Tag Archives: trauma

Talking about Trauma

Should you talk to your parent about your trauma?
Talking to your parents about your trauma can be a difficult decision. You may be hesitant to tell them because you’re not sure how they will react or if they will be able to help. Your parents are not entitled to know about your past trauma – however, you may gain additional support or closeness from telling them. Here are a few things to consider before making a decision.

How do you hope they will react?
What reaction are you hoping your parent(s) will have when learning about your childhood trauma? And how likely is that reaction based on what you know about your parents? Consider your parents’ emotional maturity, cultural/family traditions, and how they’ve previously reacted to challenging information.

What are you hoping to gain?
Think about why you want to talk to your parents. Are you looking for support and understanding? Are you hoping they can help you process the trauma and find healing? Do you want them to understand this part of your past? Are you asking them to distance themselves from your abuser? Consider what you’re hoping to gain and how likely you are to get that from your parents.

What do you stand to lose?
Safety should always be your number one priority. If you still live with your parents or rely on them for financial support, telling them about your childhood trauma might lead them to remove that support. Before taking action, weigh the risks and benefits of sharing your story. It’s okay for you to prioritize safety and security over transparency with your parents.

How to tell your parents about your trauma
Once you’ve decided to tell your parents about your childhood trauma, you may wonder how to have this conversation. If your parents don’t know that you experienced a traumatic event or events as a child, this news might come as a surprise to them.

Consider these tips as you get ready to broach the topic with them.
Make sure you’re really ready
The last thing you want is to have a rushed, impulsive, or emotional conversation with your parents. Make sure you’re emotionally ready to have the conversation and that you’ve given yourself enough time to prepare. If you’re currently working with a therapist, making a game plan together may be helpful before you decide to talk to your parents.

Choose the right time and place
There’s never a perfect time to have a difficult conversation like this, but try to pick a time and place where you and your parents can be relaxed and uninterrupted. This is not a conversation that should happen in the heat of the moment. Choose a time when you’re unlikely to be interrupted or have distractions take over. remember that this is not a one time conversation. You can initiate the conversation and then give everyone, including you, the space and time to reflect and process.

Call in support
A close friend, partner, trusted relative, and even a therapist can all be great support systems to have with you when you tell your parents about your childhood trauma. They can provide emotional support or physical support during what may be a difficult conversation. A therapist may also be able to step in if the conversation goes awry.

Stay with connection (if you have a safe relationship with the parent)
Tell your parents that you want to share this with them because you care about your relationship. Tell them what you’re hoping to gain from the conversation. For example, you might share that you want them to understand you better and support you, not pity you or try to fix things for you.

Be prepared for uncomfortable emotions
Your parents may have strong emotions when receiving this news. Anger, sadness, frustration, self-blame, and anxiety are all normal reactions to learning that their child experienced a traumatic event. Your parents are entitled to their emotions. You are not responsible for your parents’ emotions, and you should not feel guilty or obligated by their reaction.

Stick to your boundaries
Having strict boundaries on what you feel comfortable sharing with your parents is okay. Telling them that you experienced trauma as a child doesn’t mean you have to share every detail of that experience. If your parents ask you questions you’re uncomfortable answering, it’s okay to say that some aspects of this topic are off-limits.

Sample language to use when telling your parents about past trauma (please feel free to edit in your own words.)

I think it’s important for you to know about the things that have happened to me in my past. It’s affected me in ways you might not expect, and I think it’s important for you to understand why I’m the way I am.

I was sexually abused as a child. It was a traumatic experience that has stayed with me for my entire life. It’s something that I’ve struggled with a lot, and it’s something that I deal with on a regular basis.

I want you to know this because I want you to understand me. I don’t want you to see me as a victim because that’s not who I am. I’m a strong person, and I’ve overcome a lot in my life. But this experience has impacted the way I move about the world. The reason I’m telling you now is because I’ve been thinking about it a lot lately, and I think it’s been affecting my life in a lot of ways. I’m really hoping that talking to you about it will help me to start to heal.

