When Healing From Trauma Looks Like Hiding

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We manage our day-to-day lives very much like an Instagram feed. Our friends, coworkers, and family assume we are thriving and doing well. Managing impressions is especially important when a person has been impacted by trauma and works hard to move on with their lives, but continues to view themselves, others, and the world with suspicion. Our efforts to keep up our public image may be making things worse, not better.

Many traumatized individuals assume that because they do not have the hallmark signs and symptoms of post-traumatic stress disorder (PTSD), they are doing fine. But there is a world of difference between being symptom-free and doing well. Some who experience trauma may not have problems with intrusive memories, avoidance, or baseline mood. Still, they fail to see how issues with distrust, suspicion, and insecurity undermine their relationships and how they navigate life.

We know that at least six percent of the adult population experiences PTSD at some point in their lifetime. Nevertheless, depending on the type of trauma experienced, there will always be a large percentage of people who do not go on to develop PTSD. It might be simple to assume that those who do not have PTSD are, in fact, well-adjusted.

Unfortunately, simply not meeting the full criteria for PTSD does not necessarily mean a person does not struggle with issues of trust, safety, control, intimacy, and self-esteem.

The Five Problem Areas of Trauma

Cognitive Processing Therapy (CPT) provides a structured, educational approach for the treatment of PTSD that is well supported by research as an effective form of behavioral treatment for a wide variety of traumatic experiences.

During the 12 sessions of CPT, the final five sessions focus on the typical problem areas associated with traumatic experiences. These five areas include: safety, trust, power and control, esteem, and intimacy.

As you read through the brief description of each of the five problem areas, remember that a person may struggle with how they view themselves, others, and the world without having many of the disabling symptoms of PTSD.

1. Safety—The belief that you can protect yourself from harm and that you have some degree of control over life events. Safety includes beliefs about the reliability of others and their intentions to protect or to cause harm, injury, and loss. Unhelpful beliefs might consist of: “If I am afraid, I am in danger.” “If I go out, I will get hurt.” “People are dangerous.”
2. Trust—The belief that you can trust your own judgments and decisions, and trust that others can be relied on and will keep their promises. Unhelpful beliefs sound like this: “I always make bad decisions.” “People in authority will take advantage of you.” “If I trust others, they will leave me and hurt me.”
3. Power and Control—The personal conviction that you can solve problems and meet the challenges you face. You believe you have the strength to stand up for yourself, influence others, make changes, learn from failure, and grow. Problematic beliefs include: “It is my fault that I was abused.” “I must be in control, or bad things will always happen.” “If I lose control of my emotions, I will get hurt or do something bad.”
4. Esteem—The belief that you as an individual have dignity, value, and worth. You also believe you should be taken seriously by others. You desire to be seen, safe, and secure in your relationships. You can also view others with compassion, dignity, and worth, recognizing that all people are a mixture of good and bad, strengths and weaknesses. Signs of struggle include: “I am damaged goods.” “I am evil, bad.” “Bad things only happen to bad people.” “Everyone is out for themselves.” “People will always let me down.”
5. Intimacy—The ability to be alone without feeling lonely or empty. The foundation of our relationship with others is our relationship with ourselves. We need to soothe and calm ourselves so we can maintain a non-anxious presence with others. We allow others to know who we are and what we need, and we are able to form different levels of connection and closeness with a variety of people. Indications of problems with intimacy include: “I can’t tolerate being alone.” “I cannot handle my emotions without comfort or reassurance from others.” “The only thing others want from me is sex.” “I need to isolate from others—no one wants to know me. No one should know me.”

Grow Through Your Weaknesses

We are excellent at operating on autopilot, making it hard to recognize what we think, believe, want, and feel. Understandably, we want to reassure ourselves that we are doing well. We strive to maintain the perception that our lives are meaningful, our needs are met, and we are successful. But I believe this basic desire to maintain a positive perception is also a recipe for trouble—it makes it hard for us to own our weaknesses, admit our struggles, and face the pressures and disappointments we would rather avoid.

As you look through the description of five problem areas associated with trauma, first ask yourself what might describe you. Then ask a few of your friends to rate you in those five areas. If asking someone else to review this list sounds threatening, well, that may be a sign you struggle with safety, trust, control and power, esteem, or intimacy.

Change comes through awareness, and awareness comes with a willingness to embrace discomfort, to accept uncertainty, and to have the courage to turn toward difficulty rather than away. To learn more about how to show up, let go, and move on, read my article in Psychology Today on how the mind operates.