Trauma Therapy – How to Deal With Extreme Fear After Trauma

Some people experience intense emotions and thoughts about past traumas even when minor cues remind them of the event. This can make it difficult to communicate with others.

A therapist trained in Trauma Therapy will not identify trauma-related symptoms and behaviors as pathology but rather as adaptive responses to an abnormal situation. They will work with you to develop mutual and collaborative therapeutic relationships.

Resilience

Resilience is the ability to bounce back from traumatic experiences. Trauma may be a result of neglect, abuse, violence, loss, illness, injury, marginalization or discrimination. It can also be caused by witnessing the trauma of others or growing up in an environment that is prone to such events.

Resilient people are often able to overcome such challenges with little lasting effects. They have developed a range of protective factors that can counterbalance significant adversity. These factors include: optimism, cognitive flexibility, active coping skills, social support, physical health and wellness and a personal moral compass.

Resilient people tend to have a greater capacity for fear-tolerance, are more likely to develop relationships with others and are more generous in their actions. They are able to recognize the difference between feelings of stress (high zone), activation and shut down (low zone) created by their autonomic nervous system. They can also learn to track their coping and recovery strategies.

Coping Mechanisms

The ability to cope with stressful events is a vital component of mental health. People use a variety of healthy and unhealthy methods to manage stressors, like meditation or a healthy diet. Unhealthy emotion-focused coping mechanisms can be ineffective or harmful in the long run, however.

Trauma impacts your whole life, requiring a major adjustment in the way you live. It can change your relationships, job and ability to enjoy the things you used to love. It can even make you sick, as it can cause long-term physical problems.

A therapist can help you develop a broader range of coping tools to deal with trauma. They can also review your “window of tolerance” to triggers and talk about how you can recognize when you’re coping effectively (i.e., inside the window) and when you’re outside it. This approach is in line with the Stress Generation Theory of PTSD and coping.

Symptoms

Survivors of trauma often experience extreme and persistent emotions that are difficult to regulate. They may feel overexcited and hyper-aroused (hyperarousal), or shut down and numb (hypoarousal). They also experience a lack of self-confidence and feelings of helplessness, anxiety focused on memories of the event, depression, sleep problems, difficulty concentrating, fear of recurrence, and avoidance of emotions, sensations, or activities associated with the trauma. Some survivors may engage in unsafe coping mechanisms such as self-harm or drug/alcohol abuse to manage the intensity of their symptoms.

A therapist who is trained in trauma therapy will understand that many of these symptoms are a normal reaction to an abnormal event. They will help you work through your feelings and learn to regulate your emotions and thoughts in healthy ways. For example, they might recommend prolonged exposure therapy or cognitive behavioral therapy. Both involve gradually confronting your traumatic memories, fears, and emotions and learning that these are not dangerous or need to be avoided.

Treatment

Getting professional help is the best way to deal with lasting fear after trauma. You and your health care provider can discuss treatment options including psychotherapy, medications, alternative therapies, or support groups.

Treatment focuses on helping people get control of their lives after trauma. This may involve talking about the event and understanding their reactions (for example, feeling guilty or believing they should have prevented what happened).

A therapist can also help people stop avoidance habits such as avoiding things that remind them of the trauma. The goal is to face memories and feelings, gradually reducing symptoms over time. This can include eye movement desensitization and reprocessing (EMDR), which involves eight to 12 weekly sessions that last about 90 minutes each, or Narrative Exposure Therapy (NET). Another option is prolonged exposure therapy, which usually takes place over three months. Medications like antidepressants (selective serotonin reuptake inhibitors such as sertraline [Zoloft] and paroxetine [Paxil]) can reduce anxiety, agitation and depression.