What is Trauma?
When we experience stressful, frightening or distressing events that overwhelm our capacity to cope, we might define this as trauma. How events affect a person is unique and determined by many factors, what one person may experience as traumatic may not affect someone else in the same way. When we feel stressed or threatened, our bodies release hormones called cortisol and adrenaline. This release is the bodies automatic way of preparing us to respond to danger and is not under our conscious control. This process can result in a range of effects such as freeze (feeling paralysed or unable to move) flop (doing what your told and feeling unable to protest) fight (fighting struggling or protesting) flight (hiding or running away) or fawn (trying to please someone who harms you). These responses to stress signals can continue long after the trauma is over and affect your mind and body, including how you think, feel and behave.
Effects of Trauma
Flashbacks: reliving aspects of a traumatic event or feeling as if it is happening now. Panic attacks: a type of fear response, an exaggeration of the body’s response to danger stress or excitement. Dissociation: the way the mind copes with overwhelming stress, resulting in feelings of numbness, spaced out, detachment from the body or seeing the world as unreal. Hyperarousal: feeling anxious or on edge, unsafe, unable to relax or constantly looking out for threats & danger. Sleep issues: finding it hard to fall or stay asleep, feeling anxious or afraid at night or fear of having nightmares. Low self-esteem: negative view of ourselves, finding little or no value in who we are or feeling like a bad person. Grief: many people experience grief as a result of how trauma has changed their life. You might feel that trauma has caused you to miss out on things in life which is also a type of loss. Self-harm: hurting yourself to cope with difficult feelings, painful memories or overwhelming situations.
Suicidal feelings: being preoccupied by thoughts of ending your life, thinking of ways to take your life or making a suicide plan. Alcohol and drug use: a way to cope with difficult emotions or memories. Eating disorders (see eating disorder page). Feelings of self-blame: to make sense of what has happened, avoid overwhelming feelings of anger, grief or betrayal. Physical health issues: research suggest that trauma can make a person more vulnerable to physical health problems including long-term or chronic conditions. Daily challenges: lack of self-care, difficulties holding down a job, challenges trusting others, inability to maintain relationships, memory struggles, challenges with intimacy, inability to cope with change or enjoy life.
PTSD
Posttraumatic stress disorder (PTSD) may occur in people who have experienced, witnessed or heard of a traumatic event, series of events or been exposed to repeated details of trauma. A person may experience these events as either emotionally or physically harmful or life threatening, affecting mental, physical, social or spiritual well-being. Examples of these events include natural disasters, serious accidents, terrorist acts, sexual assault, historic trauma, domestic violence and bullying.
Those struggling with PTSD may have intense intrusive thoughts and feelings about the trauma that still occur long after the event has ended. They may experience the sense of “reliving” the event through flashbacks or nightmares or feel overwhelming sadness, fear, anger or total detachment from themselves and others (dissociation). Those with PTSD tend to avoid situations, people, thoughts or feelings that remind them of the event and may be hypersensitive to noises, smells or touch.
Those with PTSD are also affected by alterations in thinking and mood such as distorted views about oneself or others (“I am bad and nobody can be trusted”). These experiences also lead to alterations in emotional regulation and reactivity such as irritability, anger, impulsive behaviour, being overly watchful or having problems concentrating and sleeping. For a person to be diagnosed with PTSD these symptoms must be present for more than a month after the event and must cause a significant impact on daily functioning.
Complex PTSD
C-PTSD is a form of developmental trauma (usually involving the primary care givers) which starts at an early age. This trauma is ongoing and across a prolonged period where escape was impossible, such as child abuse, neglect or abandonment. Those struggling with C-PTSD will have the similar symptoms to PTSD alongside additional factors such as feeling empty, hopeless, permanently damaged, worthless, feeling as if they don’t fit in or no one understands and potential dissociative symptoms.
EUPD/BPD
EUPD/BPD is the byproduct of a complex web of trauma and adverse life events. It is characterized by difficulties in regulating emotions, unstable self-image, turbulent interpersonal relationships, impulsive behaviors, and a profound fear of abandonment. Many individuals with BPD/EUPD have a history of trauma, which can include physical, emotional, or sexual abuse, neglect, or other traumatic events. Trauma can profoundly impact a person’s emotional development, leading to the manifestation of BPD symptoms.
Trauma-related experiences may contribute to the development of BPD through various mechanisms. For instance, traumatic events can disrupt the development of healthy attachment patterns, resulting in difficulties forming stable and secure relationships. The intense emotional distress associated with trauma can also impair emotional regulation skills, leading to emotional dysregulation commonly seen in BPD.Moreover, trauma can profoundly affect one’s self-perception. Individuals who have experienced trauma may develop a negative self-image, feelings of worthlessness, or a distorted sense of identity. These factors contribute to the unstable self-image characteristic of BPD.
It is important to recognize that not everyone who experiences trauma will develop BPD. However, trauma can significantly increase a persons risk of experiencing the challenges associated with BPD/EUPD. BPD/EUPD might be seen as an extension of Complex post traumatic stress (C-PTSD) in that it has the characteristics of PTSD alongside ongoing developmental trauma, usually instigated by the primary caregivers. It is crucial to approach the treatment of BPD with a trauma-informed perspective. Therapeutic interventions that address both the trauma and BPD symptoms can help individuals heal and regain control over their lives.
Trauma-focused therapies, such as Dialectical Behavior Therapy (DBT), and 3- phase trauma interventions (see therapy section) have shown promise in helping individuals with BPD and trauma histories. These approaches focus on processing traumatic memories, developing healthy coping strategies, and enhancing emotional regulation skills. As a trauma therapist I am happy to work with EUPD/BPD form a trauma informed approach and I will do my best to foster a safe and supportive environment for individuals with BPD, recognizing the impact of trauma on their experiences. By acknowledging the trauma underlying this EUPD/BPD and providing targeted interventions, we can facilitate the healing and growth of individuals living with BPD.
