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By Susanne M Dillmann, Psy.D. 
Reactions to trauma follow a cyclical and often perpetual pattern, flowing from intrusive and arousal to avoidance reactions. Intrusive and arousal reactions bring the traumatic experience into one’s awareness. But being exposed to elements of the trauma is frightening, overwhelming, terrifying and at times socially embarrassing. Therefore, one often tries to bury anything connected with the trauma. These attempts at erasing aspects of the trauma are called avoidance reactions. All avoidance reactions prevent an individual from integrating the traumatic event into her or his life and thereby impede healing.
Avoidance reactions can take on many unique forms; however there are several common ways by which people attempt to avoid elements of their traumatic experiences. These common ways are: avoidant behaviors, relationship problems, emotional numbness, dissociation and addictions.
Avoidant behaviors occur when an individual avoids anything that even remotely reminds – or that she or he thinks will remind – her or him of the trauma. While this may seem to be an effective strategy, the reality is that such an approach leads to an individual’s life becoming narrower and narrower as she or he retreats from society and the world at large. Often times an individual will not explain his or her avoidance, which can allow the individual to pretend that the avoidance is not linked to the traumatic event and leaves loved ones confused about what is occurring and uncertain of how to help.
Relationships – due to the fundamental requirements of trust and vulnerability – can also remind people of the traumatic event(s), particularly when the traumatic experience was interpersonal in nature. Due to this, it is common for individuals to avoid current relationships and/or cease developing new relationships. This avoidance of relationships often leads to feelings of disconnection, loneliness, alienation, etc..., all of which can compound the distress the traumatic event unleashed. These mounting emotions are sometimes managed through emotional numbing.
Just as aspects of the larger world and relationships can be reminds of the traumatic event, emotions can also be triggers. Survivors can (falsely) believe that if they feel anything they will become consumed by that emotion and fall apart - becoming permanently unglued. Even though this will not occur, many people manage these fears through the avoidance of emotions or by shutting down when an emotion is experienced. Once again there is a degree of logic to this reaction but in reality such a response leads to emotional numbness. Emotional numbness is best described as a sense of hollowness or having a deep void. It is as if someone scooped out all of one’s feelings, discarded them and did not fill in the ensuing hole. Signs of emotional numbness are an apparent inability to feel any emotion, even if one wants to feel, and/or an inability to express an emotion, i.e. one feels sad and wants to cry, but cannot.
In some ways, dissociation is the cognitive or thinking equivalent of emotional numbing. When thoughts or emotions become too overwhelming people sometimes unintentionally alter their state of consciousness. Phrased another way, the individual’s mind simply wanders off. The individual still registers what is occurring around him or her but it is as if he or she is watching everything through a foggy window, as if he or she were in the audience watching life unfold on a big screen TV. A sense of indifference, emotional detachment and passivity often accompany periods of dissociation.
The final type of avoidance reaction we will cover is that of addictions. Another way to avoid being reminded of the trauma or to avoid emotions is to excessively use drugs, alcohol and food. Indulging in these behaviors can provide temporary relief from the pain, or fill one’s internal sense of emptiness. However, the relief provided by the addiction is temporary and makes matters worse since it is common for the avoided thoughts and emotions to return with heightened intensity once one becomes sober. If you or someone you know is using addictions to manage a traumatic live experience(s), reach out to a professional to help you navigate through the addiction.
Addictions, just like the other types of avoidance reactions: dissociation, emotional numbness, relationship problems and avoidant behaviors, create havoc and turmoil in one’s life. These ‘solutions’ do not bring about the promised reductions in distress, pain and emotional suffering; rather they add to one’s distress, pain and emotional suffering. Often times the way to reduce an avoidance response is to do the exact behavior that one is avoiding. With regards to trauma, this means confronting the reality and healing through the impact of the trauma(s). Utilizing a therapist who has professional expertise in trauma will aid you in this healing process.
As noted in the title, the next type of trauma reactions we will look at is the ever-present ‘other’ or miscellaneous category. These reactions fall into this category not because they are less impacting or prevalent than any of the other reactions mentioned. In an effort to organize this category, we will look at emotional, thinking and physical reactions.
Common emotional reactions include depression, anxiety and traumatic grief which if not managed can develop into psychological disorders. A halting to one’s emotional development is another reaction to trauma. This means that one navigates life and behaves like the age one was when the trauma occurred. A twist to this response is behaving in a manner more appropriate for a younger developmental age. Additional emotional reactions are: a decrease in self-esteem, a loss of confidence and engaging in verbal/emotional self-abuse, for example harshly deriding oneself for experiencing these trauma reactions.
A change to one’s thinking and belief systems may also occur. Survivor guilt and self-blame are two ways that one’s thinking can change. Survivor guilt is feeling guilt for surviving the trauma, having fewer injuries (physical & emotional), having more support, etc… when others who experienced the same trauma were/are not as fortunate. Self-blame is feeling guilt and responsibility for the event, believing that it was one’s fault. This sense of self-blame is partly due to American society’s ‘blame the victim’ approach to trauma and partly due to an individual’s difficulty in accepting her or his powerlessness during the traumatic event. A preoccupation with justice and revenge is also a common reaction. Intertwined with this preoccupation is a belief that if and when justice is served the negative impact of the trauma will vanish. While inaccurate, this belief often exists when legal proceedings occur. Another change in thinking has to do with a sense of a foreshortened future. Phrased another way, this is when an individual develops a sense of doom for the future, presuming that the future holds more bad than good, more danger than safety. Intertwined with these erroneous predictions is a belief that one is powerless to impact the future. These beliefs coupled with the often ensuing poor planning or excessive risk taking can block one from accomplishing one’s goals such as career and relationship milestones.
Physical reactions are the final set of issues we will look at within the miscellaneous category. Due to the severe danger that accompanies traumatic events, it is quite common to have memory difficulties following a traumatic experience. This includes both struggles with remembering the traumatic event as well as having memory difficulties after the event. In addition to memory problems, struggles with concentration are a frequent occurrence. Additional common physical reactions are: intestinal problems, such as diarrhea, abdominal distress and irritable bowel issues, frequent urination, irregular menstruation, hot flashes or chills, difficulties with swallowing and struggles with chronic fatigue, chronic pain and fibromyalgia. Whenever such physical reactions occur it is wise and encouraged to consult with a trusted medical physician to whom one can share the reality of one’s traumatic experiences and physical reactions. Keep in mind that just because these are common physical reactions to a traumatic event that does not mean only individuals who have experienced trauma grapple with these physical issues.
While not exhaustive, this article covers many of the common emotional, thinking, physical and avoidance reactions that occur after a traumatic experience. Each of these reactions is pursued in an effort to calm the distress that the traumatic event(s) unleashed. Unfortunately these efforts due not bring about the resolution and healing that the survivor of the traumatic event so desperately desires and deserves. Thankfully it is possible to learn how to develop effective ways to manage the consequences of a traumatic event and to heal. About the Author...
Dr. Dillmann works with individual adults to improve their emotional lives, find peace from painful memories/experiences and develop skills for healthy living. Dr. Dillmann has focused much of her work on helping adults come to terms with and heal from traumatic events. For more information on Dr. Dillmann, please visit her website at http://www.drdillmann.com. Last Update: 11/2/2009
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