Psychology

“A sensitive person will probably never become a tough guy”

When is a trauma a trauma? And why do some people suffer more from psychological distress than others? Yvonne Egenolf explains. The co-head of the Psychotherapeutic Practice at the University of Bern supports people who have been through stressful events.

Personally, I was shocked some time ago by an incident on my way home when a young man knocked me down with a blow to the chest.

I hadn’t assessed the situation as threatening and so had to adjust my sense of knowing how the world works after the incident. For a few weeks, I was more alert and cautious than usual.

As a psychotherapist, I may have a slightly more trained emotional skill set. This may sometimes make it easier for me to perceive my own experience, put it into words and reflect on it.

I do actually regret the lack of differentiated words we use in everyday language to describe our emotional and psychological well-being. I think it’s worth taking a closer look at yourself here and looking for suitable words for your own experience. If you use pathologizing language to describe an emotionally unpleasant but non-pathological experience, there is something degrading about it – especially for the person themselves. It makes them the victim of their experience, rather than highlighting their own ability to exert influence. I think that’s a pity.

Rather than issuing a warning about using these words, I would like to encourage people to be more curious about their own experience, rather than rashly label it. If we give our feelings more space and mindfulness, we may notice that we are not depressed, but rather sad, dejected, disappointed, hurt, exhausted, overwhelmed, criticized, misunderstood or discouraged. That way, our feelings can tell us something about what we need in the situation.

The term trauma comes from the Greek and means wound or injury. In psychology, it refers to a severe psychological shock that can be caused by very different experiences. We speak of psychological trauma when a person is confronted with a threatening or perceived as threatening event that exceeds their individual capacity to process the experience. Typically, it is accompanied by feelings of powerlessness, helplessness and being at the mercy of others.

There are many potentially traumatic events such as natural disasters, accidents, war and torture, sexualized and physical violence, or witnessing a violent death. But even events that seem less severe at first glance, such as bullying, emotional neglect or a difficult birth, can be experienced as traumatic.

“Even events that seem less severe at first glance, such as bullying, emotional neglect or a difficult birth, can be experienced as traumatic.”

Yvonne Egenolf

An adjustment disorder is when a person suffers from a depressed or anxious mood shortly after the onset of the event and no longer than six months after the stressor ceases, and when the symptoms significantly and disproportionately affect well-being and social and occupational functioning. Those affected usually feel a lot of strain and are unable to integrate the event into their lives. By the way, highly normative life events, i.e. predictable transitions from one phase of life to the next – such as the beginning of parenthood, the start of working life or retirement – also place high demands on our ability to adapt; they, too, can lead to adjustment disorders.

In psychotherapy, we first work with those affected to find out which factors stand in the way of adaptation. We often come across negative assumptions about the self that can be questioned during therapy. Sometimes certain abilities and competencies are not sufficiently developed, such as the ability for people to control themselves and regulate their emotions, or social competencies are limited. The development and training of these specific competencies are then at the forefront of therapeutic work. Another focus is usually on activating unused resources such as social relationships or beneficial activities.

About the person

Yvonne Egenolf

has been head psychologist of the Psychotherapeutic Practice at the Institute of Psychology at the University of Bern since 2018. She specializes in emotion-focused therapy and also runs her own psychotherapeutic practice in Bern.

contact: yvonne.egenolf@unibe.ch

 

Those affected often suffer from recurring, disturbing memories. They act and feel as if the event is happening again, i.e. they have flashbacks: When a sound, smell or physical sensation reminds them of a rape, for example, they experience intense stress. People with PTSD avoid thoughts and situations, often including places, activities and people, that could trigger memories of the event, and withdraw accordingly. They experience a significant impairment of their mood and thinking. In addition, those affected often suffer from sleep disorders, nightmares, difficulty concentrating, increased irritability and hypervigilance, i.e. a type of heightened alertness.

In addition to the symptoms mentioned above, people with complex PTSD also suffer from significant disturbances in their self-image and in attempts to regulate their emotions. They often feel inferior and find it hard to feel close to others or maintain relationships with others.

The treatment of PTSD and complex PTSD are somewhat similar, but there are also significant differences. Basically, they can be divided into three phases: Stabilization and rebuilding of internal and external security, dealing with traumatic experiences as well as reintegration and reorientation.

Symptoms persist and people often develop dysfunctional strategies. It leads to the consumption of alcohol and drugs, emotional avoidance, deafness, social withdrawal or even self-harm in order to escape the painful experience. This, in turn, can be a breeding ground for the development of further mental disorders, and the condition of those affected deteriorates further.

Magazine uniFOKUS

"Disruptions"

This article first appeared in uniFOKUS, the University of Bern print magazine. Four times a year, uniFOKUS focuses on one specialist area from different points of view. Current focus topic: "Disruptions"

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The term “resilience” originally comes from materials research, in which we search for flexible, resilient materials that can return to their original state even after being exposed to considerable pressure, heat or friction. So resilience actually refers to a system’s tolerance for malfunctions. Applied to human experience, it describes a person’s ability to adapt and recover despite disruptive influences and confrontation with various stressors. We are all born into very different worlds and are shaped differently in our self-image and our expectations of competence and self-efficacy. Genetic factors also play a role in resilience. For these reasons, some people are much more vulnerable – without ever having chosen to be like that or having caused it through their own negligence.

I don’t think a vulnerable and sensitive person will or should ever become a tough guy. But people can definitely learn to be in better contact with themselves, to support themselves better, and to better perceive opportunities to influence themselves and use them in a more socially competent manner. In doing so, they learn that they are able to overcome difficulties well and on their own. This increases their tolerance for uncertainty and allows them to react more flexibly to stressful situations.

When something that is important to us is lost or ends, it is important to give yourself space and mourn it. I don’t think there’s any shortcut. Of course, this process doesn’t have to start on my last day of work, for example, when I retire. I can start developing my leisure activities and social contacts outside of work a few years beforehand. With the inevitable imminent death of a loved one, I might be able to bring friends and family closer so that I don’t have to mourn alone.

The people who come to my practice are naturally those whose psychological state is severely strained after a traumatic event and who are stuck in this experience. But yes, after a successful therapeutic process and the reintegration of traumatic experiences into therapy, I have witnessed significant and growth-oriented changes in the lives of my patients on a number of occasions.

Yes, I remember a successful businessman who had narrowly survived a life-threatening event and started questioning his priorities during therapy. He gave up his professional life, became socially engaged and changed his way of life considerably. Eventually, he tried to deepen the relationship with his children again. However, post-traumatic growth is not always as visible from the outside as in this case. Patients often experience a new and beneficial modesty and mindfulness towards life. Or they feel deep gratitude in their interpersonal relationships for the security they have now experienced or are ready to take the next step in their life’s development.

In most cases, I am very confident that the person is willing to continue their process independently. These are often very personal and intimate processes in which I was able to support them in our joint therapeutic work: To a certain extent, there is a space in my heart for all the people I have been privileged enough to work with.

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