trauma events. Small t’s bring the study of trauma into the arena of abusive homes, and into the physical, sexual and neglectful environments and caretakers. Likewise, areas of concern toward those who are being bullied, criticized and rejected are viewed as linked to traumatic reactivation.
Early maternal experience is also being studied by experts as it relates to traumatic reactions, poor interpersonal and intra self-evaluations and the development of chronic diseases. Small t, or “complex trauma” as it is coming to be known, tends to tune up the physiology, leading to significant difficulties in the individual’s concentration, affect modulation, self-regulation, bonding and self-esteem.
Many addictive problems undoubtedly stem from developmental or complex trauma, and the individual’s efforts to control affect (mood) and to find pleasure and function in the world. Recent evidence suggests that many psychiatric conditions are associated with complex trauma. Dissociative disorders, obsessive compulsive disorder (OCD), depression, personality disorders and border personality disorder have all been linked to a past traumatic experience.
The presence and prevalence of trauma is pervasive in our society. The National Comorbidity Survey (NCS) consisted of individual interviews with a representative group of Americans between the ages of 15 to 54 years. Five percent of the men and 10.4 percent of the women had posttraumatic stress disorder (PTSD) at some point in their lives. In addition, 60.7 percent of the men and 51.2 percent of the women had experienced at least one traumatic event in their lifetime. In many cases, these trauma sufferers are common citizens. However, this type of trauma statistic is much greater among individuals who are combat veterans, police and fire personnel, emergency paramedics and others who are frequently exposed to violence and suffering.
Little data is available on trauma that is linked to children and adolescents, but some research indicates high levels (in the 30-40 percent range) of exposure to traumatic events, and as many as 21 percent of children and adolescents who have been traumatized developed diagnosable PTSD symptoms. At-risk samples of children (for example, those who were present where there were school shootings, gang violence, sexual abuse, and so on) bring the rate of PTSD in children up further, to above 50 percent, and some estimates are as high as 100 percent of children in these samples!