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Trauma

Our guest expert in July 2011 was Dr. Catherine Classen, a clinical psychologist and associate professor in the department of psychiatry at the University of Toronto, and director of the Women's Mental Health Research Program at Women’s College Research Institute.

Traumatic events are experiences that overwhelm your ability to cope, such as events involving injury or the threat of physical harm, including interpersonal events such as assault or abuse. They can leave you with feelings of terror, shame, helplessness and powerlessness, and a sense of being out of control. Reactions to trauma can seem extreme or “crazy.” But these reactions and symptoms are not only normal; they are often ways to cope with extreme circumstances.

Here are Dr. Classen’s answers to your questions on Trauma.

Q:  Is there anything that can be done about reoccurring nightmares or daydreams? I find myself constantly revisiting past violent traumatic events throughout my days and nights. It happens every day. I relive it in my head only to realize I have been grabbing my hair or saying "no" out loud like a crazy person. Is there any way to actually repress these memories so that I don't have to relive them every day?

What you describe is a classic symptom of post-traumatic stress disorder (PTSD), although it is not possible to diagnose PTSD based on this symptom alone. I wonder if your daydreams are actually flashbacks where you feel as though you are reliving the trauma. Nightmares and flashbacks are the mind’s attempt to make sense of an overwhelming and frightening experience. Often what goes along with repeatedly re-experiencing a traumatic memory is hypervigilance (being hyperaware of your surroundings out of a fear that something will trigger the memory) and a tendency to use avoidance strategies in an attempt to prevent re-experiencing these distressing memories. Although there might be immediate relief from avoiding remembering what happened to you, avoidance strategies ultimately prevent a person from dealing with the trauma, which can lead to a recurring cycle of re-experiencing, hypervigilance and avoidance. By avoiding dealing with your traumatic past, these experiences will remain unintegrated into your understanding of yourself and the world, and the cycle will continue. To break this unsettling pattern, I recommend seeking psychotherapy from a knowledgeable mental health professional who can help you to deal with the intense emotions and beliefs that are associated with the experience and to enable you to gain a new perspective on these events in your life and how they affect your sense of yourself and the world.


Q: Can people who experience trauma early in life recover from it and have good lives? Everything I read about survivors of childhood emotional abuse, violence and neglect seems to suggest that the damage is both serious and permanent (especially if it began before age four or five). Can people recover from this type of damage?

Absolutely – people can and do recover from histories of child abuse and neglect and go on to lead satisfying lives. The extent of the abuse and/or neglect, the environmental supports the person had as a child and has as an adult, and the survivor’s own innate capacities, will all influence the healing process. Healing from severe and early traumatic experiences may require years of hard work but it can be done, especially with the help of a knowledgeable and caring therapist and a good support system.


Q: In January 2011, I broke my leg and a few days later had two massive pulmonary embolisms and five cardiac arrests! I spent several weeks in intensive care and several months recuperating at home and undergoing physiotherapy for my leg. Physically, I am well now.

Mentally, I'm not so sure. I seem to be in a mental fog about the accident and nearly dying. I do not want to talk about it, or think about it. But as a painter and writer, I feel that I need to explore this major experience in my life. However, I am scared even to read my journal notes that I made during my recovery, never mind going deeply into my feelings. I feel an overwhelming sense of shock that my life could have ended just by tripping and falling. Although happy to be alive, I feel incredible sadness about it all, a sense of urgency to do things just-in-case, and a sense of guilt that I put my loved ones through this trauma and slow recovery.

In your experience, is there a process, like there is for grieving, that I am going through? If so, what are the stages and when can I expect to clear my mental fog?

There is no simple answer to your question. The answer will depend on your personal history, your psychological capacity, and the availability of a support system. Your reflection on what happened to you suggests that you are already working to process this experience and that you would benefit from continuing to explore it in small and manageable doses. You might benefit from seeking professional help. However, as a painter and writer you may already have the tools you need to do this work. If you decide to explore this on your own, be gentle with yourself and go slowly. Make sure you have a good support system.  Allow yourself to do this work at a pace that is tolerable and that does not overwhelm you. Seek out a mental health professional to guide and support you if you feel overwhelmed by the process.


Q: I am a 21-year-old survivor of childhood sexual abuse. I recently completed psychological therapy, and have confronted my sexual abuser. Now, after facing all of my feelings, and working through so many problems, I find myself facing another huge hurdle. I am in a committed, monogamous relationship with an amazing man, and the thought of having sex with him terrifies me. Before I began therapy, our sex life was great. Now, I am afraid, and unable to physically enjoy any sexual activity. How can I learn to like sex again?

First of all, congratulations on the work you have done so far to recover from your experience of childhood sexual abuse (CSA). When I think about the work involved in recovering from CSA, I often think about the proverbial onion and peeling away layers of the onion skin. You have done a huge piece of work already but clearly there is more work to be done.

I wonder what the context was when you confronted your abuser. Was this something you did while you were still receiving psychotherapy and did you work on it while in therapy? Or, was this confrontation something that happened after therapy ended? If the confrontation occurred after therapy ended, that confrontation may have re-activated memories of your CSA experiences and that is what is now getting in the way of your sex life.

Regardless, it seems as though you are re-experiencing your trauma and that this is another layer of the onion that you need to peel away. I have two recommendations to offer but, of course, you will need to decide whether either makes sense for you. One is for you to enlist the support of your partner and be as open as you can about what happens for you while you engage in sex. Together you might be able to find how to make sex feel safe and pleasurable once again. The other recommendation is to seek professional support from a sex therapist who is knowledgeable about trauma or a trauma therapist who is comfortable working with these issues. I have no doubt that you will be able to work this through and once again enjoy your sex life with your partner.

 

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