The thing about trauma is that it’s always unexpected. In one crucial moment, it descends quickly upon its victims, dousing them with fear, striking them helpless and horrified, and leaving them with intense amounts of grief and distress to untangle in its aftermath. The effects can certainly be profound, but researchers studying traumatic psychological reactions and have found that with proper treatment, hope and healing can be had by even the most devastated victims.
The world-renowned Dr. Edna B. Foa, Director of the Center for the Treatment and Study of Anxiety, spoke at Drexel University recently as part of the College of Arts and Sciences Dean’s Seminar Series about what constitutes trauma, the process of a traumatic reaction, and how to treat trauma victims as they struggle to recover. Dr. Foa has extensively studied many anxiety disorders, including groundbreaking work on obsessive compulsive disorder and the psychopathology and treatment of post-traumatic stress disorder, and she is among the world’s three leading researchers in the field of anxiety. She has also won two lifetime achievement awards from the American Psychological Association, among other merits, and is currently part of the Department of Psychiatry at the University of Pennsylvania. A small woman dressed entirely in black apart from the red chiffon bubbling out of her sleeves, Dr. Foa beckoned the sixty or so students and faculty in the audience to move closer in her European accent as she began her presentation titled, "Healing after Trauma."
The definition of a traumatizing experience has become over-extended in everyday conversation to mean anything from a car accident to embarrassing oneself on stage. Some experiences labeled as traumatic are merely stressful. In a clinical sense, traumatic experience occurs when a person experiences or witnesses an event that involves actual or threat of injury or death to oneself or another person. Emotional responses include feeling horrified, terrified, shocked, grief-stricken, or helpless during the event. Common traumatic events include natural disasters, war zones, accidents, and physical attacks. Once the event has passed, victims of trauma are left with any combination of post-traumatic stress disorder, traumatic grief, depression, alcohol or substance abuse, or impaired functioning; symptoms only occur after the event. Trauma causes a person to feel incompetent and unsafe, making it very difficult to return to the way life was before.
As devastating as the effects may seem, the possibility of recovery is substantial. One of the most important components of recovery is continuing normal activity; avoiding the circumstances in which the unexpected event occurred is not helpful because it fosters feelings of helplessness and the idea that the world is dangerous. By continuing life as it was before the event happened, victims are able to realize that the traumatic event was unique and rare.
Treatment options available today are very effective in recovery from anxiety and grief precipitated by trauma. Individual counseling, support groups, psychoanalysis, and cognitive-behavioral therapy are the most commonly applied treatments. Dr. Foa developed a treatment called Prolonged Exposure Therapy (PE), aspects of which include education about the event, controlled breathing exercises, imaginal exposure to the source of the anxiety, and in vivo exposure to the source. PE drops post-traumatic stress disorder by 20% and also works for treating depression. Traumatic grief treatment is similar, involving imaginal exposure to the experience to reduce the intensity of distress and guilt. Grieving victims are also encouraged to re-engage in daily activities.
Dr. Foa discussed the efficacy of these treatments, especially PE, and said, "Not every patient is cured, but most people feel better. She also remarked that post-traumatic stress disorder sufferers are reluctant to engage in treatment for various reasons—they believe they will get over it on their own, they feel guilty about the event and therefore that they should suffer, they don’t associate their feelings with the event, or they don’t believe in effective treatments—but that it is crucial that sufferers embrace recovery. "Facing the trauma will help you reclaim your life."