The Psychological Basis of Trauma and How to Cope with it

The following page is based on a presentation given by a psychiatrist at a FACT conference in 2021

What is psychological trauma?

Put simply: psychological trauma is damage to a person’s mind because of one or more events that cause overwhelming amounts of stress that exceed the person’s ability to cope.

The result is:
• Your sense of security is shattered
• You feel helpless in a dangerous world
• You struggle with your emotions, memories, and anxiety

Why is trauma after a false allegation so bad?

There is a lot of research around why false allegations affect us so deeply – possibly even more than any other form of trauma. There are lots of theories as to why this might be, but I think to understand it we need to go back to first principles.

Our Core Beliefs make us who we are, but there are some core beliefs that many of us share. There are five core beliefs around how the world works, they are nature, progress, liberty, happiness, and reason.

Nature – The world around us. The belief that the environment is stable.
Progress – The world around us is changing – for good and for bad. Nothing stands still.
Liberty – We are free to make our own choices – right or wrong choices.
Happiness – Our decisions are governed by our pursuit of happiness whether that be financial happiness or relationship happiness.
Reason – The world is just and fair. This core belief doesn’t always develop, and it depends on your upbringing, but in most people it does develop.

Not let’s see what happens to our core beliefs after a false allegation.

Nature – Our world is no longer stable, it is shattered
Progress – What we were working towards has been taken away – our careers, our relationships , our lives.
Liberty – Our freedom has been curtailed; our decisions restricted.
Happiness – The pursuit of happiness is gone – we enter a dark place, surviving becomes our aim.
Reason – The world is not a just place, it is unfair, it is hateful, it is cruel.

All our core beliefs are shattered, just like that. So no wonder it affects us so deeply.

What are the symptoms of psychological trauma?

The effect of psychological trauma is significant and many of us looking at this website will be familiar with the impact. A good way to look at the potential symptoms and to recognise them is to use the acronym: CONCERNS

Crying
Overuse of alcohol and or drugs
Not sleeping
Confrontational/angry/irritable
Eating changes
Restlessness
No enjoyment in activities
Suicidal thoughts

The psychological effects of a wrongful allegation can also be compared with that of a bereavement. For many suffering a wrongful allegation, the suffering may be even worse than a bereavement, because the bereaved person usually has a lot of support from their family, friends, and community, whereas the victim of a false allegation may often be denied this support and suffer rejection.

Dr Kubler Ross is well-known for developing a model of the grieving process, and it can be applied to many other situations involving loss and distress.
It is important to note that the stages do not necessarily follow this order, but that most people, when reacting to difficult situations, go through these stages. diagram of Kubler Ross's stages of grieving drawn like a rollercoaster

The first stage is shock or denial – how can this be happening to me?
The second is anger – why is this happening, what have I done to deserve this?
The third and fourth stages are bargaining and depression – there is a reluctance then begrudging acknowledgement that this is happening. This can be the hardest and lowest moment as it begins to dawn on us the enormity of what is going on.
The last stage is acceptance and, although it can take a different amount of time per person, it is important to reach a stage of acceptance and it will come.

How to beat psychological trauma

If we use the analogy of a footballer – you must kick the ball where it is. You don’t know how the ball is going to come to you, so you need to change your approach to kick the ball and score a goal.

It’s a bit like that with responding to psychological trauma. It affects all of us in different ways, so each person must use a unique approach. Here are some of the techniques that worked for me, and I know have worked for many people, but you will need to find your own bespoke approach.

Underpinning many of the techniques is the cognitive behavioural triad first described by the American psychologist Aaron Beck in the 1960s. He described how our thoughts lead to certain feelings and emotions and then influence our actions. diagram of thoughts affecting feelings which affect behaviour

Let’s use an example – after a false allegation many people can think they are a ‘bad person’, this in turn can result in the emotions of sadness, anger, and low mood. In turn these emotions can lead to behaviours like self-harm and substance addictions. Therefore, by challenging things at the thoughts stage, you can stop some of the actions later.

One of the most important aspects of trauma is to keep our thoughts in the present moment. False allegations occur in the past, and therefore if we dwell too much on the past this can lead to strong emotions of anger, worthlessness, and frustration. In turn, this can result in low mood and depression. Hard though it is, it is not helpful to constantly ruminate and focus on the past.

There may also be worries and concerns about the future – financial, reputational. In time this can lead to anxiety and distress.
Someone once said ‘you can’t change the past, and you can’t predict the future so stay in the present. It’s a gift, that’s why it’s called the present!’ – a little cheesy I know, but it’s right.

So how do we stay in the present – because it is a harder said than done! Practising mindfulness may help.

Mindfulness

The following is an exercise in mindfulness, a technique to help you live in the present.

Start by finding a comfortable seat. You might find it helps if you close your eyes with this, but it’s up to you. This is all around sensing the world around you and staying in the present.

Let us start at the feet. Your feet are flat on the floor – is the ground stable beneath your feet? What shoes are you wearing – don’t look – just imagine them in your mind? Are they soft, are they comfortable, is the sole of the shoe smooth?