Trauma is not a Life Lesson

Please stop describing trauma as a life lesson or badge of honor that people survived or it made them stronger.

-What doesn’t kill you can dysregulate your nervous system, That includes your mood, sleep, eating habits, and daily functioning.

-What you survived can impair your ability to have attachments or trust people. Your relationships.

-What you endured can make you sick. Trauma can contribute to chronic diseases such as type 2 diabetes, heart disease, and rheumatoid arthritis.

-What you “tough out” changes your brain. Trauma changes brain chemistry and structure from the hippocampus (which is your memory functioning), to your amygdala (your ability to manage stress and emotional responses) and your prefrontal cortex (problem-solving and reasoning).
Trauma sucks. Don’t glorify it.

Also see Racial Trauma and Mental Health

The Neuropsychological Costs Of Poverty

Poverty is Trauma
Kids growing up in poverty are constantly releasing the stress hormone cortisol, which can give them short attention spans, restlessness, and short tempers. Physically, they feel the same kind of heart-pounding stress an adult feels after a car wreck. And they feel it all the time.

If you think about the impact on education, imagine if right after you were in a car crash or had a huge health scare, I walked up to you and said, ‘I need you to take a test.’ Or, ‘you just need to sit down and focus.’  Could you do it? Would you perform well? It’s doubtful.

And for kids, with their frontal lobe and brain functioning still developing well into their 20s, lingering effects of poverty are even more significant.

Experiencing prolonged adversity takes its toll. Research indicates that even more striking than lack of adequate nutrition and limited access to consistent healthcare, chronic stress, across the longterm, makes children and adolescents susceptible to cardiovascular disease, high blood pressure, depression, and diabetes.

The impact upon the brain, development and functioning, for children with chronic financial adversity is commensurate with those suffering from other forms of post-traumatic stress disorder: the hippocampus part of their brains is atrophied; the amygdala, which regulates the processing of acute emotional responses, is overwhelmed. Chronic financial stress experienced by children can be devastating for learning/education, since the hippocampus and amygdala, in tandem, regulate emotional responses and are also critical in the formation of memory, consolidated knowledge, and spatial awareness.

Poverty Affects One In Six American Children
Poverty during childhood development has immediate effects on cognitive ability and neurological activity. Children from low-SES backgrounds show decreased levels of cognitive function and brain activity across numerous domains. The most severe effects are found in language/communication and regulation of executive function (attention, organizing, self-monitoring, prioritizing, planning).

Snapshots of family poverty in data from 2018 showed a troubling picture for America’s youth, with 13 million children food insecure and one in six children living in poverty (research stats were collected before the Covid-19 pandemic). Living in a financially unstable environment can threaten a child’s sense of safety because it may mean they cannot access basic needs, like food, shelter, and healthy relationships, on a consistent basis.

Children who live in poverty move more frequently, have families more likely to deal with eviction/housing instability/credit problems, have reduced ability to attend school on a regular basis or access curriculum virtually, and may have parents who work several jobs making them less accessible for quality child and parent time.

Long-standing financial hardship IS trauma. It changes the brain, affects everyday functioning, restricts life experience, and ultimately, personal outcomes.

Stats Sources:

    • Childrensnational.org (Disclosure: Dr. Siddique previously worked at the adolescent medicine department at Children’s Hospital, Washington DC)
    • American Academy of Pediatrics (Www. AAP.org)

Also see the mental health blog at Embolden on racial trauma and the brain:

Racial Trauma and Mental Health

Racial Trauma and Mental Health

Meta-analysis reviews of racial trauma research unequivocally demonstrate symptoms that mirror post-traumatic stress disorder (PTSD):

  • Mental Health.
  • Psychologically, racial trauma can cause symptoms of post-traumatic stress disorder (PTSD).
  • Arousal: higher reports of somatization when distressed (e.g., stomach aches, headaches, rapid heartbeat).
  • Anger and disruptive behavior: more behavioral problems in children and teens
  • Chronic Stress: depression, anxiety, low motivation.
  • Hypervigilance: reduced ability to trust or form social connections.
  • Avoidance: less willingness to take academic risks, higher school drop-out rates after racial discrimination is perceived.

