HSPs and Trauma

Originally published in Comfort Zone Newsletter: November 2007.

I hope none of you are recovering from a traumatic experience. But if that is the case, as an HSP, you need specialized advice. As it happens, I have a friend, Dr. Camille Wortman, who is an expert on trauma, as well as another friend who works with persons who have been in automobile accidents. So I was well prepared when an HSP friend of mine was in one recently.

A trauma is defined as “experiencing, witnessing, or being confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, or learning about an unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.”

“Trauma” is a word often used lightly, so it helps to begin with a definition, this one from the Diagnostic and Statistical Manualof the American Psychiatric Association. It is part of the description of Post Traumatic Stress Disorder, PTSD. If you want to know the symptoms of that you can find it in that book, or in some version based on it on the internet. Not every trauma leads to PTSD, but every trauma does lead to some symptoms like PTSD. It’s the quantity and their duration that makes the difference.

The problem with trauma for HSPs is that it takes less of an event to affect us because even a minor automobile accident can make us imagine vividly “actual or threatened death or serious injury.” My friend was imagining automobile accidents for weeks afterwards—not only the emotional memory of it, but whenever he was driving, the possibility of it happening again.

What Happens After a Trauma, Especially to an HSP

Basically, after a trauma you will, to some degree, relive the event over and over, have distressing recurring dreams about it as well as intrusive thoughts about it during the day, want to avoid any place or activities that remind you of it, feel emotionally numb and unable to enjoy much, and have increased general arousal. You are jumpy all the time, cannot asleep, or wake in the middle of the night. To count as the actual disorder, at least some symptoms must go on for at least a month and impair your daily life. Whether you have the true disorder does not really matter very much, except perhaps when insurance companies want a diagnosis before they will pay for treatment. And a description of the possible symptoms helps in that you know that others have the same symptoms; you are not “going totally crazy.”

Although I have done no research on trauma and HSPs, I am certain that we are more vulnerable to being distressed by it, and possibly to the disorder. Even if your reaction does not reach that acute point, as an HSP you will relive the event more vividly than others would, think about it more, focus on how to avoid it happening again, have more vivid dreams about it (because you have more vivid dreams generally), feel more emotional about it, and become more over aroused by all of this. Those are the symptoms, and that’s us on high alert, which we switch to more easily than others.

Trauma can also lead to depression and anxiety, and we are more vulnerable to these as well, especially if we have had these in the past. My friend was prone to depression and went right into one after his accident.

How to Make It Less Traumatic

Treatments for PTSD emphasize talking about the experience, especially with others who have been through something similar. Some studies have found, as have I as a therapist, that it helps to talk about the event over and over, even if you do not want to. With my friend, I had to insist that he relive the whole event with me, several times. Each time he surprised himself by suddenly crying.

All humans are social beings, who do better when we share feelings freely—cry, rage, have our fear. Our emotions are there mostly to signal our inner state to others. Journaling has also been found to help, although it works better if someone will be reading what you write.

I think these expressive treatments work especially well for us because otherwise we will surely be reliving the experience in our heads anyway. But HSPs especially must have the right person listening to them—someone who does not decide after awhile that we are overreacting or now it’s time to just get over it. For some the recovery is very slow, and for some it happens almost suddenly one day. Shame about the symptoms can only slow down your return to a sense of being safe enough in the world.

That lost sense of safety was partly an illusion, of course, as every HSP knows. After a trauma we can feel that life has changed forever. The world seems full of dangers. How do you enjoy anything? Well, you relearn to, slowly. Theoretically at least, this can actually leave you better prepared to live through a future trauma. You know how it feels and that the emotions do fade. But it is important for you, an HSP, to do all you can to help yourself through the time after a trauma. Otherwise, your own intense HSP response can feel as traumatic as the event was itself.

What can you do?

• Accept that you must stop and shift gears. Not forever, but for more than a few weeks or a month or even two months. With my friend, he truly wanted to go on with his life. However, it did not work. He had to take some days off and then cut down on his work for awhile. How long depends on whether you have physical injuries, and the meaning of the event for you, and the support you receive from family, friends, and health workers. But I think the first reaction is to try to return to life as it was just before the event. That cannot be.
• Do not follow your natural inclination to avoid things having to do with the trauma, especially if these are going to be a continuing part of your life. For example, after a car accident you need to go back to driving as soon as you can. HSPs especially want to avoid risk, but this is not the time for that aspect of your trait. Have someone else with you, but get back on the horse.
• Increase the use of all your usual methods of reducing arousal–meditate, pray, be in nature, be in water (bathing, swimming, or at a hot spring), exercise. I guess praying while swimming in a beautiful lake would be perfect! For some people. Others will want to garden more, be with their animal friends, watch comedies, get a massage, or listen to music. Whatever works for you, do more of it.
• Use positive distractions, and not just your work.At those times when you are not talking about the event with someone, or doing the minimum amount of work that you have to do, do more of the things you would normally enjoy. Engage in some of the subtle pleasures listed in the article on that in this issue. My friend followed my suggestion in the last email and went “day camping,” resting on a cot in the woods since he could not hike for awhile. Do these things even though you feel no pleasure in them. It still has an effect on your nervous system.
• Trust me: An HSP will have health issues. Even a psychological trauma affects the entire body. The result is fatigue. Get enough sleep, even if that means taking a sleep medication (but I would avoid Ambien—it can have very strange neurological effects). I repeat, you will fatigue easily. Tell people you are sick if you have to, because it is true. All traumas are extremely depleting for every part of the body, but especially the nervous system. And you have a more delicate nervous system.
• Get extra help dealing with injuries. What a fix. Here you are traumatized, and then having to figure out the best medical treatment, usually from too many alternatives, each carrying some risk of not helping or even making you worse. Get help with this–have someone else gather information from the internet for you. But avoid hearing others’ stories of surgery and so on. Everyone’s situation is different. You can even say that, and then add if necessary, “I don’t think hearing this is going to help me much right now.”
• Ask for all sorts of help. This is important. Some people will be glad to help by running errands, cooking a meal, keeping you distracted, or listening to you and handing you the box of Kleenex. You may be the type who wants to withdraw after a trauma, afraid of burdening others. But helping you only reassures your friends that others will help them when they need it.
• Notice helpful strangers. These can give you a renewed sense of hope in the human race. Even when we are alone, if people are around when something happens to us, they will almost always want very much to help. My friend was surprised by the genuine kindness of the two police when they arrived on the scene.
• Talk with someone who cares about you regarding any sense of shame or regret. Even if you did something to contribute to the trauma, there was probably a good cause, and everyone understands that accidents happen. Indeed, when someone reassures of that, it reassures them as well, that they can be allowed to make mistakes.
• Take it easy, starting immediately. Right after a trauma you may actually feel unusually good, if it required your competence or you faced a sudden emergency. Sudden emergencies mobilize a set of hormones (adrenaline, etc.) that we could call the Fountain of Youth, in that they prepare us to do superhuman feats. A long time ago my burned down. During the fire my husband tossed a trunk out the window. The next day he and a friend could not lift together. Do not go to the gym the next day or take a ten-mile hike, coasting on this false sense of immortality.

Again, I hope you will never need this advice. But as an HSP, you are more easily traumatized, and you like to be prepared, so remember to retrieve this article when you need it.