Trauma: Psychological and Behavioral Effects on Humans

Introduction to Trauma: Definitions and Origins

Trauma is considered a form of "mental agony" — distress arising from problems internal or personal to the patient or victim, undergone during a given period. Even physical or mental distress can be considered trauma. The word itself means "injury" and derives from the Greek word for "wound." Trauma is any physical or mental shock or injury, specifically a serious wound or injury caused by some physical action, such as an automobile accident or violent assault. It also refers to psychological damage or an experience that inflicts such damage. Trauma may be physical, psychological, or both; it may refer to the injury itself or to the condition that results. Profound emotional shock, physical injury, and physical shock syndrome are all defined as forms of trauma.

Traumatic experiences shake the foundation of our beliefs about safety and shatter our assumptions of trust. These events and experiences provoke reactions that seem strange and overwhelming. Such reactions are unusual and disturbing, but they are typical and expected from trauma survivors — that is, they are normal responses to abnormal events. Trauma involves exposure to a life-threatening experience and has a significant effect both cognitively and affectively. A mental health problem is considered a disorder only when it is a clinically significant behavioral or psychological syndrome associated with a painful symptom (distress) or impairment in one or more areas of functioning. Trauma may be caused by ill health, continued suffering due to illness, family problems, or employment-related stress. It may also stem from terminal diseases, sexual harassment, unemployment, poverty, accidents, disasters, exam failure, or social stigma.

This paper delves into several facets of trauma and the behavioral changes it causes in different individuals with different backgrounds. It argues that trauma has a strong effect on human behavior both cognitively and affectively, while also examining physiological responses and the degree of social support provided. A psychic trauma is one that leaves some more or less lasting effect upon the individual and their adjustment. Emotional and psychological trauma can follow many diverse kinds of physically and psychically injurious events, and the response to any given trauma can show wide individual variation — due to inherent personality and to unconscious factors that are individual-specific.

Traumatic events can play an important role in an individual's life for months, years, or even a lifetime. From the broadest viewpoint, all emotional symptoms and illnesses can be regarded as ultimately stemming from trauma, whether that trauma is physical, psychological, or both.

Psychological and Physiological Effects of Trauma

Certain types of neuroses and neurotic reactions can follow traumatic events, in which they may be regarded as being caused or precipitated by those events. The prior existence of favorable psychological vulnerability has a considerable bearing upon the relative emotional impact of a given traumatic event. Trauma is a common and potent cause of shock. The shock associated with physical wounds is a combination of oligemic and neurogenic shock. Neurogenic alarm is caused by strong emotional stimuli, pain, fear, bodily injury, and by deep general or spinal anesthesia. Trauma, in a sense, is a psychological condition that leads to a disturbance of intellect, consciousness, or mental functioning.

The effects of acute conditions include persistent confusion, disorientation, constant restlessness, hallucinations, and delusions. Chronic conditions lead to a progressive, steady decline in memory, intellect, and behavior. In recent years, increased knowledge has heightened awareness of the relationship between trauma and psychological disorders. Disabilities following trauma are sometimes observed to be disproportionate to the accompanying physical injury — a disproportion that provides presumptive evidence of emotional factors. Emotional problems not infrequently result in more pain, suffering, and disability than physical ones (Laughlin, 1963).

Anxiety, hypochondriacal, and conversion reactions are the most frequently encountered specific emotional patterns of reaction to trauma in human life. The trauma may be physical, psychic, or a combination; it may be major or minor, and its role can vary widely in the initiation of symptoms. It can initiate, precipitate, contribute to, or aggravate a neurosis. The onset of symptoms can follow the trauma immediately or may be delayed for a considerable period. The effect of a given trauma will vary widely from person to person and is largely unpredictable. When the trauma is physical, the resulting disability is sometimes seen to be disproportionate to the physical injury. The acuity or repetition — or both — of the trauma are also factors that must be considered. Psychological trauma in early childhood can often lay the foundation for later emotional illnesses and can contribute to the vulnerability of the individual to subsequent physical or psychological traumatic events, though it may alternatively lead to the development of more effective defenses.

The neuroses following trauma may be expressed in a wide variety of symptoms that can be disabling, increase the patient's susceptibility to further trauma, and interfere with or prevent normal functioning. It has been long recognized that both physical and psychological trauma can and do have far-reaching effects on human beings. A significant group has also recognized that the disability following traumatic events frequently extends far beyond any demonstrable physical impairment. Handicaps and disabilities that are emotionally based are at least as real and as troubling to the victim as physical ones. In some ways they are even more so, since one has less control or understanding of them and is thus more helpless and less able to cope effectively (Cattell, 1963).

When one begins to study emotional problems, it quickly becomes apparent that they are apt to be more painful, more troubling, and more disturbing than physical ones. Physicians can report instances in which a patient will try — sometimes with great effort — to discover physical bases for symptoms that are essentially emotional in origin. Emotional problems are likely to be far more complex in terms of resolution than physical ones. It is indeed rare, on the other hand, for a patient with physical symptoms to seek an emotional or psychological origin for them. Knowledge about neuroses and traumatic factors in their onset is becoming increasingly widespread.

An important issue, therefore, is: who is receiving what injury, and in what setting does the injury occur? One factor in determining the reaction to injury is its relative reversibility. The setting in which an injury occurs and the motivation to return to full function have a striking influence on the person's reaction. A college football player, for example, may sustain a fracture of the collarbone or shoulder blade during a game and not be aware of it until the game is over. Individuals who sustain injuries while under the influence of alcohol are also less likely to develop a post-traumatic emotional reaction than those injured in an industrial accident. The former group would prefer to overlook the situation and minimize the effect of the injury (Shulzinger, 1956).