[Punching] [Screaming] [Scream of agony] This is trauma. Actually, no. That’s death. [Punch] This is trauma. Trauma is any experience that threatens your life or the life of someone you love. 70% of people experience something traumatic in their lives. [Dings] 30% of people experience trauma 4 or more times. [Dings] [Punching] Ow! Ow! Ow! Ow! Do you think you’ve experienced trauma? Examples of trauma include: miscellaneous traumas including unexpected death of a loved one, being threatened with a weapon, or man-made disaster. Accidents and injuries including car accidents, life-threatening illnesses, natural disasters, toxic chemical exposure, and having a child with a serious illness. Causing or witnessing bodily harm including witnessing death, combat experience, accidentally causing injury or death, and purposely injuring or killing someone. Intimate partner violence including sexual assault, being stalked, trauma to a loved one, being raped, and being beaten up by a partner. Interpersonal violence, including being beaten up, child abuse including neglect, and witnessing physical fights at home. Collective violence including being a civilian in a war zone, being a civilian in a region of terror, being a refugee, being kidnapped, and doing relief work in a war zone. Not getting what you want. Figure: It’s not fair! [Buzzer] Okay that last one isn’t trauma unless it’s a parent that’s neglecting a child’s needs. What do you think the most commonly experienced forms of trauma are? These are the 15 most commonly experienced forms of trauma worldwide in order: Unexpected death of a loved one. Witnessed death or someone hurt. Threatened with a weapon. Automobile accident. Witnessed physical fights at home. Life-threatening illness. Child with serious illness. Beaten up by caregiver. Natural disaster. Other life-threatening accident. Beaten up by someone else. Sexually assaulted. Traumatic event to loved one. Being stalked. Civilian in a war zone. [Ding] The first 5 represent 49%
[Meter filling] of all experienced trauma. The first 10 represent 67%
[Meter filling] of all experienced trauma. Theses 15 represent 81%
[Meter filling] of all experienced trauma. For some people the effects of trauma end here. They have resilience.
[Chime] Yaaaayyy!!!!! What do you think makes someone resilient? Examples of resilience include: Extraversion – or an openness to social interactions and expression of emotions. Figure: Can somebody help me?! Social support post trauma. [Squishing] Figure: Ahhhhhhh that feels so much better! Avoiding trauma altogether. [Slam]
[Agonizing grunt] [Buzzer] Actually avoidance makes things worse. Figure: I can’t just avoid things? Trauma is an unavoidable part of life. It’s not resilient to avoid life. Without having enough resilience a person may develop trauma symptoms. It’s sort of like the original trauma leaves something behind. Figure: Ohhh!
[Short-circuit] What are trauma symptoms? Can you recognize them? Trauma symptoms include: Intrusion symptoms, avoidance symptoms anhedonic symptoms, dysphoric symptoms, arousal symptoms, and dissociative symptoms. Let’s look at them each. Intrusion symptoms. Intrusion symptoms involve involuntary and distressing thoughts. Intrusion symptoms include: Recurrent memories of the traumatic event. [Punching]
[Short-circuit] This can look like play in children. Recurrent dreams.
[Short-circuit] [Shudder] Recurrent dissociative reactions
[Short-circuit] also known as flashbacks. This can also look like play in children. Intense or prolonged stress
[Short-circuit] due to cues related to trauma
[♫ Dun dun dun] also known as triggers. Physiological reactions to cues related to trauma.
[Short-circuit] [Shiver] Avoidance symptoms. Avoidance symptoms involve keeping away from distressing thoughts and reminders of trauma. Avoidance symptoms include: Efforts to avoid external reminders of the event.
[Short-circuit] Figure: Uhhh… See you later! Efforts to avoid distressing memories,
[Short-circuit] thoughts, or feelings about the traumatic event. Figure: Don’t think about it! Anhedonic symptoms. Anhedonia is when we lack pleasure in life’s experiences. We may disengage from life or find we lack the energy and motivation to do things. Anhedonic symptoms include: Diminished interest in significant activities. Children may socially withdraw. Feelings of detachment or estrangement from others.
[Short-circuit] Figure: Uh hi… Persistent inability to feel positive emotions.
[Short-circuit] 🙁 Dysphoric symptoms. Dysphoria is when we feel intense depression, discontent, or indifference about the world. Dysphoric symptoms include: Persistent and exaggerated negative beliefs about oneself, others, or the world.
[Short-circuit] [Echoed evil laughter] Persistent distorted thoughts about the cause or consequences of the trauma that leads the person to blame themselves or others. Figure: I should have been able to stop it!
[Short-circuit] Persistent negative emotional state. Figure: This sucks! Why bother doing anything?!
