Signs of Unresolved Trauma

Signs of Unresolved Trauma

Inability to tolerate feelings or conflicts:
•     Blunt or numbness, withdrawal, no obvious affect in appropriate situations
•     Movement to intense or overwhelming feelings suddenly and rapidly (e.g., rage)
•     Depression (problem sleeping, eating, poor energy, low motivation, poor self esteem, 
            poor memory, anxiety)
•     Panic feelings (trouble breathing, feeling as if having a heart attack, fearful, anxious, etc.)

A pattern of out-of-control and self-injurious behavior:
•     Addictive behaviors (over/under-eating, gambling, drinking, smoking, etc.)
•     Patterns of repeated behavior to avoid feelings (promiscuity, internet use, sleeping, etc.)
•     Chaos in life (problems with relationships, employment, financial, etc.)
•     Self-harmful behavior (often “alluded to” but not obvious) such as scratching and cutting,            
            burning self, hair pulling, etc.)

Intense self-blame and feelings of unworthiness or belief they are “ruined:”
•     Belief that they were responsible for original trauma
•     Irrational/illogical beliefs about responsibility for events in the present
•     Belief that they are bad, a failure, unlovable, a loser, damaged, insignificant, worthless
•     May induce others to treat them badly

Staying stuck in the victim, perpetrator, or rescuer roles:
•     Seek out relationships with abusive people
•     Induce abuse from others rather than waiting for it to happen
•     Perceive abuse which confirms the belief that they are unworthy and unlovable
•     Hurt others (different than appropriate self-protection)
•     Act aggressively toward others who are weak and vulnerable
•     Compulsively driven to help others, often to their own detriment
•     Acts of generosity not in accord with the relationship 

Disorganized attachment patterns:
•     Inability to tolerate their ambivalence toward the perpetrator even after the trauma ceases
•     Inability to tolerate their ambivalence toward other trusted figures, such as failed rescuers 
            or those who denied the trauma
•     Inability to tolerate their ambivalence toward significant persons currently in their lives

Difficulty maintaining healthy relationships:
•     Avoid relationships altogether
•     Avoid close relationships because of inherent risk
•     Avoid situations that might lead to closeness
•     Protect themselves, e.g., unfriendly to others before others are unfriendly to them
•     Have intense but brief relationships
•     Remain attached even when the relationship is unhealthy
•     Perceive the relationship in a distorted manner

Black and white thinking and other cognitive distortions:
•     Child-like, concrete, and magical thinking
•     What they think is normal and real does not coincide with “real life”
•     Derive “life rules” and “automatic thoughts” from childhood distortions
•     Cling to the distortions despite challenge or contrary evidence
•     Provoke a non-existent reality into being in order to verify a distortion
•     Collect evidence to support the distortion while ignoring evidence to the contrary
•     Patterns of distorted thinking (such as generalizations, all or nothing, discounting, 
            jumping to conclusions, assuming, labeling, and emotional reasoning)

Intrusive thoughts, images, feelings, memories, and nightmares

Pathological dissociation:
•     Loss of (long) spaces of time (can’t remember what they said or did)
•     Appear to “switch” personalities, or be different people, even in speech and behavior
•     Trances or sleepwalking
•     Childhood companions, “voices,” “too much noise in my head”
•     Inability to recall important information, usually of a stressful or traumatic nature
•     Confusion about personal identity or assumption of a new identity

Extensive comorbidity/multiple diagnoses, which may include addictions, mood disorders, 
    and personality disorders

  Picture

Suicidal ideation:
•    Talk about suicide 
•    Wish they were dead
•    Have a plan to end their life

                                                                                                   Melissa Engle and Ken Schmidt at Ireland workshop