11 Ways Trauma Makes It Hard to Ask for Help

Discover how trauma makes it hard to ask for help. Uncover the barriers, effects, and strategies for healing.

11 Ways Trauma Makes It Hard to Ask for Help

11 Ways Trauma Makes It Hard to Ask for Help

Understanding Trauma and Its Effects

Trauma can have a profound impact on an individual's mental health and overall well-being. It can disrupt various aspects of life, making it challenging for individuals to seek the help they need. In this section, we will explore the impact of trauma on mental health and the prevalence of post-traumatic stress disorder (PTSD).

Impact of Trauma on Mental Health

Experiencing trauma can significantly affect an individual's mental health. It can lead to a wide range of emotional and psychological reactions. While most individuals are able to recover from their symptoms over time, some may continue to experience distressing symptoms, which may result in a diagnosis of post-traumatic stress disorder (PTSD) [1].

The effects of trauma on mental health can vary from person to person, but common symptoms may include:

  • Intrusive memories or flashbacks of the traumatic event
  • Avoidance of reminders or triggers related to the trauma
  • Negative changes in thoughts and mood
  • Hyperarousal or heightened sensitivity to potential threats
  • Sleep disturbances and nightmares

These symptoms can significantly impact an individual's daily functioning, relationships, and overall quality of life. Seeking professional help is crucial for individuals experiencing ongoing distress after a traumatic event.

Prevalence of PTSD

PTSD is a mental health condition that can develop after experiencing or witnessing a traumatic event. According to the National Center for PTSD, about 6 out of every 100 people will experience PTSD at some point in their lifetime. It is more prevalent among women compared to men [1].

Children and adolescents can also experience traumatic events, and their reactions may differ from those of adults. Symptoms in younger children may include behavioral regression, separation anxiety, and difficulties with sleep and concentration [1].

Complex trauma, which refers to repeated or prolonged exposure to traumatic events, particularly during childhood, can have long-lasting effects on an individual's mental health. The Adverse Childhood Experiences (ACE) Study found that nearly 64% of participants experienced at least one exposure to childhood trauma, with 69% reporting two or more incidents [2].

Understanding the prevalence and impact of trauma, including PTSD, is essential in providing appropriate support and resources to individuals who have experienced trauma. By raising awareness and fostering a trauma-informed approach, we can help create a more compassionate and supportive environment for those in need of help.

Barriers to Seeking Help After Trauma

Experiencing trauma can have profound effects on an individual's well-being and make it challenging for them to ask for help. Two significant barriers that trauma survivors often face are the fear of repercussions and the impact on self-esteem.

Fear of Repercussions

Trauma survivors may be hesitant to seek help due to the fear of potential repercussions. This fear can stem from various factors, such as the belief that disclosing their trauma may result in negative consequences, judgment from others, or the fear of retraumatization. The fear of not being believed or understood can intensify this barrier, making it difficult for individuals to reach out for support.

It is crucial for trauma survivors to understand that seeking help is a courageous step and that there are professionals who are trained to provide support in a safe and confidential manner. By connecting with trusted individuals, such as therapists or support groups, survivors can navigate their healing journey with guidance and understanding.

Impact on Self-Esteem

Trauma survivors often experience feelings of shame, guilt, and self-blame, which can significantly impact their self-esteem. These emotions can erode their sense of self-worth, making it challenging for them to ask for help. The destructive emotion of shame makes individuals feel deeply flawed, worthless, and unlovable, damaging their self-image in a way no other emotion can.

It is essential to recognize that shame and guilt are not the same emotions. Shame involves negative self-judgment and viewing oneself as worthless, while guilt stems from evaluating an action or behavior as unfavorable but still feeling valued internally as a person. Overcoming shame associated with trauma requires strategies such as developing self-compassion, distracting oneself from negative thoughts, and identifying triggers to avoid or manage them effectively [3].

Therapy can play a crucial role in addressing shame and rebuilding self-esteem. Through therapy, trauma survivors can explore their experiences in a safe and supportive environment, challenge negative self-perceptions, and develop healthier coping mechanisms. By working with a therapist who specializes in trauma, individuals can gradually rebuild their self-worth and recognize their resilience.

Understanding the barriers that trauma survivors face when seeking help is vital to providing effective support and interventions. By creating a safe and compassionate environment, trauma survivors can be encouraged to overcome their fears and reach out for the assistance they need to heal and recover.

Complex Trauma and Childhood Experiences

For individuals who have experienced complex trauma during childhood, the effects can be far-reaching and have a profound impact on their emotional and physical well-being. In this section, we will explore two significant aspects of complex trauma: its effects on emotional regulation and the long-term health implications.

Effects on Emotional Regulation

Children who have experienced complex trauma often struggle with identifying, expressing, and managing their emotions. They may have limited language for feeling states, leading to difficulties in effectively communicating their emotions. These children often internalize or externalize stress reactions and may experience significant depression, anxiety, or anger. Their emotional responses may be unpredictable or explosive, making it challenging for them to regulate their emotions in a healthy manner.

