Trauma Symptoms in Women You May Not Recognize
Written by Dr. Adrianna Holness, Ph.D.
Oftentimes when people hear the word trauma, they are cued to think of BIG EVENTS. Think war, major accidents, and violence. Or nightmares, flashbacks, and extreme anxiety or avoidance. Many of the women I have worked with don’t see themselves in these descriptions. They may be functioning well at work (with anxiety bubbling under the surface), pushing forward in their graduate degrees (and rocking it!) while stuck in a pattern of unhealthy or unsafe relationships, or confident leaders on the outside while feeling chronically depressed and alone in their struggles.
Trauma Symptoms in Women never looks just one way.
Let’s look at some other ways that trauma can show up for women.
Struggling with Emotional Regulation
While our emotions are a beautiful and enriching part of our lives, they can also lead to suffering when we aren’t able to regulate them. Women who have experienced trauma may find that they experience feelings of annoyance, anger, deep sadness, and anxiety, as well as suicidal ideation. Oftentimes, these emotions can feel like a runaway train and can lead to secondary feelings of guilt or shame when they impact other parts of your life. Let’s say for example, your annoyance with your partner suddenly shifts to anger. Maybe you slam the door on the way out of the room, yell at them, or react by throwing something at them. Or perhaps you feel the need to lock yourself in your room and stay beneath the covers all weekend.
Issues with Self Esteem
Trauma can impact the way that you view yourself. The narrative that the mind creates as it sorts through and attempts to make sense of your trauma can lead to feelings of guilt, shame, and/or helplessness. Maybe you’ve noticed that you think everything is your fault, that you’re always messing up or falling short somehow. Or perhaps you are always the helper, the people pleaser, feeling like you won’t be accepted if you don’t give to others. As women, trauma can impact how you see yourself, how you talk to yourself, and how you believe others see you - which may leave you feeling like you’re not good enough. Like you need to give others a reason to want to spend time with you and this in turn can lead you to accept poor behavior, have porous boundaries, or to minimize your own wants and needs.
Trauma Symptoms in Women & Difficulty with Relationships
Trauma can impact not only the way that we see ourselves, but also in the ways that we relate to those around us. For some individuals who have experienced trauma, you may find that you feel exhausted, struggle to connect socially with others, or just never feel like you quite fit in. Trust is a major area that can be impacted within relationships and you may find that you feel alone and responsible for everything, because you believe those around you can’t be depended on when you need them. Additionally, each perceived slight from others can add layers to your distrust and you may find yourself thinking, no one really cares, I can’t depend on anyone, or people only hurt you when you let them in.
Within romantic relationships, you may keep finding yourself in unhealthy dynamics that repeat feelings of pain, loss, or abandonment. For instance, maybe you keep ending up in relationships that are hot and cold. Even though you crave close and consistent relationships, you might also notice that the stable person - you know - the one who never makes you guess about how they feel and is consistent might also be the person you dismiss as boring. Trauma can change your view of healthy relationships and can influence you to repeat old patterns from your past, leaving you caught in unfulfilling relationship dynamics.
Detachment from the Trauma
While some women will struggle with difficulty regulating their emotions after a traumatic event, others may feel confused by a complete lack of connection to the event or to their emotions (depersonalization). Sometimes it can feel like it happened to someone else - a version of you that you no longer relate to. For others, maybe your memories of the trauma may be so cloudy that you doubt it even happened or you may convince yourself that you remembered it incorrectly. Another way of detaching may show up as a sense of disconnection from the world and the people around you (derealization). Perhaps you notice that you don’t want to spend as much time with loved ones and friends. That the emotions you used to feel when around them feel foggy or far away. While you want to connect, the idea of doing so feels overwhelming and out of reach.
Loss of a System of Meanings
System of meanings can describe the way you view the world which may include religion or spirituality. For example, someone who looked at their world as an overall safe and good place may think differently about these areas after a traumatic experience. You might believe that people are selfish, people won’t show up for me when they say they will or if bad things don’t happen to good people - then I must be bad. For those who were previously religious or spiritual, you may start to doubt either the existence of a deity or the qualities of that deity. For example, you may believe that, God doesn’t care about me, I must have done something wrong to make Allah abandon me, or If I hadn’t skipped mass/church/temple/etc… then this wouldn't have happened to me. When our internal system of meanings is challenged, it can deeply shake our trust in others as well as ourselves.
