Traumatic Experiences: Catalysts for Psychological Illness, Study Finds

Commonly, the word “trauma” is used to describe aversive situations that involve stress and produce a negative experience. According to Álvaro Cabral Araújo, doctor and guest professor at the Institute of Psychiatry (IPq) of the Hospital das Clínicas (HC) of the Faculty of Medicine of USP (FMUSP), the term is frequently used to describe situations of stress and everyday frustrations. 

For psychology and psychiatry, however, the word is used to describe serious experiences, potentially capable of promoting psychological illness. “Psychiatric diagnostic manuals such as the ICD-11, from the World Health Organization (WHO) and the DSM5, from the American Psychiatric Association, describe trauma or traumatic event as an exposure to serious experiences, such as concrete episodes, or threats of death, serious injury or sexual violence”, explains Araújo. 

Consequences 

The psychiatrist explains that “trauma” is not the name given to a psychiatric diagnosis or a specific psychiatric disorder. Exposure to a traumatic event does not necessarily lead to the development of psychiatric disorders. The suffering and harm experienced by people who suffer trauma are variable, and most people recover spontaneously. 

However, there are some disorders that are related to trauma and stressors, such as Post-Traumatic Stress Disorder (PTSD), a condition that affects approximately 10% of individuals exposed to a traumatic event. Araújo points out that, in cases of PTSD, there are specific diagnostic criteria and that it is possible to carry it out. After an individual is exposed to trauma, they may experience some symptoms, segmented into three groups. 

The first concerns the reliving of the traumatic event – ​​also known as an intrusive symptom. “These include frequent memories about the trauma, intrusive thoughts; It’s not that the person makes an effort to think about that topic, they are invaded by these memories. This can also happen in the form of nightmares and flashbacks”, he explains. 

The second group of symptoms is avoidance or avoidance. From the moment an individual develops Post-Traumatic Stress, it is normal for them to start avoiding things related to the traumatic event. “If a person suffered a robbery walking down a certain street, it is possible that the person avoids passing through that place, avoids being in contact with people who were present on the day of the robbery, for example”, explains the psychiatrist. 

The third group concerns symptoms of hyperactivity or hyperarousal, in which individuals affected by the disorder, after exposure to trauma, live in a state of alert, are more easily frightened and are more reactive and irritable than in normal conditions. 

Miriam Debieux Rosa, professor at the Department of Clinical Psychology at the Institute of Psychology (IP) at USP and coordinator of the Psychoanalysis, Society and Politics Laboratory (PSOPOL/IPUSP) and the Veredas Group: psychoanalysis and immigration (PSOPOL/IPUSP), points out that the Diagnosis is decisive in determining the type of treatment appropriate for people who have suffered trauma.

Memory erasure 

People exposed to traumatic events, severe stressors or very intense emotional situations may present manifestations of dissociation, such as dissociative amnesia – a condition in which some individuals are unable to remember relevant aspects of the traumatic event they experienced.  

According to Mario Otero, psychologist at the Somatic Disorders Outpatient Clinic (Soma) at the Hospital das Clínicas of the Faculty of Medicine of USP, in some cases, this amnesia affects some moments in the individual’s life, or it can be more severe, in which case the person can forget who she is, if she has a family and what she does professionally, for example. “This dissociation occurs to protect the person from bad memories and emotions linked to some type of experience that they were unable to develop psychically”, he explains. 

Cabral explains that there are other dissociative manifestations, such as derealization – a feeling of disconnection with the environment, as if it were not real or if something had changed – or depersonalization – a situation in which the individual sees themselves as if they were outside the situation they are experiencing. “These dissociative phenomena can be described as a disintegration of psychic functions, consciousness, perceptions, memory. These are phenomena that can occur in the face of serious stressors, causing this dissociation”, he points out. 

Even if traumatic memories are blocked, situations such as re-exposure to a traumatic event or contact with details of the experience can allow memories to be accessed. In the case of a person who suffered sexual violence in late childhood or early adolescence, for example, and spent a good part of their life without coming into contact with that memory, it is possible that this content will be accessed again if they experience another situation. abusive, or hear reports of violence. 

Treatments 

In cases of dissociation, Otero explains that the treatment of these conditions consists of asking the affected individual to report what is possible and what is remembered and, as he opens up to the analyst, he is able to access the bad experiences and attributes a meaning to the event. “When a person feels safer and stronger to approach these bad experiences from the past, it is almost as if the dissociation, this separation from that bad content, was no longer so necessary”, explains the psychologist. 

Miriam points out that the degree of traumatic situations influences the way in which treatment with those affected should be carried out. “Violent situations, for example, will have several levels of elaboration, so there is a life to deal with losses, especially these very intense ones. But that doesn’t mean that the person has to live in suffering all the time”, she explains. In psychoanalysis itself, according to the professor, there are numerous approaches regarding the type of treatment, but they depend on the way in which the individual defends himself in his psychic organization. 

For Araújo, it is important that individuals who are exposed to a traumatic situation are welcomed. “Both professionals and family members who are going to provide some type of assistance in the immediate moment, a few days after exposure to the traumatic event, must be careful not to force the person to remember or tell details of the situation that happened to them, just put themselves there available, welcome and try to strengthen the support network”, he explains.

According to the psychiatrist, around 90% of people exposed to events of this nature recover completely and spontaneously within a few days. However, there are cases in which the individual recognizes that, since the traumatic event, they have suffered impairments in their usual function. In these scenarios, it is important to seek psychological treatment from good professionals.