Not All Wounds Are Visible

24 May Not All Wounds Are Visible

We’re gonna talk about trauma. I know this isn’t a sexy or cool topic of discussion; in fact, it sucks. We want to gloss over it really quickly so we can get back to “real life.” But that’s just what trauma wants us to do – avoid talking about the pain at all costs. We commonly think of it as a disorder relegated to the military and people who have been sexually assaulted. But it affects more of us than we want to admit or are aware.

According to PTSD United (, a non-profit dedicated to supporting those with PTSD, 70% of American adults have experienced a traumatic event in their lives, which is approximately 223.4 million people. Of those 223 million, about 20%, or 44.7 million people, have or had PTSD. This means that, in all likelihood, you know someone or are someone that has experienced trauma.

So what is trauma? Broadly defined, trauma occurs when an individual experiences a distressing experience. This could be a “Big T” trauma (a car accident, assault, natural disaster, combat/military experience, being shot, etc.) or a “Little t” trauma (these are more subjective, but usually include stressful experiences in interpersonal relationships, illness, grief, infidelity, neglect/abuse from a loved one, etc.). Most of us are able to file away these distressing experiences in the part of our brain that stores memory; we might think of the event, but in general, it was simply something awful that happened to us. But for those 44.7 million people, these Big and Little T’s get stuck in their prefrontal cortices (the part of the brain responsible for helping us to make good decisions and to understand information).

Because the memory or memories get stuck, the individual is forced to replay them over and over again, trying to make sense of the experience. With every replay she feels like she is reliving the event, feeling the same feelings and experiencing the same distress. The body then kicks into what we all know as “fight/flight/freeze” mode, causing a surge of the stress hormones, cortisol and adrenaline.  Constantly elevated levels of these two hormones cause physical stress on the body and keep the person on high alert at all times.

You may notice that you feel anxious and panicky all the time; and when you do not feel anxious, a depression takes over. You may look for the exit in every restaurant/bar/shopping mall, making sure that you are aware of the safest, fastest way out. You may feel like nothing seems real, or like you are watching your life happen from a distance. You might experience nightmares or night terrors that prevent you from getting good sleep. Some people will react in anger and frustration out of an inability to tolerate uncomfortable thoughts and emotions that continue to arise from re-experiencing the event(s).

Another common experience among those with PTSD is the sensation of feeling numb or disconnected. Others will engage in risky, impulsive behaviors just so they can feel something. And some will self-medicate with drugs, alcohol, sex, or relationships to avoid the intrusive thoughts. Some will experience a combination of all three.

Treating Trauma

So what should you do if you find yourself identifying with any of the scenarios above? My suggestion is to seek the help of a trained medical professional. Trauma, whether that is one or multiple incidents, is resolvable and does not have to be in control of your life. Help can come in many forms, so it is important to do your research so that you can find the most appropriate course of treatment for your trauma symptoms. Here are some basic guidelines when looking for help:

1.    Find a medical professional (therapist/psychologist/psychiatrist) who specializes in the treatment of trauma and is abreast of the most current treatment methods. You can look for these professionals at,, or a Google search.

2.    Make sure that you feel secure with the therapist you select. You will be providing this professional with details about your life and distressing events. It is important that your therapist provide a comfortable, nonjudgmental environment for you.

3.    Once you have found a therapist, insist on creating a safety/crisis plan with him/her so that you know what to do if you experience upsetting or distressing emotions. This should include a list of positive coping skills, a list of things for you to do when overwhelmed, and a list of people you can call.

4.    It can also be helpful to treat some of the physical symptoms of trauma with bodywork like acupuncture, massage, and/or increased physical activity. It is important for you to find the most effective and comfortable form of treatment for you.

5.    Research a treatment method called EMDR (eye movement desensitization and reprocessing). It is an evidenced-based form of therapy that continues to have many positive results. You can go to or for more information.

6.    Look into other treatment methods such as Biofeedback, Cognitive Processing Therapy, and Trauma-Focused Cognitive Behavioral Therapy. There is no single prescription for curing trauma, so it is important to find what works for you.

7.    Find a local support group. It can be a very powerful and healing experience to hear how your peers are dealing with their own experiences. Check out,, or for a list of meetings/groups in your area.

8.    Educate yourself about trauma and how it affects your life. There are many good books, articles, and websites dedicated to providing information about trauma and how to treat it. If you’re interested, start with, or check out these books:

·      The Body Keeps the Score, by Bessel van der Kolk

·      Getting Past Your Past, by Francine Shapiro

·      Waking the Tiger, by Peter Levine

Treating your trauma is a bold and courageous step. It requires you to face the things you would rather avoid and run from. But you have the strength it takes to confront your trauma and allow your brain and body to heal.

Online Therapy, Video Therapy, Teletherapy

Sue Shrinkle, MS LMFT, is a Marriage and Family Therapist. She is currently in private practice at Coastal Counseling. If you would like to make an appointment with Sue, please call 1-888-470-4415.

This article and the information herein are for educational and informational purposes only. It is not meant as a substitute for professional psychological or therapeutic services.  The self-help information provided by this blog are solely the opinion of the bloggers and should not be considered as a form of therapy, advice, direction, diagnosis, or treatment of any kind. Instead, the information is designed to be used in conjunction with ongoing treatment provided by a mental health professional. Use the information in this blog at your own risk. All of the information is provided “as-is,” with no warranties of any kind, express or implied.

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