The line between stress and trauma

It’s no secret that many of us are waking up each day to a very stressful reality. Yet where is the line between stress (from which we can recover) and trauma that overwhelms us?

Trauma can occur when stress becomes prolonged, when we don’t have a chance to recover from a state of either profound shut-down or extreme hyperarousal.

Shut-down is a feeling of numbness, depression, lack of energy and motivation, withdrawal into the self and away from relationships.

Hyperarousal is a constant stream of adrenaline, activation, feeling restless, keyed up, on edge, braced for danger.

Being in either state for too long can have effects on our immune system, relationships, and ability to concentrate, focus, and function.

Yet it’s not just prolonged states of an overactive or shut-down nervous system that can turn a stressful situation into a traumatic one.

Our inner coping mechanisms, including our defense mechanisms, need to be functional and powerful enough to stop our egos from collapsing under stress. When our usual ways of coping with internal and external experiences are overwhelmed, we can find ourselves regressing to negative behaviors or emotions that feel out of control, younger, less consolidated, or habitual.

According to Judith Chertoff in the article “Psychodynamic Assessment and Treatment of Traumatized Patients”, there are 5 specific factors noted by Anna Freud that can turn a stress into a trauma:

  • The intensity and nature of an event and the meaning a person gives this
  • Sensitization due to prior trauma (This is when constant stress or trauma makes us extra reactive)
  • Inborn factors that affect one’s ability to cope (such as a genetic vulnerability to becoming depressed)
  • Age and stage of development when trauma happens
  • Environment at time of trauma (for example, is it safe and supportive)

PTSD occurs when an event collapses a person’s ability to use their regular defenses to mediate between external demands (like the need to cope in daily life) and inner tensions or emotions.  A person’s normal defenses may not work anymore.

One example is when someone has a tendency to cope with difficult experiences or emotions by using the coping technique of distraction; if something happens that is so upsetting or overwhelming to the ego that distraction no longer works, he might find himself unable to cope with daily life as usual, regressing, or being completely emotionally overwhelmed. This could lead to PTSD.

What this means for all of us is that even though many of us are all dealing with objectively similar situations due to the coronovirus,  such as health fears, schools and public places shutting down, being in quarantine, fear of running out of supplies, etc., each of us will have a unique reaction to these stressful circumstances.

Some of us will become especially frightened or overwhelmed by these events if we habitually rely on a sense of predictability or control in order to cope with our emotions and stresses in our daily lives. These defenses of control and predictability may no longer be available to us, although focusing on what we can control and creating routines can certainly mitigate some of the stress.

For others, leaning on loved ones may be a way to feel secure, but our loved ones may be so stressed themselves at this time that they perhaps withdraw from us, or else feel too anxious themselves to provide support. Learning how to be in this together while each person uses their own ways of coping is important but not so easy! For example, what happens if your partner wants space while you want connection, or if your child is acting up when all you want is quiet and decreased stimulation?

Another important point is that sometimes we feel anxious about things that are going on inside of us, for example wishes or feelings that feel forbidden or conflict with our values, such as wishing your kids would move out for a few weeks because it’s so draining to take care of them, or wanting to break free and stop following the rules you live by. We often suppress these wishes or feelings, or we justify them to ourselves consciously while feeling unconsciously guilty, and then we become anxious or feel things are out of control…and it’s easier to blame our anxiety on things like the coronavirus than the actual feelings or impulses that are fueling it.

This is also an opportunity to develop new coping mechanisms, for example, instead of distracting yourself from uncomfortable emotions, learning to sit with them. Or instead of withdrawing when you feel stressed or vulnerable, sharing yourself with someone else and letting them in. It’s a time for us to get closer to those we love, to reassess our typical coping mechanism, and to find small moments of recovery even as we struggle to get through each day.