There are psychological and physical trauma. In both areas, the term can be used both for the trigger and for the symptoms of the clinical picture. Everything about causes, course and prognosis.
The term trauma is used very often, but has different meanings in different contexts. There are traumatic effects on the organism, for example due to an accident or a psychological injury, but this also results in traumatic consequential damage such as broken bones, organ injuries or psychosis.
Overview of article content:
What is trauma?
Trauma (plural: trauma or trauma) is defined as an event that damages the human organism. You can also use the German term injury. Although the term trauma is quickly equated with psychotrauma today, there are very different traumas.
The trauma in psychology is a severe psychological injury caused by a traumatizing experience. But trauma is also a physical injury that can result from an accident, an event or the effects of violence.
Finally, the term trauma also describes the symptoms that have arisen from a physical or mental injury. This can be seen particularly clearly in the term birth trauma. This can mean a psychological damage that the birth left with mother or child. In psychoanalysis in particular, birth trauma describes particularly negative consequences of one's own birth, and the birth itself is also referred to as trauma.
The term birth trauma can also refer to the physical injuries that have occurred to the mother through birth, such as tears in the perineum and vagina or uterine injuries. But the child can also suffer traumatic physical damage such as traumatic brain injuries or broken collarbones.
Traumatology deals with the emergence, diagnosis, treatment and prevention of wounds and injuries. This applies to physical as well as mental trauma and the resulting symptoms and sequelae. The medical specialty that deals with physical trauma is surgery, especially trauma surgery. The term traumatologist is therefore mainly used for trauma surgeons. Psychotherapists and psychiatrists help with psychological trauma. There are specially trained child and adolescent psychologists for children who treat mentally injured children.
How does a trauma arise?
The term trauma comes from the Greek and means “injury, wound”. It says nothing about the origin of this wound. The causes of trauma can be of a mental, mechanical, physical or chemical nature. Examples of how trauma can occur:
Psychological (mental) trauma: War and persecution, sexual violence, loss of loved ones, life-threatening illnesses, natural disasters, stress, bad experiences in childhood, termination of a love relationship, bullying, loss of job
Mechanical trauma: Accidents, for example in road traffic or during sports, shots, blows and blunt violence, bites, stings and cuts
Physical trauma: Burns, cold, radiation, extremely loud noises like an explosion (bang trauma), change in pressure conditions (barotrauma)
Chemical trauma: Poisoning, burns
In most cases, physical wounds and injuries result from various types of accidents and can basically affect all parts of the body. That is why doctors from a wide range of specialties are involved in the treatment of physical trauma. Primary care is carried out in the vast majority of cases by trauma surgeons, followed by ophthalmologists, dentists, thoracic surgeons, orthopedists, gynecologists, urologists, internists and other specialists depending on the trauma.
The physical trauma is named after the location of the injury. Typical examples are: traumatic brain injury, thoracic trauma (affecting the chest), extremity trauma (arms and legs), abdominal trauma, tooth trauma and spinal trauma.
The following terms are used to describe the extent of a trauma:
Monotrauma: single, not life-threatening injury
Barytrauma: serious individual injury that is life-threatening (e.g. traumatic brain injury, amputation injuries, torn organs)
Polytrauma: Multiple, simultaneous injuries that affect multiple organs or parts of the body. One of the injuries or the sum of the trauma is life-threatening. The most common causes are serious traffic accidents, falls from great heights, serious accidents at work and violent crimes.
Microtrauma: Minor injury caused by external or internal damage. If microtraumas occur repeatedly, they can suddenly lead to considerable problems (e.g. fatigue fractures).
Minor trauma: Minor injuries where there is little or no tissue damage under normal conditions. You have no high illness value. Examples are bruises, sprains or grazes.
A distinction is made between two large groups with regard to the development mechanisms.
Blunt trauma: The injury was caused by blunt-edged, non-perforating violence. Internal organs can also be injured. Dull trauma typically arises from accidents, fights, pinches and spills.
