The Impact Of Unresolved Trauma

While witnessing or experiencing a traumatic event or events can affect each person differently, it’s widely understood that trauma can impact an individual on multiple levels. Specifically, trauma that’s unresolved and unaddressed can result in additional distress as well as impacts on mental and physical health. Read on to learn more about trauma and its potential impact along with research-based treatment methods.

Defining trauma 

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma as an event or circumstance involving physical harm, emotional harm, and/or life-threatening harm. While some people may not experience lasting effects from the event, others might have traumatic stress reactions long after. SAMHSA further notes that traumatic experiences—especially in childhood—are linked to several chronic health conditions. 

Timeline of responses to traumatic events

A person’s reaction to a traumatic event can depend on various factors, including the details of the event, their support network, coping skills, the meaning assigned to the trauma, and sociocultural factors, among others. That said, common initial reactions to trauma include confusion, sadness, agitation, anxiety, dissociation, and blunted affect.

While some individuals may experience pronounced symptoms of post-traumatic stress disorder (PTSD) or acute stress disorder (ASD), others may have subtle symptoms that fall outside diagnostic criteria. It’s also worth noting that a person’s initial way of responding may be less influential on their longer-term well-being than the coping efforts used to sustain self-esteem, maintain interpersonal relationships, and partake in life activities afterwards. It’s also possible for a person to show little to no response immediately after trauma but to experience a delayed response later. 

Regardless of the timeline, some common signs of a response to trauma—which may or may not indicate a trauma-related disorder—include: 

• A sense of ongoing tiredness or fatigue
• Sleep disturbances
• Sleep disorders
• Fear of reexperiencing the trauma
• Symptoms of depression
• Anxiety 
• Avoidance of emotions, sensations, or activities that remind them of the trauma
• Flashbacks
• Impaired memory
• Difficulty recalling key aspects of the traumatic event

A person's physical body may also respond to trauma long after the distressing events occurred, particularly when in a situation that indirectly recalls the trauma. Traumatic stress-related physical symptoms may include things like:

• Headaches
• Gastrointestinal problems
• Joint or muscle pain
• Heart palpitations
• Sweating
• Feeling easily startled
• Fatigue
• Dizziness
• Blurred vision

Other emotional and physical symptoms of trauma

In addition to common symptoms associated with initial and delayed reactions to trauma, a person may also experience a range of other emotional and physical symptoms over time. These symptoms tend to be a result of emotional dysregulation, psychic numbing, and/or somatization.

Emotional dysregulation refers to difficulty navigating and managing one’s feelings. One way that people try to regain control of emotions might be through self-medication, which may involve excessive drinking and substance use, or by engaging in high-risk behaviors to cope with strong or overwhelming feelings. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

The American Psychological Association characterizes psychic numbing as "a post-traumatic symptom pattern in which the individual feels incapable of emotional expression, love, or closeness to others." While numbing blocks out emotions and can be seen as the opposite of emotional dysregulation, a person may experience both emotional numbing and emotional dysregulation at different periods after going through trauma.

Finally, somatization refers to the manifestation of physical symptoms—such as tiredness, nausea, joint or muscle pain—to express emotional distress. Symptoms can be temporary or become chronic, potentially manifesting as various ailments and conditions such as gastrointestinal, neurological, cardiovascular, and autoimmune disorders—and many of these conditions are comorbid with PTSD. 

The impact of unresolved trauma from childhood

Studies suggest that experiencing trauma during childhood in particular is associated with the development of anxiety and depression in adulthood, which may stem from the neurological response system. It’s thought that trauma exposure raises cortisol levels, causing the body to constantly prepare itself to react to perceived threats through the fight-flight-freeze system. Researchers also indicate that coping mechanisms like denial, self-isolation, and substance misuse are associated with having experienced childhood trauma, and that survivors are also more likely to experience concerns related to low self-esteem.

Experiencing child abuse—especially sexual abuse—has also been linked with chronic pain later in life. Receiving little support from family members afterward may raise one's risk of developing PTSD from such an experience. A person with this experience may also be at increased risk of developing mental health conditions, and they may be at increased risk of trust issues, revictimization in adolescence and adulthood, and substance use disorders in adulthood as well. 

Ways to treat unresolved trauma

The interrelatedness between trauma and mental and physical symptoms points to the need for a holistic approach to addressing trauma and its effects on an individual. One evidence-based approach to addressing trauma is trauma-focused cognitive behavioral therapy (TF-CBT). TF-CBT often involves cognitive restructuring techniques, which aim to help a person reexamine and make sense of the traumatic event(s), and is focused on the interaction of thoughts, feelings, and behaviors. The rationale is that by changing patterns of behaving, thinking, and feeling, one may improve functioning and relieve their distressing symptoms.

Other common therapeutic approaches to addressing trauma include: 

• Exposure therapy
• Cognitive processing therapy (CPT)
• Cognitive therapy
• Eye movement desensitization and reprocessing (EMDR)

In addition, a provider may also suggest techniques like yoga, mindfulness, grounding techniques, breathing exercises, and massage to incorporate more direct physical methods into the healing plan.

Therapy for addressing unresolved trauma

Trauma can impact one's body and mind. Whether attended in-person or online, talk therapy may help foster resilience by introducing coping strategies, cognitive restructuring skills, and other techniques that may be useful in reframing distressing experiences and alleviating associated symptoms. 

If trauma-related symptoms make it difficult to leave the house, online therapy through platforms like BetterHelp might be a more convenient alternative, since it allows you to attend sessions with a licensed therapist from the comfort of your own home. You can speak to your therapist by phone or video and exchange in-app messages—whatever is most convenient and comfortable for you.

A growing body of research points to the potential effectiveness of online CBT for people with mild to moderate PTSD. The study compared in-person trauma-focused CBT with the same approach delivered online. The latter consisted of an eight-step program and three contact hours with a therapist, plus additional check-ups by phone or email. The study's findings suggest that "people who received online CBT-TF benefitted as much as those who received face-to-face therapy."