In addition, children with complex trauma histories may have problems thinking clearly, reasoning, or problem-solving. Growing up under conditions of constant threat can hinder their ability to plan ahead, anticipate the future, and act accordingly. The constant need to focus on survival can consume their cognitive resources, affecting their cognitive functioning.

Long-Term Health Implications

Traumatic experiences in childhood have been linked to increased medical conditions throughout an individual's life. The Adverse Childhood Experiences (ACE) Study, a longitudinal study exploring the impact of childhood trauma into adulthood, revealed that nearly 64% of participants experienced at least one exposure, and of those, 69% reported two or more incidents of childhood trauma.

The long-term health implications of complex trauma are significant. Children who have experienced complex trauma are more likely to develop chronic health conditions, such as cardiovascular disease, diabetes, obesity, and autoimmune disorders later in life. The impact of childhood trauma on health is further exacerbated by the adoption of unhealthy coping mechanisms, such as substance abuse or self-destructive behaviors, as a means to cope with the trauma [2].

The cumulative economic and social burden of complex trauma in childhood is also substantial. Based on data from various sources, the annual cost of child abuse and neglect is estimated to be $103.8 billion, or $284.3 million per day (in 2007 values). Additionally, a recent study examining confirmed cases of child maltreatment in the United States found the estimated total lifetime costs associated with child maltreatment over a 12-month period to be $124 billion.

Understanding the effects of complex trauma on emotional regulation and long-term health is crucial in providing appropriate support and interventions for individuals who have experienced such trauma. By recognizing the unique challenges faced by individuals with complex trauma histories, we can work towards creating trauma-informed systems and interventions that promote healing and resilience.

Overcoming Shame and Guilt

When individuals experience trauma, it can often lead to the development of powerful emotions such as shame and guilt. These emotions can significantly impede their ability to ask for help and seek support. Understanding strategies for rebuilding self-worth and addressing shame in therapy is crucial for individuals on their journey of healing.

Strategies for Rebuilding Self-Worth

Shame is a uniquely destructive emotion that can make individuals feel deeply flawed, worthless, and unlovable. It damages their self-image in a way that no other emotion can [3]. Rebuilding self-worth after experiencing trauma requires patience, compassion, and a commitment to self-care. Here are some strategies that can help:

  1. Develop self-compassion: Practicing self-compassion involves treating yourself with kindness and understanding. It means acknowledging that everyone makes mistakes and that you deserve love and acceptance, just like anyone else.
  2. Challenge negative self-talk: Identify and challenge negative thoughts that contribute to feelings of shame and worthlessness. Replace them with positive and realistic affirmations that affirm your value and strengths.
  3. Cultivate supportive relationships: Surround yourself with individuals who uplift and support you. Seek out friends, family, or support groups that provide a safe space for you to share your experiences and receive validation and understanding.
  4. Engage in self-care activities: Prioritize activities that bring you joy, relaxation, and a sense of well-being. This can include hobbies, exercise, mindfulness practices, or anything that nourishes your mind, body, and soul.
  5. Set realistic goals: Break down larger goals into smaller, achievable steps. Celebrate your progress along the way, as each accomplishment helps to build your self-confidence and reinforce your sense of worth.

Rebuilding self-worth is a gradual process that requires time and self-compassion. Be patient with yourself and remember that healing is a journey unique to each individual.

Addressing Shame in Therapy

Shame and guilt are distinct emotions, with shame involving negative self-judgment and viewing oneself as worthless, while guilt focuses on evaluating specific actions or behaviors as unfavorable but still maintaining a sense of self-worth. When seeking therapy to address shame associated with trauma, there are several effective approaches:

  1. Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and challenge negative thought patterns and beliefs that contribute to shame and self-blame. Therapists guide clients in reframing their thoughts and developing healthier perspectives.
  2. Dialectical Behavior Therapy (DBT): DBT combines elements of CBT with mindfulness techniques to help individuals regulate their emotions and develop self-compassion. It focuses on accepting oneself while working towards positive change.
  3. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a trauma-focused therapy that helps individuals process traumatic memories and associated negative emotions, including shame. It facilitates the reprocessing of distressing experiences, leading to adaptive healing.
  4. Group Therapy: Participating in group therapy can provide a supportive environment where individuals can share experiences, gain insights, and receive validation from others who have experienced similar emotions and challenges.

Therapy provides a safe space to explore and address the shame associated with trauma. A skilled therapist can guide individuals through the healing process, helping them develop coping mechanisms, challenge self-defeating beliefs, and cultivate self-compassion.

By implementing strategies for rebuilding self-worth and seeking therapy to address shame, individuals can break free from the grip of shame and guilt, allowing them to move forward on their healing journey. Remember, reaching out for help is a courageous step towards healing, and there are professionals ready to provide the support needed to navigate the challenges associated with trauma.

Trauma and Mental Health Services

When it comes to addressing the impact of trauma on mental health, trauma-focused interventions play a vital role in helping individuals recover from post-traumatic stress disorder (PTSD) and related symptoms. However, there are barriers that can impede access to these crucial treatments.

