Any deeply distressing or disturbing experience that impacts a person’s ability to function, either in the moment or over a period of time, can be considered trauma.
According to the federal government’s Substance Abuse and Mental Health Services Administration, 15 to 25 percent of women in the United States will have experienced sexual abuse either as children or adults.
Statistics from the U.S. Veteran’s Administration indicate that as many as 50 percent of all women will have experienced trauma in their lifetime.
Trauma in women is more likely to be the result of sexual, emotional or domestic abuse, as well as psychological abuse or neglect.
Among men, Post Traumatic Stress Disorder (PTSD) is more likely to have resulted from violence experienced during military service; as more women are deployed, however, rates of war-associated PTSD are becoming more common among them.
Whatever the cause, many research studies have shown — and our experiences at Cooley Dickinson Hospital in Northampton bear this out — that traumatic events have mental health, emotional health and chronic physical health ramifications. This bio-psycho-social combination is particularly evident when traumatic events occurred in childhood. When this is the case, re-traumatization can occur due to a triggering event. We see this often among our relatively large college-age population in the Pioneer Valley.
Young women who experienced early trauma may be leaving home for the first time. When they arrive on campus, they enter an entirely new social scene and their personal interactions often trigger long-buried vulnerabilities.
Outward signs can include alcohol or drug abuse, depression or anxiety and self-destructive or risky behaviors.
For example, a woman who was physically abused by her father when she was a child might choose to date a man who is violent toward her. She gravitates toward the re-traumatizing event because she believes that if she can “fix” the man who beats her, she can “fix” her relationship with her father and, in the process, “fix” her trauma.
In another scenario, a woman who experienced sexual trauma in the past may enter a romantic relationship, only to sabotage it through her actions or words because, unconsciously, she believes “I’m not worthy of a healthy relationship.”
It is important to recognize symptoms because the residual effects of trauma can create roadblocks, prohibiting women from building self-esteem, moving forward in their relationships and careers, and fulfilling their goals and dreams.
The first step for a woman who has experienced trauma is to speak to her primary care provider. This is important because a provider who is aware of and understands the impact of traumatic experiences on a particular patient will have a point of reference for the future. Effective care encompasses not only physical care but also builds toward psychological, spiritual and emotional health and safety for the patient. This is called trauma-informed care.
For example, for a woman who has been sexually abused, something as simple as a request at an office visit to “take off all your clothes and put on this johnny” could be a trigger for re-traumatization. Knowing a patient’s past can help a provider avoid this.
In addition to speaking with their primary care providers, many women benefit from psychotherapy. There are many types, and a good therapist can sort out which approach might be most beneficial.
Supportive therapy allows women to talk about their trauma and its effects. Cognitive behavioral therapy shows women how to identify the causes and effects of trauma and alter their responses to triggering events. Sensory modulation therapy alerts women to over stimulation and helps them make sensory choices to avoid re-traumatization.
Economic and social barriers often prevent women from seeking the care they need. Challenges include social stigma, inadequate insurance, and lack of access to clinicians with the necessary training to effectively treat trauma.
The experience of invalidation — from whatever source — causes many women to question whether they caused the abuse themselves. For instance, a parent may comment, “If you are having problems with your husband, it must be your fault. Just try harder.”
It could be a judicial system that often appears to protect the perpetrator rather than the victim of a campus sexual assault.
It could be a well-meaning friend who, despite knowing about her friend’s trauma, cannot understand or tolerate her friend’s depression or self-destructive behavior.
Most women who have experienced trauma will benefit from knowing they are not alone. They may also take comfort in knowing that the effects of trauma are treatable and help is available.
In emergency situations, immediate help is available from hospital emergency departments and emergency services providers. In non-emergency situations, many primary care physicians are trained to identify and refer patients to professionals qualified to treat the effects of trauma. And, for many women, finding a safe and supportive community or group where women can talk about past trauma with empathetic listeners can be a powerful tool in healing.
Bruce Bradley-Gilbert is counseling and group program coordinator, Inpatient Behavioral Health at Cooley Dickinson Hospital in Northampton.
Women’s Health is written by health care professionals affiliated with Cooley Dickinson Hospital in Northampton. It appears here monthly.