Trauma affects the brain, body, and mind in ways people may not understand. This can include self-isolating, finding it hard to bond with people—even a spouse or kids—being constantly angry, thinking people can’t be trusted, or feeling guilt and shame.
“I wouldn’t talk to anybody, I cut off all my friends … it was hard to have emotional connection with people,” said Mojisola Edu, a former Army specialist who was diagnosed with Post Traumatic Stress Disorder due to Military Sexual Trauma. “I didn’t feel like I deserved to be loved, I felt like most of the things that happened with me were my fault, I blamed myself for a lot of things.”
Reactions to trauma vary, but regardless of how long people have had PTSD symptoms, healing is possible. In-the-Moment Reactions to Trauma Part of starting on the road to healing includes understanding the reactions people have at the moment of trauma. The brain’s reactions to traumatic events—like fight, flight, freeze—are not within the conscious control of people, as their body’s survival mechanism takes over to keep them alive.
This can include running away during a firefight or freezing if they experience a sexual assault. Emotional reactions—like fear, helplessness, or anger—may also occur, although there can also be no emotional reaction—such as numbness or dissociation—said Dr. Abigail Angkaw, a consultant with the National Center for PTSD and clinical psychologist who works with veterans with PTSD in the San Diego, California, VA system.
No reaction at all is normal, especially if it is dangerous to process the trauma in the moment, such as in the middle of a firefight, said Angkaw. Bodily reactions, such as tunnel vision, increased heartbeat, or bladder urgency, are also normal, as the body is preparing itself to fight.
In the case of sexual assault, bodily reactions such as arousal, erection, and ejaculation during the assault are also outside the person’s conscious control. A person’s body can involuntarily respond to physical stimuli—that does not mean the person wanted the assault.
“We often will work in therapy on helping to separate those (bodily) reactions from a sexual assault that happened without your freely given consent—those are independent (of each other),” Angkaw said.
Long-Term Responses to Trauma In the weeks, months, and years after a traumatic event, symptoms can evolve into constant intrusive thoughts, unwanted memories, nightmares, flashbacks, hypervigilance, shifts in thinking such as believing you no longer have control in your life, and avoidance.
“Avoidance is really a hallmark (reaction) after a trauma,” Angkaw said. “If somebody experienced a traumatic event it’s really common for them to avoid both their thoughts and their memories about it.”
“People who avoid the most are more likely to have PTSD—and some people get really good at avoiding—avoiding public places, going out at night, places that feel unsafe or anything that might remind them (of the trauma),” Angkaw said.
For sexual trauma, people may experience sexual dysfunction and confusion about their identity—especially straight people who were assaulted by someone of the same gender as them. Distorted
thinking, such as blaming yourself instead of blaming the perpetrator, is also a symptom of PTSD.
When these symptoms persist after a few months, a person may be diagnosed with PTSD, Angkaw said. Of those people who have ongoing PTSD symptoms, about 80% will also have another mental health issue such as depression, anxiety, and substance misuse, she said.
Hope & Healing
In the immediate aftermath, healing means just taking care of yourself and focusing on getting through the day, said Angkaw. Connecting with people if they find themselves withdrawing is also important, she said.
Angkaw also suggests some of the following steps to help people heal and recover long term.
1. Learn and understand as much as you can about trauma and PTSD. Understanding the brain’s automatic responses, bodily reactions, and the emotional impact of trauma can help people cope.
“That can help … to realize that (the reactions) they experienced make sense, that they are not alone,”Angkaw said. “That’s such an important piece in healing—first understanding.”
2. Seek treatment. “PTSD is unlikely to improve on its own without treatment,” Angkaw said. There are many new treatments, people should give them a try, she said.
“They deserve it and we would hope for them to experience those positive outcomes that we have seen with so many of our patients that we work with here.”
3. If you are not ready to seek treatment. There are self-help apps available to help cope with PTSD symptoms. The PTSD Coach mobile app is available at the National Center for PTSD website.
People should also try to avoid unhealthy coping mechanisms such as drinking, using substances, or binging on food. Angkaw recommends trying healthier ways to cope like exercising in moderation, taking up a healthy hobby, or talking to loved ones or spiritual or religious leaders.
Edu found yoga and meditation, which she tried during an event hosted by Challenge Aspen, an organization that provides adaptive activities for people with physical or cognitive disabilities, helped her become calm. She now teaches a free traumainformed yoga class for veterans once a month through the DC Mayor's Office of Veterans Affairs.
4. Family and friends are important. Loved ones of a person with PTSD should also learn about trauma, it will help them understand some of the behavior their loved one is exhibiting, Angkaw said.
Other ways Family and friends can help is by reminding their loved one to take their medication, helping them with their therapy exercises, or supporting them during appointments. Angkaw said it’s important they continue to do regular Family activities and encourage their loved one to stay connected to their support network. Angkaw recommends Family members also remember to take the time for their own self-care.
Family is extremely important in encouraging their Soldier to seek help, Angkaw said.
“There are so many veterans and service members I’ve worked with who say that their primary motivation for seeking help is their Family or their relationships,” Angkaw said. “A lot of folks will say ‘I’m here for my wife,’ or ‘I’m here because of my kids,’ because they have encouraged them, so that is meaningful and I think that is helpful.”
For Edu, healing from trauma is not a ‘one and done’ situation.
“Healing is an everyday process, it’s not something that happens overnight … every day you’re healing, but every step that you take gets you closer and closer to your goal," Edu said.
“For people who are living with PTSD, know that it is not over for you, know that you are not alone,” said Edu. “The things that happened to you in your life are not your future. That is not your whole story, there is more to you than just your PTSD. Re-finding that person, and coming home to yourself, is the biggest accomplishment that you can do. Give yourself grace.”
For additional resources on understanding trauma and healing, see the National Center for PTSD website: https://www.ptsd.va.gov/apps/aboutface/
The book "The Body Keeps the Score," by Dr. Bessel van der Kolk, gives in-depth information on trauma and healing, and is based on his research and work with veterans and trauma patients.
The Army Resilience Directorate website also offers resources on resilience Family members and Soldiers can use to help them cope with daily stressors: https://www.armyresilience.army.mil/ard/R2-home.html