Trauma-Focused Interventions

Trauma-focused interventions, such as cognitive-behavioral therapy (tf-CBT) and eye movement desensitization and reprocessing (EMDR), have shown significant reductions in symptoms and distress for individuals with PTSD. These therapies aim to help individuals process traumatic experiences, develop coping skills, and reframe negative beliefs [4].

For individuals with psychosis and comorbid PTSD, trauma-focused interventions have been recognized as effective treatments. The prevalence of PTSD in people with psychosis is estimated between 14% and 47% NCBI. However, due to harm expectancies, individuals with psychosis are often excluded from research trials, leading to uncertainty about the efficacy of trauma-focused interventions for this population NCBI.

Barriers to Accessing Treatment

Despite the effectiveness of trauma-focused interventions, there are barriers that can hinder individuals from accessing these services. Clinicians perceive significant barriers to the delivery of trauma-focused interventions for individuals with psychosis and PTSD NCBI. Some of the key barriers include:

  1. Integration into clinical discourse: Incorporating trauma discussions into clinical practice can be challenging for clinicians. The sensitive nature of trauma-related topics and the need for a safe space to address potential harm can make it difficult to effectively integrate trauma-focused interventions into treatment.
  2. Structural factors: Service configuration and communication can impact the delivery of trauma-focused interventions. Inadequate resources, limited availability of specialized services, and fragmented care can create barriers to accessing trauma-focused treatments.
  3. Clinician skills and support: Clinicians require training, supervision, and organizational support to effectively deliver trauma-focused interventions. Building the necessary skills and ensuring ongoing professional development are essential for providing high-quality care.

Addressing these barriers requires a multifaceted approach. Training and education should be provided to clinicians to enhance their knowledge and skills in trauma-focused interventions. Additionally, organizations and healthcare systems should prioritize the integration of trauma-focused care into existing services, ensuring that individuals with PTSD and psychosis have access to appropriate treatment options.

By overcoming these barriers, individuals can receive the trauma-focused interventions they need to address their PTSD symptoms and work towards healing and recovery. However, it is crucial to continue research and advocacy efforts to improve access to trauma-focused interventions for all individuals who can benefit from them.

Trauma-Informed Approach in Public Health

Recognizing the impact of trauma on individuals and society, a trauma-informed approach has emerged in the field of public health. This approach aims to integrate an understanding of trauma and its aftereffects into various aspects of healthcare and support services. In this section, we will explore the concept of trauma-informed care and the implementation of trauma-informed practices.

Understanding Trauma-Informed Care

The term "trauma-informed" was introduced as a means to integrate trauma knowledge into mental health services, acknowledging that many individuals accessing these services have experienced physical and sexual abuse. Trauma-informed care emphasizes the importance of understanding how trauma affects individuals and the need for creating safe and supportive environments that promote healing and resilience.

A trauma-informed approach recognizes that experiences of trauma are widespread and can have far-reaching social and health consequences [5]. It aims to shift the focus from asking, "What's wrong with you?" to "What happened to you?" This shift in perspective helps professionals and service providers understand the potential underlying trauma that individuals may have experienced and respond in a compassionate and supportive manner.

Implementing Trauma-Informed Practices

Implementing trauma-informed practices involves integrating trauma knowledge into various aspects of public health policies and services. This approach acknowledges that trauma can have a significant impact on an individual's overall well-being and aims to mitigate the potential negative effects.

Trauma-informed practices include:

  1. Training and Education: Providing comprehensive training to healthcare professionals, social workers, and other service providers to ensure a deep understanding of trauma and its implications. This education helps professionals recognize trauma-related symptoms, respond appropriately, and provide trauma-informed care.
  2. Creating Safe Environments: Establishing safe and supportive environments where individuals feel respected, heard, and understood. This involves creating physical spaces that are calming and ensuring that interactions are sensitive to potential triggers.
  3. Building Trust and Collaboration: Fostering trust and collaboration between service providers and individuals who have experienced trauma. This includes promoting shared decision-making, active listening, and involving individuals in their own care.
  4. Avoiding Re-traumatization: Implementing practices that minimize the risk of re-traumatization. This involves being mindful of language, tone, and behavior that may inadvertently trigger trauma-related responses.
  5. Addressing Secondary Traumatic Stress: Recognizing the potential impact of working with individuals who have experienced trauma on the well-being of service providers. Supporting the mental health and self-care practices of healthcare professionals and other service providers is essential to maintaining their well-being.

By adopting a trauma-informed approach, public health policies and services can better support individuals who have experienced trauma. This approach recognizes the complex interplay between trauma and health outcomes, emphasizing compassion, understanding, and empowerment as key pillars of care.


[1]: https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd

[2]: https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma/effects

[3]: https://questpsychologyservices.co.uk/shame-why-does-it-come-from-trauma/

[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9304310/

[5]: https://www.nature.com/articles/s41599-022-01227-z

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