Guide
Guide | Reference

15  Trauma-Related Experiences

15.1 Summary

  • Experiences of intrusion, hyperarousal, avoidance, or shutdown tied to past or ongoing threat.

15.2 Patient-Language Phrases

  • “I keep reliving it.”
  • “I feel on edge, like something bad is about to happen.”
  • “I go numb or shut down.”
  • “I avoid anything that reminds me of it.”

15.3 Core Features

  • Intrusions (memories, flashbacks, nightmares).
  • Hypervigilance and exaggerated startle.
  • Avoidance and emotional numbing.
  • Dissociation or fragmentation under stress.

15.4 Boundary Markers

  • What it is: threat-linked responses that persist beyond the event.
  • What it is not: expected short-term stress reactions to acute events.

15.5 Quick Structure

  • Variants / Spectrum
    • Intrusion-dominant (re-experiencing).
    • Hyperarousal-dominant (vigilance, irritability).
    • Dissociative/shutdown-dominant.
    • Grief-trauma overlap or moral injury.
  • Severity (0-4)
    • 0: No trauma-linked symptoms.
    • 1: Mild, intermittent, manageable.
    • 2: Moderate, recurrent, impacts function.
    • 3: Severe, persistent, with avoidance or dissociation.
    • 4: Extreme, disabling or unsafe.
  • Time-course
    • Acute post-event reactions.
    • Chronic persistence with triggers.
    • Fluctuations with stress or reminders.
  • Functional impact
    • Work/school: concentration issues, avoidance.
    • Relationships: withdrawal, mistrust, conflict.
    • Self-care: sleep disruption, hyperarousal.
  • Developmental expression
    • Childhood: behavioral regression, play reenactment.
    • Adolescence: risk-taking, emotional volatility, shutdown.
    • Late life: reactivation around losses or medical events.
  • Cultural/context notes
    • Trauma meaning varies by culture and community narratives.
    • Ongoing threat changes interpretation and management.