Trauma Therapy for Women
Let’s explore some trauma therapy and PTSD treatment approaches! There are a number of different options for addressing the symptoms of trauma. These include EMDR Therapy, Emotion-Focused Individual Therapy (EFIT), mindfulness-based approaches, and Interpersonal therapy. There are also several types of cognitive approaches including, Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE). I have experience in providing all of these approaches. Like trauma, there is no one approach that fixes trauma. Your trauma therapist can help you choose the right fit for your needs. Let’s take a look at some of these approaches.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR therapy is a structured 8-phase approach that utilizes the body’s natural process of healing. When you get a cut or break a bone, your body works on healing itself. Our minds function much in the same way as we take in new information, sort and attempt to make sense of difficult or traumatic situations, adjust our opinions and viewpoints, and move toward healing.
Except sometimes, we can stuck somewhere in the process…
When talking to prospective clients, I often describe the process of EMDR as a gently flowing stream that based on life events gets clogged up with rocks and debris. The natural inclination of the water is to flow downstream as it always does, but now in order to do so - it slowly moves around the blockage or stays in place growing stagnant. In the same way, hard life events or trauma can change the way that you show up and experience the world around you. Maybe you notice that you’re still getting through your day… but at a slower pace. Perhaps you feel stuck in a life phase you don’t want to be in, but you can’t quite figure out how to break the pattern. Or you may find that you’re so distanced and numbed out from your emotions and others, that you don’t recognize yourself.
When our mind attempts to engage in that natural healing process and can’t move over the clogged up parts, EMDR can help to sort through all that clutter to help you start your healing journey.
Want to learn more about EMDR? Click here.
Cognitive Processing Therapy (CPT)
CPT is a 4 phase approach created in 1988 by Dr. Patricia Resick, a professor of Psychiatry at Duke University Medical Center. The three main goals to CPT are to 1) reflect, 2) redefine, and 3) recover from your trauma. CPT is often used in Veteran Affairs Hospitals to treat returning heroes struggling with symptoms of PTSD. With the extensive research put in by the VA Hospital Systems, CPT is an evidenced-based approach for treating PTSD.
Reflect
CPT aims to help clients reflect on the impact of PTSD and the ways that it has impacted them across various domains including: safety, trust, power and control, self-esteem, and intimacy.
Redefine
As CPT is a cognitive approach to treating trauma, you will learn to catch, assess, and challenge your thoughts about the trauma. For example, sometimes those thoughts like, “no one cares about me” can feel 100% true and can impact the way that you interact with others. CPT will help you assess the validity of your thoughts and help you reframe them in a way that honors the life you want to build.
Recover
The recovery process focuses on helping you to integrate what you have learned in therapy into your day to day life, while reducing the big emotions associated with your trauma. During this phase, you will also focus on “stuck points” which are beliefs that keep you stuck in the trauma process.
Phase 1: Education about PTSD and CPT
During the education phase, you will learn more about how trauma can show up, you’ll review your own symptoms, your therapist will explain how CPT works, and you will engage in treatment planning.
Phase 2: Processing the Trauma
You will begin to process your trauma either through a written trauma account (CPT+Account) or by working through the “stuck points” associated with your trauma. It is important to note that both methods of CPT (either with or without the written account) have been shown to be effective in treating the symptoms of PTSD. You can discuss which choice feels right for you with your trauma clinician.
Phase 3: Learning to Challenge Thoughts about Trauma
During this phase, you will learn to begin to identify that thoughts that get you stuck within the trauma process. One thing to note about CPT is that there are guided worksheets following each session which build on one another. If you don’t see yourself working on and bringing the worksheets to each session, you likely will benefit from one of the other trauma therapy approaches.
Phase 4: Addressing Trauma Themes
Trauma can create a ripple effect that impacts us in many different life domains. CPT will help you to address how your traumatic experience has impacted you in the areas of safety, trust, power and control, self-esteem, and intimacy. For example, you may think that “no one can be trusted and I’m never safe” or “I have to have control or something bad will happen.” Perhaps you tell yourself that “I’m worthless and unlovable.” These areas will be addressed within the final phase of CPT as you continue to integrate what you learn into your day to day life.
