Trauma-Related Difficulties

Traumatic events are ones that are so extreme and threatening that they overwhelm a person's ability to cope. Some examples of experiences that may be experienced as traumatic include rape, physical assault, and life threatening injuries or accidents. Even once the traumatic event is over, many people find that they are so distressed by it that they are unable to effectively go about their daily activities. Examples of the difficulties people may experience after a traumatic event include: problems at work due to difficulty with concentration, sleepless nights, and apprehension about leaving the house; disruption in personal relationships due to irritability, feelings of mistrust, and a strong desire to withdraw from others; feeling "haunted' by memories and dreams about the event.

Friends with good intentions may urge a person who has experienced a trauma to "just forget about it" and "put it behind you," but it is often not possible to simply push it away. In fact, when a person tries to push thoughts about the traumatic event out of mind, often they come back more forcefully. As disruptive as exposure to a traumatic event can be, with appropriate treatment its distressing effects can be greatly reduced or entirely eliminated, frequently within a matter of weeks.

Problems Related to Child Abuse

In recent years there has been a growing recognition that the sexual and physical abuse of children and adolescents is much more common than previously thought. Child abuse is a deeply hurtful and potentially damaging experience. It can continue to affect the abuse survivor for years and decades after its occurrence in numerous ways. The types of difficulties that have been associated with a history of prolonged child abuse include:

• depression, a sense of hopelessness, and extremely low self-esteem;

• feeling fearful, anxious, mistrustful, and guarded much of the time;

• periodic flashbacks and/or nightmares of the abuse, and thinking about the abuse even when one does not want to;

• craving for acceptance, over-attachment to others even when they are mean or abusive;

• escape into compulsive or addictive behaviors such as substance abuse, eating disorders, compulsive sexual behavior, or self-injury;

• and dissociative experiences, described below.

Problems Related to Dissociation

The term "dissociation" refers to a range of experiences that have in common the purpose of allowing someone who has been exposed to overwhelmingly painful situations to mentally escape from or block out the resulting distress. Dissociative experiences are common among survivors of sexual and physical abuse, although they occur among other people as well, especially those who have suffered similarly extreme and intensely disturbing events. Examples of dissociation include:"spacing" or blanking out, having difficulty sustaining awareness of or staying focused in the present; extensive forgetting and significant gaps in memory; not being able to account for significant periods of time in the recent past, ranging from minutes to hours to days; not feeling real, not feeling "like oneself," feelings as if you are watching yourself from outside your body, feelings as if our srroundings are not real; finding evidence of or being told by other people about having recently  engaged in activities of which you have no recollection.