Trauma and Trauma Symptom Expression

When a child experiences early life trauma, it impacts emotional and behavioral reactions in successive environmental situations that are either stressful or relatively nonthreatening; trauma symptom expression ranges between reactions of hyperarousal and disassociation (Perry, 2009; Perry et al., 1995).

Trauma during critical developmental stages can influence trauma symptom expression, resulting in severe presentations of post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety (Suliman et al., 2009). Furthermore, more trauma leads to the expression of more trauma symptoms (Turner et al., 2010).

Trauma and executive functioning  

There is strong evidence revealing that early life trauma contributes to deficits in neurological processes responsible for executive functioning (i.e., planning, organizing, and regulation). Traumatic events, particularly those that repetitively occur (e.g., sexual or physical abuse), activate a child’s stress response system. In turn, this generates and reinforces neurological pathways in the limbic system (Miyake & Friedman, 2012). Recurring trauma inhibits normative neurological development in the prefrontal cortex, which is responsible for executive functions (Kerig et al., 2010). Using prospective data analyses, researchers suspect that early childhood maltreatment might have the most significant impact on executive functioning during adolescence (Nikulina & Widom, 2013). 

teen in trauma

Moreover, there is a great deal of evidence suggesting that the sequela of early childhood adversity can meaningfully impair prefrontal cortex development (De Bellis, 2001; Rutter & O’Connor, 2004). Brain imaging scans in children exhibiting symptoms of PTSD show low concentrations of prefrontal cortex gray matter (Richert et al., 2006), which is tied to executive functioning processes such as decision-making, emotional regulation, interpersonal communication, and moral reasoning (Schore, 2003). 

Why Trauma Leads to Helplessness

A common definition for helplessness includes language that “represents a lack of control” (Gelbrich, 2010, p. 569) and, as an emotion, occurs when people perceive that they will be unable to cope with a current or future situation (Gelbrich, 2010; Lazarus, 1991). Many authors distinguish it from learned helplessness and powerlessness. Learned helplessness is a psychological pattern that represents a perception of being unable to control anything across time and place that can lead to depression (Gelbrich, 2010). In contrast, helplessness is “a state triggered by a single, negative event” (Gelbrich, 2010, p. 569). Powerlessness is when someone feels that others are controlling them; in contrast, helplessness is not bound by the presence of people but rather by situations (Gelbrich, 2010).

Therefore, for traumatized individuals with an impairment in executive functioning, it makes sense why they might feel overwhelmed in situations where non-traumatized people cope easily. Did your boss say something critical about your work? Most people might feel frustrated for a few minutes and move on. But the traumatized person is more likely to feel the criticism personally and struggle to concentrate for the rest of the day. Did your partner forget to say goodbye before leaving for work? Most folks might forget this well before lunch. The traumatized person, by contrast, might start imagining that she’s done something horrible to upset her partner and fear that a break-up is imminent. Or take her partner’s forgetfulness as a sign that he or she is having an affair. Catastrophizing is common among traumatized individuals.

Acting impulsively is a common coping mechanism—unplanned shopping sprees, alcohol and drug use, high-risk sex, travel—anything to help distract from the discomfort of feeling helpless.  If this describes you, it is not your fault, and it is not a character flaw; it might be the natural consequence of a brain injured by emotional trauma.

Therapy Helps

Feelings of guilt and shame that result from traumatic events can cause emotional pain and impairment that lasts throughout life. Addressing these feelings in therapy can help improve functioning in personal and work relationships. Early traumatic experiences negatively affect the development of the neural circuitry necessary for self-regulation.

If this happened to you, it is not your fault. Therapy can be a lifesaving tool to help rework the circuitry of your brain by gently addressing unresolved trauma in ways that support healing and enable improvements in your life. Reach out today to get started.

References

De Bellis, M. D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13, 539–564.

Gelbrich, K. (2010). Anger, frustration, and helplessness after service failure: Coping strategies and effective informational support. Journal of the Academy of Marketing Science, 38(5), 567–585. doi:10.1007/s11747-009-0169-6

Kerig, P. K., & Becker, S. P. (2010). From internalizing to externalizing: Theoretical models of the processes linking PTSD to juvenile delinquency. In S. J. Egan (Ed.), Posttraumatic stress disorder (PTSD): Causes, symptoms and treatment (pp. 33–78). Nova Science Publishers.

Lazarus, R. S. (1991). Emotion and adaptation. New York, NY: Oxford University Press. 

Miyake, A., & Friedman, N. P. (2012). The nature and organization of individual differences in executive functions: Four general conclusions. Current Directions in Psychological Science, 21(1), 8-14.

Nikulina, V., & Widom, C. S. (2013). Child maltreatment and executive functioning in middle adulthood: A prospective examination. Neuropsychology, 27(4), 417–427. https://doi. org/10.1037/a0032811

Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the Neurosequential Model of Therapeutics. Journal of Loss and Trauma, 14(4), 240–255.

Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits.” Infant Mental Health Journal, 16(4), 271–291.

Richert, K. A., Carrion, V. G., Karchemskiy, A., & Reiss, A. L. (2006). Regional differences of the prefrontal cortex in pediatric PTSD: An MRI study. Depression and Anxiety, 23(1), 17-25. 

Rutter, M., & O’Connor, T. G. (2004). Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees. Developmental Psychology, 40(1), 81-94.

Schore, A. N. (2003) Healing trauma: attachment, mind, Body and brain. Canadian Child and Adolescent Psychiatry Review, 14(4), 120-121.

Suliman, S., Mkabile, S. G., Fincham, D. S., Ahmed, R., Stein, D. J., & Seedat, S. (2009). Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents. Comprehensive Psychiatry, 50(2), 121-127. 

Turner, H. A., Finkelhor, D., & Ormrod, R. (2010). Poly-victimization in a national sample of children and youth. American Journal of Preventive Medicine, 38(3), 323–330.