Prolonged Exposure (PE)
Prolonged Exposure is a 4-phase, 90-minute therapy that is is often used in Veteran Affairs Hospitals to treat returning heroes struggling with symptoms of PTSD. With the extensive research put in by the VA Hospital Systems, CPT is an evidenced-based approach for treating PTSD.
Prolonged Exposure is specifically geared to address areas which you may be avoiding at this time as a direct result of your traumatic experience. For example, let’s say you were in a major car accident on Pacific Coast Highway coming back from your favorite beach one Tuesday afternoon. Let’s fast forward three months and imagine that you no longer drive, that you worry about family and friends driving on Tuesdays, that you no longer visit the beach, and you feel uneasy watching shows that involve driving of any kind. You may even try dissuade others from going out when you feel it’s unsafe (e.g., at night, in the rain, etc…). Prolonged Exposure can help you learn to re-introduce these elements of your life so that you can get back to living a life without trauma-based rules about what you “can” and “can’t” do.
Phase 1: Education about PTSD and PE
During the education phase, you will learn more about how trauma can show up, you’ll review your own symptoms, your therapist will explain how PE works, and you will engage in treatment planning.
Phase 2: Breathing Retaining
Oftentimes when we experience anxiety, our body responds with a shift in breathing. These changes can often heighten the anxiety, lead you to feel like you are out of control, and may remind you of how you were feeling during the actual traumatic event. Breathing Retraining is taught early on in the process of treating PTSD to help you experience more normalized breathing and to reduce potential reminders of the trauma while engaging in the treatment protocol. When you can ground yourself, you can be more engaged throughout the process.
Phase 3: In-Vivo Exposure
You and your trauma therapist will work on an exposure hierarchy - which is an ascending list of things you avoid as they relate to your trauma. Once you and your therapist have created a full list of items that you avoid, you will slowly work on approaching these areas so you can get back to living your big beautiful life.
Simplified Exposure Hierarchy:
10 - driving by the scene of the major car accident you experienced
5 - wearing a seatbelt
1 - watching television shows that include a major car accident
Phase 4: Imaginal Exposure
During the Imaginal Exposure Phase, clients record a narrative of their trauma in session. The client then listens to this narrative in between sessions. Revisiting the event has been shown to promote processing where the client can activate the memory and the accompanying emotions within a safe context. With time, the client learns that they are able to cope with distress related to the memory of their trauma. Speak with your trauma clinician to learn if this is the right fit for you.
Start Trauma Therapy in Los Angeles, CA
Do you think you could benefit from EMDR trauma therapy? If so then Worth and Wellness is here to help you! In order to chat about starting trauma therapy or learn more about EMDR, please follow these steps:
Schedule a free 30-minute consultation.
Make your first appointment with an EMDR and trauma therapist
See for yourself how beneficial EMDR can be for your mental health
Other Counseling Services I Offer in Newport Beach, CA
At Worth and Wellness Psychology, I offer in-person and online therapy. This includes individual therapy for relationship issues, dating, and anxiety. In addition to therapy for therapists and women of color. Reach out to talk about how I can support you.
About the Author, An EMDR & Trauma Therapist in LA and Orange County
Dr. Adrianna Holness, Ph.D., is a Licensed Clinical Psychologist at Worth and Wellness Psychology, serving clients online and in-person throughout California. She received her Ph.D. in Clinical Health Psychology from Loma Linda University. As a trauma and PTSD psychologist, she specializes in creating space for healing and wholeness as clients take on the brave and beautiful work of addressing life’s hardest moments. She is trained in many evidence-based trauma treatment approaches, including EMDR. She also works with clients in the spaces where trauma intersects with your self-confidence, relationships, dating, anxiety, and identity.
Disclaimer:
This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, website, or in any linked materials are not intended and should not be considered, or used as a substitute for, medical or mental health advice, diagnosis, or treatment. This blog does not constitute the practice of any medical or mental healthcare advice, diagnosis, or treatment. We cannot diagnose, provide second opinions or make specific treatment recommendations through this blog or website.
