What Are the Common Psychological Reactions to Trauma?

Much of the time our lives seem safe and predictable.

Serious road-traffic collisions, plane crashes, train accidents, natural disasters, criminal assaults, terrorist attacks, and other sorts of traumatic events seem to happen to other people, not us. We may read about them in the papers, or watch them on TV, but we do not expect to experience them directly ourselves.

But for those of us who have gone through trauma, we know that any of us, at any time, can be the victims of sudden and unexpected tragedies or losses.

Most people will experience various psychological reactions in the days following a traumatic event. Common psychological responses include the following.

• Anxiety—feelings of fearfulness, nervousness or sometimes panic, especially when faced by reminders of the event; concerns about losing control or not coping; worry that the situation may recur.
• Hyper-vigilance—constantly scanning the environment for cues of danger or seeing threat in things that would have appeared innocent before. This could mean being overly protective of children or loved ones, e.g. worrying if they are slightly late home or haven’t phoned at exactly the time they said they would.
• Sleep disturbance—difficulty in getting off to sleep, restless sleep, vivid dreams or nightmares. At first these may be about the incident itself or the experience, but they can change to be less specific, where the content can just be unsettling or generally disturbing.
• Intrusive memories—intrusive thoughts/images of the traumatic incident, which can appear to ‘come out of the blue’, without any triggers or reminders. Other thoughts, images or feelings may be prompted by media triggers, e.g. something on TV, newspapers, sounds, a song or piece of music, smells.
• Guilt—feelings of regret, about not having acted or coped as well as one would have wished, about letting one’s self or others down, about being in some way responsible. Other feelings of guilt may be present because the person survived, whilst a friend or loved one died—again, this is a common phenomenon and is known as ‘survivor guilt’. Often when we feel guilt we want to make things right again somehow.
• Shame or embarrassment—feelings related to how we think of ourselves, often related to a sense that we were not good enough in some way. When we feel shame we want to go into hiding.
• Sadness—feelings of low mood and tearfulness.
• Irritability and anger—at what happened, the injustice of the event; ‘Why me?’ at those you feel are responsible for the trauma and wanting somebody to accept responsibility or blame. Irritability can often be directed at loved ones, close family, friends or colleagues.
• Emotional numbness or blunting—feeling detached from others or being unable to experience emotions such love or happiness.
• Withdrawal—tending to retreat into one’s self, avoiding social and family contact.
• Mental avoidance—avoiding thoughts to do with the trauma. People try to push distressing thoughts out of their head, often unsuccessfully, and in the longer term this can cause further problems because it interferes with the person processing and making sense of their experience.
• Behavioural avoidance—avoiding thoughts, feelings, activities that are reminders of the trauma.
• An increased startle response—becoming ‘jumpy’ or easily startled by sudden noises or movements, e.g. a door slamming shut, the phone or door bell ringing.

These are normal and natural reactions in the immediate aftermath of a traumatic event. Most people will recover in the days and weeks following a traumatic event, particularly if it has not affected them directly through personal loss or injury.

For others, however, who are directly affected by trauma, these reactions may persist or even worsen as the weeks pass. Their ability to get on with their lives is severely impaired.

If you or someone you know are still experiencing several of the reactions listed above several weeks after a traumatic event it may be advisable to seek professional advice.

Find out more about post-traumatic stress and its treatment in our new book.