Kaely Ferrara

Psychotherapy for Trauma and Stressor Related Disorders

What is Trauma?

This is a loaded question, but lets keep it simple:


Trauma is any event that ruptures 

our general sense of predictability and safety 

within the world.

Trauma is Subjective 

Trauma is not a ‘’conscious’ decision but rather an executive decision made by our nervous system’s interpretations and interactions with specific parts of the brain.


What this means:

  • What can be felt as ‘traumatic’ by one person, may not be ‘traumatic’ to another person.
  • Our body may have a trauma response, even when we don’t believe it should.
The good news:

If trauma impacts our body’s way of processing information... and if  we view symptoms as ‘overactivity’ or ‘under activity’ within certain regions of our brain... we can teach our body how to ‘rebalance’ itself by decreasing activity in certain neurological regions and strengthening other neurological regions. 

Neuropsych and Trauma 101

Trauma can physically change the way in which our brain processes information. Below are a few areas that can become altered post trauma. Neuropsychology provides a framework for how to assess under active and overactive regions within the brain.

The Amygdala

The ‘Fire Alarm’ system for our brain. When overactive, we become hyper alert to our surroundings and feel constantly ‘on edge’. In order for trauma therapy to be successful, we have to decrease the over activity of this region.

The Thalamus

Receives messages from our 4 senses (sight, sound, touch, taste) and communicates this information to our amygdala (the ‘fire alarm’ of our brain). This is important because we can adjust how active our amygdala is through our sensory experiences.

The Hippocampus

The ‘Memory Chip’ of our brain that communicates with our amygdala. This part of our brain can take ‘pictures’ of events and file it away for future reference. It is built to quickly make a decision (but not always accurately) whether or not a real threat exists based on first hand experiences and evolution.

The Insula

Responsible for ‘feeling into the body’ and interpreting sensations into emotions (eg., racing heart= I am scared). 

With an under active Insula we may see dissociation (e.g., ‘blacking out’, daydreaming) or feelings of numbness. 

If over active, the body can start to feel the same internal experience that it felt during the trauma- despite the trauma having ended. Individuals with panic attack disorder can show a pattern of interpreting their symptoms inaccurately based on Insula interpretation of sensations (e.g., heart racing = ‘I’m dying’). 

The Cingulate

The ‘Error Check’ center of our brain. It monitors for when a mistake occurs. This part of our brain allows us to think one thing while feeling another (eg., ‘I know I should quit smoking...but I don’t want to’.)

The Prefrontal Cortex

Our ‘Higher Functioning’ center. The area responsible for organizing information, tending to tasks, sustaining attention, and decision making. Includes our Left Hemisphere (attention, concentration) Middle Hemisphere (thoughts about ourself, self awareness) and Right Hemisphere (empathy, our ability to feel what others are feeling). Typically this area is under active post trauma.

Common Sources of Trauma

Abortion

Terminating a pregnancy can result in a mixture of emotions and at times psychological distress. Therapy can be a safe space to process the complex feelings that result from terminating a pregnancy.

Abuse

Whether as an adult or as a child, experiencing abuse (physical, emotional/verbal, or sexual abuse) can shatter ones basic sense of safety and lead to symptoms of trauma.

Addiction

Having a loved one who struggles with addiction can be incredibly stressful and confusing. Therapy can provide a space to process the damage often caused by addiction and develop new ways of coping with a loved one’s recovery process. 

Community Violence

Communities can dramatically affect our core sense of safety. Individuals who have lived in a chaotic or violent community can develop symptoms of trauma, regardless of whether or not they have directly experienced an act of violence.

Complex Trauma

The dark underbelly of social media and texting. Too often, individuals suffer in silence. Low self esteem, suicidal thoughts and self harm can result from bullying. The effects of cyber bullying can be lifelong. Treatment can help find healing post trauma.

Divorce

The process of divorce can be chaotic and confusing in nature. Individuals who have experienced traumatic divorces often need support in recreating life post divorce as well as processing the grief of what life used to look like.

Domestic Violence

Intimate relationships are intended to be a source of safety and support. When intimate partner violence is experienced or witnessed, symptoms of trauma can occur.

Grief

Grief can take many shapes and forms, including unexpected loss or ambiguous loss (loss which lacks a clear sense of closure). Therapy can provide a safe space to process the complexity of grief.

Infidelity

When betrayal occurs in a relationship the effects can be devastating. Emotional infidelity, physical infidelity, or having a partner who engages in chronic porn use, often ruptures the sense of safety within the relationship.

Life Change Event

Major Life events that are experienced with extreme stress can lead to symptoms of trauma. Examples of life change events may include the birth of a child, a career change, loss of a job, or having moved to a new place.

Natural Disaster

The process of rebuilding post natural disaster can be a daunting task, both physically and emotionally. Therapy can help provide space to process feelings of fear, loss and hope.