[Short-circuit] Arousal symptoms. Arousal is related to someone’s state of awareness and alertness. Arousal symptoms include: Irritable or angry outbursts. [Short-circuit]
[Angry scream] [Glass breaking] Reckless or self-destructive behavior. Figure: Heyyyyy! [Groan] Hypervigilance. Figure: Huh?! Huh?! Huh?! Oo?!
[Short-circuit] Exaggerated startle response.
[Short-circuit] Figure: Huh?!
[Thud] Problems with concentration. Figure: Uhh… Sleep disturbance. [Short-circuit]
[Shudder] Dissociative symptoms. Dissociation is when we split off thoughts or emotions from conscious awareness. Dissociative symptoms include: Inability to remember important aspects of the traumatic event. This can also be dissociative amnesia. Figure: Was it a hand? Or was it a foot?
[Short-circuit] Depersonalization – a feeling of not being connected with your body. Figure: Whoooaaaa!
[Short-circuit] Derealization – a feeling of not being connected with your environment. Figure: Whoa!
[Short-circuit] Trauma symptoms and PTSD are not just “being triggered”. They’re not the same as being offended, angered, or upset by something. They are experienced because of real systems that we all have in our bodies. What percentage of people do you think will experience PTSD in their lifetime? If these symptoms are repeatedly experienced for 1 month or less it’s called acute stress disorder. [Ping] Resilience may keep someone from experiencing symptoms beyond 1 month. [Chime] [Ping] If these symptoms persist for longer than 1 month it’s called posttraumatic stress disorder or PTSD. [Ping] Approximately 7% of people will experience PTSD in their lifetime. How can you help someone who has experienced trauma? There are a lot of ways that you can help. Take care of yourself first. Spend time together with them. Be a source of safety. Be there to listen, but don’t force someone to talk. Be patient. Acknowledge when you aren’t able to listen and let them know compassionately. Validate what they went through. Repeat back what you heard and empathize with their emotional experience. Encourage them to take control. Remind them of the ways that they already are protecting themselves and the resources that they have access to. Help them learn to recognize how they feel and to soothe themselves. Understand that they may need to repeat the same thing over and over as they remember the traumatic experience. If they seem dissociated help them engage with the present moment through their senses. Encourage them to have hope and make plans for a positive future. Encourage them to talk with others about how they feel and build a support network. Encourage them to consider therapy without being judgmental. Save sensitive topics for a time when they are already feeling calm. React to anger with curiosity. If anger becomes explosive, call a time-out and promise you’ll visit the topic again later. What do you think might not be helpful to say? These phrases are not helpful to someone experiencing trauma symptoms: [Short-circuit] Deep voice: Get over it! It’s time to move on You need to change your negative attitude! Maybe if you did something different this wouldn’t have happened! Let go of the past! You’re just not trying hard enough! Stop talking about it! Calm down! No one else reacted like you are! If you don’t stop I’m leaving! You should be over it by now! You’re exaggerating! It’s not that big of a deal! You’re making stuff up! Saying things like this can be retraumatizing. This means that the person experiences what it feels like to be traumatized all over again, reinforcing a feeling of not being safe. These things may have been said by someone who neglected their emotional experience in the past. What kinds of help are available for someone experiencing PTSD? The National Institute for Health and Care Excellence, or NICE, recommends trauma-focused CBT. NICE defines trauma-focused CBT as having three important components: Exposure: People confront traumatic memories and associations while in safe situations. Cognitive therapy: People identify and modify negative thoughts and beliefs that get in the way of living. Stress management: People learn skills to cope with stress. The American Psychological Association, or APA, goes a step further to recommend specific trauma-focused therapies. The APA strongly recommends: CBT Cognitive Processing Therapy Cognitive Therapy and Prolonged Exposure. The APA recommends: Brief Eclectic Psychotherapy and Narrative Exposure Therapy. NICE and the APA both recommend Eye Movement Desensitization and Reprocessing or EMDR. For medication NICE and the APA both recommend Paroxetine, also known as Paxil. NICE recommends: Mirtazapine, also known as Remeron Amitriptyline, also known as Elavil and Phenelzine, also known as Nardil. The APA recommends: Fluoxetine, also known as Prozac Sertraline, also known as Zoloft and Venlafaxine, also known as Effexor. Remission of symptoms and loss of the PTSD diagnosis is possible with treatment. Trauma is unavoidable. [Punch]
[Scream] Dealing with the effects of trauma
[Short-circuit] is unavoidable. But by staying educated and having empathy for those who’ve experienced trauma we can make the world a better place. Thank you to the patrons who help me make content like this! They help me to humanize mental health. If you’d like to join my community of patrons the link is down below. To learn more about mental health head over to youtube.com/ryanliberty and subscribe. [Scratching on paper] [Jingling] [Thud] [Agonizing scream]