These negative psychological outcomes are not only present in adults, but have been found to appear as in children as early as 12 years of age. However, the toll of racial trauma and stress is not limited to psychological outcomes. The negative effects of racial trauma also affects physical health outcomes. These symptoms are often exacerbated by lack of access to adequate medical services.

Physical symptoms can include:

  • Physical pain
  • Cardiovascular Disease
  • Hypertension, with spikes in blood pressure following exposure to racist stimuli; blood pressure remains elevated after.
  • Respiratory Complications
  • Higher Allostatic Load (the wear and tear of the body caused by chronic stress) When the body is in a state of distress, it activates the stress response system, which helps us fight or get out of the stressful situations (a.k.a. fight, flight, or freeze). However, when experiences of stress are consistent and chronic, the stress response system becomes taxed and hormones can be unbalanced, exacerbating the physical illnesses and conditions listed above.
  • Digestive issues

See:
APA (American Psychological Association) Guide on the Effects of Stress on the Body
Racism, racial discrimination, and trauma: a systematic review of the social science literature, K.Kirkinis, August 2018. 
Mental Health and Black Patients: Survival and Stigma

Adult Symptoms of Trauma – A Quiet Epidemic

The psychoanalyst Alice Miller wrote: “the true opposite of depression is neither gaiety nor absence of pain, but vitality—the freedom to experience spontaneous feelings. It is part of the kaleidoscope of life that these feelings are not only happy, beautiful, or good but can reflect the entire range of human experience, including envy, jealousy, rage, disgust, greed, despair, and grief. But this freedom cannot be achieved if its childhood roots are cut off.”

The SAMHSA’s National Child Traumatic Stress Initiative (NCSTI) reports that by the age of 16, two-thirds of children report experiencing at least one traumatic event. TWO THIRDS. The substance abuse and mental health services administration (SAMHSA) is the agency within the US department of health and human services that leads public health efforts to advance mental health in the country. 

According to the American Psychological Association (APA), a traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes feelings of horror, terror, or helplessness at the time it occurs. This can encompass many different situations and may even be different for each person who experiences a specific event.

Potentially traumatic events can include:

  • Physical, emotional, and sexual abuse
  • Neglect
  • Community or school violence
  • Racism and microaggressions
  • Sexual exploitation
  • Sudden or violent death of a loved one
  • Witnessing or experiencing domestic violence
  • Natural disasters or terrorism
  • Refugees or war experiences
  • Assault
  • Serious accidents
  • Life-threatening illness; Chronic illness or multiple surgeries

If untreated, childhood trauma can have long-lasting effects. Trauma can affect children’s mood, development, and their ability to regulate their emotions at the neural level. Consequently, as an adult, they are two times times more likely to develop major depression and three times more likely to develop clinical anxiety.

Symptoms of Trauma in Adults

There are a number of different ways in which symptoms can manifest for adults living with childhood trauma. Unfortunately, there is no clear-cut recipe to follow when diagnosing an adult with lingering signs of trauma, however, there may be some common physical, emotional, and behavioral symptoms. Listed below are just a few symptoms of someone living with trauma. It’s important to know that these are not static, nor linear.

  • Anger
  • Hypervigilance
  • Unresponsiveness
  • Anxiety
  • Emotional outbursts
  • Depression
  • Panic Attacks
  • Physical Pain
  • Poor Concentration
  • Shakiness
  • Night Terrors
  • Lack of Energy
  • Physical Illness
  • Sleep Disturbances
  • Intrusive Thoughts
  • Compulsive behaviors
  • Eating Disorders
  • Impulsiveness
  • Isolation
  • Numbness or Seeming Callousness
  • General disorientation/Confusion

Based on my clinical work, these are just a few of the LESSER known experiences of adult trauma survivors:

-You feel no one understands you, and perhaps no one will. Adult trauma survivors sometimes say, “I don’t fit or belong anywhere or with anyone”.