Sharp (also sharp or penetrating) trauma: The trauma is the result of the mechanical action of sharp, semi-sharp or pointed objects, such as knives, hatchets, scissors or broken glass. The causes are varied and all areas of the body can be affected. Penetrating injuries are most often caused by accidents, acts of violence or with the intention of suicide.
Mental (psychological) trauma
Extremely bad and stressful events cause severe emotional shocks, psychological injuries and deep despair in people. For example, natural disasters, serious accidents, rapes, terrorist attacks, war experiences or kidnappings can trigger psychological trauma, which can manifest itself in extreme stress, a feeling of helplessness and limitless horror.
These mental wounds cannot only arise if you were directly affected by the triggering event. For many people, these psychological injuries occur even if they witness these events as an eyewitness or understand them through descriptions, pictures and videos.
Events experienced as traumatic overwhelm the human stress system. Psychotrauma therefore affects not only the psyche, but also the body. Physical symptoms such as sweating, blushing, paleness, rapid heart activity, nausea and head pressure are common companions of the psychological complaints. As the organism remains at an increased level of stress, characteristic complications such as stomach ulcers can develop from it.
People who have experienced psychological trauma can get sick. Acute and long-lasting reactions can occur. According to the international classification of diseases (ICD-10), a distinction is made between two mental disorders that can occur in response to an extraordinarily stressful life event. The acute stress response and post-traumatic stress disorder.
Acute stress reaction
If symptoms appear immediately after a traumatic event, it is an acute stress reaction. Fluctuations in feeling, attention disorders, apathy, fear and severe physical stress with rapid heartbeat, sweating or nausea are acute reactions to the experience. In addition, sufferers often have so-called dissociative symptoms. You have the feeling that you are not yourself (depersonalization) or that you are experiencing the world from afar (derealization).
The symptoms of the acute stress reaction begin immediately after the trauma and usually last only a few hours or days, but sometimes even weeks. In most cases, they subside by themselves.
Many people show acute stress disorder after a psychological trauma. However, since this usually only lasts a short time and is not treated specifically, there is no reliable information on the frequency.
Post-traumatic stress disorder (PTSD)
In this case, after the traumatic event, symptoms persist that can be very pronounced. Typical are very intense, intrusive memories of the trauma, nightmares, emotional numbness and avoidance behavior. PTSD symptoms may not be present for years, or may be very mild, and may then become more pronounced due to changes in living conditions.
Acute stress reactions and post-traumatic stress disorders are regarded as attempts by the organism to cope with extreme and possibly life-threatening situations.
Children and adolescents are also confronted with traumatic events. Just like adults, they react with acute or delayed mental disorders. Fear for one's own life or the integrity of others in particular has great potential to traumatize children and adolescents. It is not clear why some children or adolescents are more vulnerable to trauma than others. Poor family security and low family support certainly play a major role.
All people who have suffered psychological trauma can suffer from severe impairments. Early psychotherapeutic treatment with a specialist in trauma (psychotraumatologist) is therefore very important. Depending on the strength and type of trauma, different therapy methods such as psychotherapy, trauma therapy, body therapy, EMDR (Eye Movement Desensitization and Reprocessing) or talk therapy are used.
Course and prognosis of trauma
Due to the large variety of possible traumas, the course and prognosis of the injuries cannot be predicted.
It is known that traumatic injuries cause approximately ten percent of all deaths worldwide. According to the World Health Organization (WHO), 5,800,000 people die each year from the consequences of a physical trauma. In people between the ages of five and 44, traumatic injuries and their consequences are even the most common cause of death.
Even if trauma is survived, permanent life restrictions arise in many cases. 30 to 40 percent of people with traumatic brain injury die, but only 27 percent have a good recovery. The rest of those affected have severe to moderate disabilities.
After a psychological trauma, on the other hand, those affected have a good chance of recovery in most cases if appropriate therapy is initiated in good time. Post-traumatic stress disorder lasts an average of 36 months with adequate treatment. In about half of those affected, recovery without treatment (spontaneous remission) occurs on average within 64 months. About 30 percent of cases take a chronic course.