By Dr. Courtney Walraven, Ed.D., LCSW-S
Self-destructive and self-harming behaviors are highly correlated with a history of trauma (Ferentz, 2015), and they include suicidal behaviors and thoughts. Sanderson (2013) described self-harm as a secondary response in an attempt to manage the distress of traumatic events. Dr. Gingrich explained trauma that is not fully integrated could create difficulty in behavior, affect, sensory experiences, and cognitions (American Association of Christian Counselors, 2017). Traumatic experiences can result in negative and distorted beliefs about self and the world partially in the attempt for the victim to rationalize the traumatic experience (Ferentz, 2015). Children are at an even higher level of vulnerability to beliefs that they are to blame or responsible for the traumatic experience(s) (Blaustein & Kinniburgh, 2019; Sanderson, 2013). The cycle of self-destructive thoughts and behaviors may begin or be perpetuated by the client’s negative beliefs (Cohen, et al., 2017). Cohen, et al. (2017) use the cognitive behavioral therapy (CBT) triangle to explain the relationship between thoughts, emotions, and behaviors as interdependent. Additional self-destructive behaviors include substance use and addictions (Ferentz, 2015). Dr. Laaser explained the brain is physiologically altered by traumatic experiences resulting in declined functioning in the prefrontal cortex (American Association of Christian Counselors, 2017). He continued to explain the psychopharmacological impacts of substances including marijuana, alcohol and heroin impair the frontal lobe as well, therefore negatively contributing to the trauma healing and recovery process. Medications used to treat suicidal thoughts and behaviors come with risks. Limandri (2019) explained that serotonin reuptake inhibitors (SRIs) prescribed to teens pose an increased risk of suicidality (especially in children and teenagers) because they can increase the impulsivity experienced in consumers.
Resilience to trauma is an interesting topic that is still largely undefined. The presence of at least one safe and reliable adult is beneficial in the healing process (Blaustein & Kinniburgh, 2019). People who have an average and supportive development with healthy and predictable attachment to caregivers seem to have increased resilience to trauma (Blaustein & Kinniburgh, 2019). Childhood trauma can result in deeply rooted cognitive distortions (e.g., “I am unlovable”, “I don’t deserve good things”) that are enhanced by future traumas (Blaustein & Kinniburgh, 2019). Complex trauma is a result of a history of repeated exposure to traumatic experiences (often childhood sexual and physical abuse) (Ferentz, 2015). Traumatic experiences resulting in dissociation can increase vulnerability to future traumas because the person is less aware of environmental and interpersonal dangers (Sanderson, 2013).
Faith can be a very helpful resource for people with a history of trauma. Kress, et al., (2015) found that religiosity is one variable that can result in increased internal coping skills which has positive correlation with resilience. Dr. Hawkins explained religion can also complicate the survivor’s view of religion and spirituality if the perpetrator is connected to a religious organization, or they question why God didn’t stop or prevent the trauma (American Association of Christian Counselors, 2017). I really appreciated Dr. Hawkins’ advice to sit with those who are suffering with a crisis of faith. This practical advice provides guidance for me as I move forward as a therapist.
References:
American Association of Christian Counselors. (2017). TRMA 810 DVD Set. AACC.
Blaustein, M. E. & Kinniburgh, K. M. (2019). Treating traumatic stress in children and adolescents (2nd ed.). Guilford Press.
Cohen, J. A., Mannarino, A. P., Deblinger, E. (2017). Trauma focused CBT for children and adolescents: Treatment applications. Guilford Press
Ferentz, L. (2015). Treating self-destructive behaviors in trauma survivors. (2nd ed.). Routledge.
Kress, V. E., Newgent, R. A., Whitlock, J., & Mease, L. (2015). Spirituality/religiosity, life satisfaction, and life meaning as protective factors for nonsuicidal self-injury in college students. Journal of College Counseling, 18(2), 160-174. https://doi.org/10.1002/jocc.12012
Limandri, B. J. (2019). Psychopharmacology of suicide. Journal of Psychosocial Nursing & Mental Health Services, 57(12), 9-14. https://doi.org/10.3928/02793695-20191112-02
Sanderson, C. (2013). Counseling skills for working with trauma: Healing from child sexual abuse, sexual violence, and domestic abuse. Jessica Kingsley Publishers.
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