-You may minimize. Adult survivors say to me, after describing extremely painful experiences, “but, doesn’t everybody go through that? “
One meme that was shared with me by an adult survivor said:
Get up. No one‘s coming to help you. This is a trauma response

-You overperform. Meanwhile, you’re silently dreading the mountain of tasks you’ve signed up for — a list that only seems to get longer as the week wears on.

-You’ve got a love/hate relationship with work or being helpful, and no matter how many times you try to break up with the word “yes,” saying “no” just doesn’t come naturally to you. Extra hours to work on the weekend? You’re the first one in line.

-You may spew emotions seemingly out of nowhere. To others, who are not part of your trauma history, it might seem random or unfair. I have found that people described as “drama queens “ often have unspoken histories that are very painful.

-You might be unloading feelings onto distant strangers. For example, you might be able to talk to your deepest feelings to a server, bartender, or someone you just met at a party, but not to friends or family who have known you for a while. This might seem paradoxical, but it’s not. You do not want to be seen as a burden to those closest to you, which means you’re reluctant to open up when you’re struggling, so you only do so when you’re on the brink of totally breaking down, because you’ve held it all in for far too long.

Similarly, social distance may make it easier to express feelings.
Hello, Social Media: Sure, I’ll tell you all about my trauma. That way, if someone bails on us for being messy or “too much,” it stings less, and the stakes don’t feel as high.

-You feel guilty when you’re angry at other people. You might get angry, only to feel like a terrible person for having feelings at all five minutes later. You might even feel like you’re not “allowed” to be upset with other people. One adult symptom of this is constantly apologizing. In my experience, adult survivors of trauma are apologizing for their very existence. So even minor infractions may send them into a flurry of apologizing. 

-You feel responsible for other people’s reactions. Whenever you recommend a restaurant, a movie, or a book to someone, there’s a moment or two of intense panic. “What if they hate it?” Sometimes you just let other people make decisions on where we go and what to do, because if something goes awry, it won’t be because they failed” to make a good choice.

-You find yourself compromising your personal choices. This can be difficult to notice at first. You might think of yourself as being chill, good at compromise, easy to get along with. But if you pay attention to the conversations you’re having, you might notice you’re a little too agreeable. Sometimes it’s seemingly benign things, like saying you don’t have a preference for what you want to eat for dinner when you actually do. Other times, it may include validating a perspective or behavior that you don’t agree with. It’s not speaking up when you have an opinion, or something is upsetting.

-You sometimes dissociate in social situations. This is where you disconnect emotionally. This can show up as daydreaming, spacing out, withdrawing, or even “going blank”. I’ve heard many adult survivors say that they have been accused by partners, colleagues, and family members of not paying attention or not caring.

-You may feel numb, even cauterized. During the pandemic, I have heard numerous trauma survivors say that they do not feel any significant fear or concern. They may actually function more calmly than others who have not experienced a history of trauma.

Overall, this limited list of behaviors I have observed over the years in clinical work has one thing in common: an inability to fully experience the range of feelings that make us human. Restricted experiences have consequences for our interpersonal relationships, choices, lifestyles, and longterm mental health.

Minority Mental Health: Everyday Traumas and Microaggressions

Just a few words about the presentation that I’ll be giving to the Association of Practicing Psychologists (APP.org), Montgomery & Prince George’s Counties on November 17th.  The topic is Minority Mental Health: Everyday Traumas and Microaggressions and its being offered as part of their Continuing Education series.

APP is a professional organization for practicing psychiatrists, and as such they are approved by the American Psychological Association to sponsor continuing education for psychologists. This workshop is for licensed psychologists who want to better describe, discuss and assess the psychological stressors that clients may struggle with in the context of everyday micro-aggressions or racism.

I’ve been told by the organizers that my workshop is almost sold out already. I’m gratified to know that so many of my colleagues are committed to cultural diversity and minority mental health. And I look forward to giving similar workshops, with/for APP and other organizations in the future.

 

                                                              

Embolden Psychology
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Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

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