Let’s move up to your legs and knees. You are all sitting on a chair. What does that feel like? Is it pleasant to be sat down, are your legs going numb? As you do this let’s focus on your breathing – take a deep breath in for 4 seconds – 1, 2, 3, 4 and let’s hold that for 4 seconds 1, 2, 3, 4 and let’s breathe out slowly for a count of 5 – 1,2,3,4,5

How does the chair feel – is it stable, is it still, is it moving?

Let’s move up to the back of the chair – can you feel that against you? Sit back and feel what it is like – is it hard, is it comfortable?

We have focused so far on the sensation of touch. They think about sounds – close your other senses and focus on your hearing – what can you hear, is it pleasant, is it soothing, is it calming?

Can you smell or taste anything? Maybe if you slowly open your eyes, you can see the world around you.

Sometimes at this stage you can start to think of a happy place. Your happy place is unique to you. This is my happy place – it’s a beach on Jersey. Its somewhere where I went on holiday with friends. I was happy, relaxed and calm. When I am sad, I close my eyes and think of my happy place. I think of all the senses – not just what it looked like, the sounds, the smells the feel of the golden sand through my fingers, the taste of chips by the sea. The happy place must mean something for you.

Dealing with anger

A lot of people talk to me about anger. And anger is a very natural and understandable emotional response to a difficult situation. However, if we reflect back at the Kubler Ross Model, if we always remain in anger, we will never move on to the acceptance phase, which is where we want to be.

Ultimately the only person that will get hurt from anger is ourselves. I know that is easy to say – and at times, I still feel very angry with the way I was treated. But I also recognise that staying angry with people is only going to harm me. One way to deal with anger is through a technique called positive framing. Try this exercise in postive framing.

Take a Post-it Note. On the Post-it Note, please write 3 negative things about either yourself or the situation.

Now, turn the Post-it Note over. On the back write 3 positive things about yourself or the situation. You may find this harder, and that’s ok, but it is important to write down an equal number of positive things.

Keep your Post-it Note. Every time you think of something negative – turn it over and read the positive side. You are challenging your negative thought cycle through positive framing.

Early Recognition

The last technique is early recognition of destructive thoughts. I use the analogy here of the toys of terror.

The toys of terror

Act Quickly. Imagine an old-style helter-skelter. This represents how things can sometimes spiral and go down, so early recognition here is key. So, it is important not to bottle things up – like a jack in the box – because you don’t know when they will explode out.

Mental Health First Aid

Here are some guidelines for helping ourselves or someone else in distress.

You can remember these steps with the acronym ‘ALGEE’.

Assess their risk of self-harm or suicide
Listen non judgmentally
Give information and encouragement (not advice)
Encourage professional help
Encourage self help and support

Step 1. Assess the risk of self-harm or suicide

Observe their behaviour

Are they responding normally to the environment around them?
Do they appear anxious/restless/suspicious?
Do they behave in a way that causes you concern?

If they appear to be at risk of self-harm or suicide take immediate action.

Get Help by phoning 999 or 111
Keep observing them discreetly if safe for you to do so

Step 2. Listen non judgementally

Opening Question – ‘Hello, are you ok?’

If you are worried: ‘Hello, I’ve noticed you seem upset. How can I help you’?

Let people speak uninterrupted
Don’t try to solve their problems
Be patient
Show empathy – ‘that must be really tough for you’
Don’t dismiss their worries even if you think they’re not that bad
Try normalising statements ‘it is understandable that you feel sad about that’
The biggest problem in communication is not listening

Step 3. Give information and encouragement (not advice)

Opening Statement – ‘You are not alone, lots of people feel like you do’.

Give factual information about the condition.

1 in 10 people have a diagnosed Mental Health Condition – but it is likely to be much higher
Many people go through life without getting help, but the people who seek support do much better

Make normalising statements – it is understandable that you feel like this.

Step 4. Encourage professional help

Opening Statement – ‘Have you thought about talking this through with someone’.

Give information about where to get help.

GP – Make an appointment with their GP – they can signpost to professional services.

NHS 111 for signposting towards professional help.

Samaritans Phone for a listening ear -116 123

If they’ve already got help encourage them to speak with CPN, Psychiatrist, Counsellor etc.

Encourage compliance with medication and support.

Step 5. Encourage self help

Opening Statement – ‘There are loads of things you can do to support yourself’.

Give information about where to get help

Self Help apps – Calm, Headspace, StayAlive
Exercise – 30 minutes exercise is as good as an antidepressant for mood
Meditation and mindfulness – really helpful in staying calm
Talk to friends and family
Do something you enjoy – TV, read a book

Useful Reading

Both these books have been of great help to the editor.

Mind over Mood by Dr Dennis Greenberger and Dr Christine Padesky is a book that was recommended to me when I had a course of Cognitive Behaviour Therapy, it is practical with easy to understand explanations of how thoughts and core beliefs can affect the way we feel. It explains how we can challenge and alter our thoughts so that we can begin to change our feelings for the better. It gives examples of how other people thought and felt and what they did about it. It has many worksheets which I used as instructed by my therapist. Although it’s better to have cognitive behaviour therapy by a qualified psychologist, this book could also be used for self-help.

Mindfulness, a practical guide to finding peace in a frantic world by Mark Williams and Danny Penman is another book which is very useful. My copy had an accompanying CD which led me through the individual exercises. Highly recommended. It’s all based on scientific research into what actually works.