Is This What Trauma Feels Like?
How you process extreme stress now can pay off in the long run
My diagnosis of post-traumatic stress disorder came after a string of difficult personal events: a traumatic birth, an eviction, two close family members diagnosed with cancer, marital problems, even a cockroach infestation. Taken on their own, I might have managed each, but as they piled up over the course of three years, I found my anxiety climbing. I had nightmares and horrible daydreams; I was unable to focus on my son; I had panic attacks that put me in the hospital. A chat with my family doctor got me a referral to a social worker who specializes in PTSD. In my first session, I cried, not knowing if what I had gone through “counted” as traumatic; she reassured me that it did, and that she could help.
It was in PTSD therapy that I learned a way of thinking about trauma that can be very reassuring to people who, like me, might be compelled to second-guess the severity of their experience: ‘big-T’ trauma and ‘little-t’ trauma. Big-T covers the kinds of huge, cataclysmic experiences that we tend to associate with PTSD — things like combat, sexual assault, and life-threatening illness. Little-t traumas, on the other hand, might not be directly life- or body-threatening, but can be hugely destabilizing in a person’s life: job loss; housing uncertainty; food insecurity; loss of support systems like childcare, therapy, or time with friends — in short, what many of us are going through right now. When experienced in succession, those little-t traumas can have a big-T cumulative effect.
“Traumas large and small happen in our life,” says Hilary Fair, a psychotherapist in Stratford, Canada. While it can be tempting to downplay those smaller experiences of trauma, we shouldn’t. As Fair puts it, “Nobody really has the right to tell you whether or not you’re traumatized.”
But the difficult part of dealing with trauma is that we don’t always know in the midst of an experience whether it will be traumatic. As the world faces the same inexorable pandemic, this is one of the many ways our individual experiences of it will wildly diverge: Some will have horrific experiences and emerge saddened and exhausted but not traumatized. Others might face challenges that seem relatively manageable in the moment, then go on to suffer for years with PTSD symptoms. And, for others still, the effects of trauma will be harder to pin down.
As someone who’s still working through the reality of PTSD, I can tell you: There’s no magic bullet that’s guaranteed to stop trauma or its aftermath. A tough event that seems relatively low-impact in the moment can bubble under the surface, while a big-deal life event handled with support can be unpleasant, but not traumatic.
The good news is that there are ways to help our nervous systems regulate during and after periods of ongoing stress. In fact, research suggests that stress-reducing therapeutic tools like mindfulness, Cognitive Behavioral Therapy techniques, and old-fashioned exercise can build our resilience against trauma. Some of these tools may even help patients who have already received a PTSD diagnosis; for example, a 2017 review of PTSD treatment literature and overlapping neurobiological evidence found that mindfulness-based stress-reduction strategies showed a promising track record for reducing some PTSD patients’ symptoms.
As Fair puts it, in tough times, “it’s how we cope and care for ourselves that probably has the biggest effect on how we recover.” Here’s where to begin.
Check your 3-legged stool
If you’re really in the shit — for instance, as a frontline health care worker or an ill person’s primary caregiver — focus on stabilizing your three basic pillars: sleep, physical exercise, and nutritious food. “This sounds so banal and so boring, but it’s something we all mess up,” says Fair, who shares the stool as an image from cognitive behavioral therapy.
Sleep can be the hardest of these to correct, but Fair offers an encouraging caveat: “When we start tightening up the other legs of the stool — eating better, reducing caffeine, reducing alcohol, getting outside, getting fresh air, and calling a friend,” the emotional benefits can be profound. And better eating and exercise habits can often lead to better sleep.
Connect to your comforts
This is what therapists sometimes mean when they say “self-care.” Make a list of things that feel good. Put everything on that list: tactile sensations like soft blankets, petting an animal, or snuggling with a loved one (if you’re able). Reading a great book or watching a favorite movie. Activities like cooking, baking, or crafting. Writing or painting. Calling a friend or family member. Hot showers or baths. Walking in the forest or gardening.
Burn the energy
Run, walk, dance, do yoga or martial arts, work the stairs in your apartment building. While exercise isn’t a mental health cure-all, there’s an overwhelming body of research to back the mood-boosting and stress-relieving benefits many of us will receive from regularly moving our bodies. If you’re anxious, movement can help you expend some of your buzz; if you’re lethargic, it can help combat feelings of fatigue.
Lean into it
Boredom, stress, anxiety, and fear are normal emotions, and they’re to be expected when the world is scary or uncertain. Remind yourself that it’s okay to feel stressed out when things are stressful and that you don’t need to avoid or fight those feelings. Just do your best to move through them.
Feel the feeling
Emotions don’t just happen in our brains; they also have physical manifestations in the body. (Think of how sweaty you get when you’re nervous.) If you find yourself overcome by the stress of your situation, try to stand back and let that sensation run its course without getting too invested in the story behind it.
Let’s use, say, tightness in the chest as an example. It’s a common manifestation of stress. As you feel the squeeze, notice that sensation and name it, with words, in your head: “My chest feels tight.” Our human tendency is to come up with a reason why. We might start asking ourselves whether we’re having a heart attack or if Covid-19 is invading our lungs. For this strategy, skip that step. Resist the urge to figure out why the sensation is happening, and instead, tune in to how it feels. Relax your body as much as you can. Remind yourself, with words, in your head, that this sensation will pass.
Take your emotional temperature
When I started PTSD therapy, my counselor asked me to draw a thermometer. On one side, there were emotions, thoughts, and beliefs; on the other, body sensations. At my most relaxed — a one on the scale — my body felt loose and my thoughts were calm. At 10, when I was having daily panic attacks; my thoughts were all about how quickly I could flee. It may be helpful to spend some time figuring out your scale.
At the current moment, most of us can’t expect to live down in the chill zone, but this exercise can help us identify when we’re creeping into our highest numbers: What do our thoughts sound like? What parts of our bodies are activated? We aren’t trying to go from a nine to a three; but even deescalating a single point can make a huge difference.
Fair says that when she introduces these concepts to her clients, “I always pose these as experiments.” There’s a bit of a learning curve for using these techniques, but it gets easier.