What is trauma?
People respond to negative events in different
ways. Trauma is the emotional response when a negative event is
overwhelming. When thoughts and memories of the traumatic event don’t go
away or they get worse, they may lead to posttraumatic stress disorder
(PTSD), which can seriously disrupt a person’s life.
What are the signs & symptoms of trauma?
Trauma can affect how a person feels. He or she may experience:
- too much emotion
- too little or no emotion
- feelings of hopelessness, helplessness, worthlessness
- shame, fear
- anger, rage
- grief, sadness
- anxiety, panic attacks.
Trauma can affect a person’s ability to have satisfying relationships with others. This may include:
- not knowing how to trust
- having difficulty being close to people
- having problems in sexual relationships
- being afraid of others
- being isolated and withdrawn
- not recognizing when he or she is in a dangerous situation
- not knowing how to give and take in relationships
- repeatedly searching for someone to rescue him or her.
Trauma can affect the body. The person may experience:
- body memories and flashbacks (a feeling of reliving the
traumatic experience, e.g., seeing images, hearing voices or sounds,
smelling odours, experiencing unexplained tastes and physical
- sleep problems, including nightmares
- physical complaints (e.g., headaches, nausea, stomach aches, pelvic
pain, stomach/digestive problems) for which no medical cause can be
- physical exhaustion.
Trauma can affect how a person thinks. This may include:
- problems with attention and concentration
- confused thinking
- thoughts that get in the way of daily activities
- memory problems.
Trauma can affect how a person behaves. He or she may:
- inflict self-injury (e.g., cutting, burning)
- engage in addictive behaviours (e.g., self-starvation, binge-eating, drug/alcohol misuse)
- constantly look for sexual relationships, or avoid them
- be abusive toward others.
People who experience repeated trauma tend to
have more severe symptoms. Also, the earlier the trauma, the more severe
the symptoms are likely to be.
What are the causes & risk factors of trauma?
Trauma is caused by negative events that produce
distress. These events can be physical, sexual or emotional in nature.
Some of the most common traumatic events include:
- physical, sexual and verbal assault, including childhood abuse
- being threatened with physical or sexual assault
- witnessing violence against others
- long-term neglect in childhood
- accidents and natural disasters
- community violence
- war or political violence.
What is the treatment for trauma?
Most skilled therapists are trained in several
types of treatment, which they may use in combination or alone. All
treatment approaches should follow the stages of the trauma therapy
model. Effective therapists adapt the different treatment approaches to
best suit the client.
Here is a brief description of the main therapeutic approaches:
Psychoeducation teaches trauma survivors about
different psychological processes and their effects. The therapist may
explain that what the person is feeling and doing is typical of
reactions that other survivors also describe. Understanding that these
reactions are normal may help the person feel less isolated or “crazy.”
The therapist may explain the short-term and
long-term effects of trauma and how trauma can affect the body, emotions
and development. The therapist may also give the client information
about abuse and neglect.
The therapist provides information throughout
therapy, depending on what the client and therapist are discussing and
dealing with at the time.
Cognitive-behavioural therapy (CBT) focuses on
helping the client become aware of how thoughts, attitudes, expectations
and beliefs can contribute to feelings of unhappiness. The client
learns how certain beliefs, which he or she may have developed in the
past to deal with difficult experiences, are no longer helpful or true
in the current situation. For example, the therapist may help a client
who was physically abused as a child to explore and question the
mistaken belief that he or she is responsible for the abuse.
CBT can also involve exposure techniques. These
strategies are particularly helpful for people with simple posttraumatic
stress; that is, those who have been traumatized by a single event.
Exposure therapy involves gradually exposing the person to the feared
CBT can also help the client to develop coping
strategies to reduce anxiety. Strategies may include breathing
retraining and relaxation and visualization exercises.
Eye movement desensitization reprocessing
Eye movement desensitization reprocessing (EMDR) is
a psychotherapy technique used to treat trauma responses, such as
anxiety, depression, panic, sleep disturbance and flashbacks. EMDR is
not a complete therapy system; it is a technique that can be used within
a broader therapeutic approach to treat trauma.
The idea behind EMDR is that people who have
experienced trauma have stored memories of the trauma without adequately
processing them. EMDR stimulates the brain’s natural information
processing mechanisms, allowing the “frozen” traumatic memories to
EMDR can only be done by a properly trained clinician.
Many people with posttraumatic stress find that
medication gives them relief from sleeplessness, depression, panic
attacks and other trauma reactions. Only medical doctors, including
psychiatrists, can prescribe medication. The doctor should be trained in
understanding trauma as well as in prescribing psychotropic drugs
(medications used to treat mental health issues). Medication can help to
manage some of the effects of trauma, but it is not a complete
solution, and is best used along with psychotherapy.
Trauma affects the body and the mind, so therapy
should address both. Body psychotherapy targets the physiological
reactions to trauma. Sensorimotor psychotherapy is a type of body
psychotherapy that helps trauma survivors deal with disturbing bodily
reactions. It can help them manage and disconnect physical feelings from
trauma-based emotions. Therapists who practise sensorimotor
psychotherapy will sometimes touch clients, but only when clients give
Where can I find help, treatment and support?
Treatment from CAMH
Help for Families from CAMH
Ontario Mental Health Helpline (open 24/7 for treatment anywhere in Ontario)
Various resources are available to help people with abuse-related trauma:
- women’s health centres
- community health centres
- therapists in private practice (e.g., psychologists, psychiatrists and social workers)
- sexual assault centres
- crisis lines for women who have been abused
- women’s shelters
- spiritual centres
- family service agencies
- mental health and addictions programs and services
- family doctors.
Where can I find more information related to trauma?
Common Questions about Trauma
Women: What Do These Signs Have in Common? Recognizing the Effects of Abuse-Related Trauma (PDF)
Anxiety: An Information Guide (PDF)
Information on Posttraumatic Stress Disorder (PTSD) for Refugees and New Immigrants (PDF)
Posttraumatic Stress Disorder 101 (online tutorial) Please Note:Your pop-up blocker must be turned off to view this tutorial
Cognitive-Behavioural Therapy: An Information Guide (CAMH online store)