Hi Stimuli subscribers, it's Steve back again for a new audio series called trauma and ADHD. We had quite a lot of interest from the trauma audio I recorded for one of my CBT series and a few people asking if we could expand on that and I was more than happy to do so because it's a very important subject and it's my sort of specialist professional area of interest prior to working with ADHD.

So I guess this first audio really is just to answer the question, what is trauma? It's a word we use quite a lot in everyday life. So what does it actually mean? How do we define it? The National Child Traumatic Stress Network defines trauma as an event or series of events that involve fear or threat.

It's pretty vague, isn't it? One of the leading writers on trauma is Bessel van der Kolk, a bit of a sort of professional hero of mine. And he wrote way back in 89 that trauma occurs when both internal and external resources are inadequate to cope with the external threat. And, yeah, that's pretty important, really.

And we'll talk a bit more about that, perhaps in the next episode or two, about the appraisals of that event that felt traumatic. It's really not just about what happens to us, it's the meaning of what happens. And I'll expand on that further later on. But especially in the NHS here in England and I'd imagine similarly in other mental health services across the world, we, you see a lot of, discussion about what is trauma, what isn't trauma.

And I've always personally found that a bit of a pointless conversation because what is traumatic to me might not be traumatic to you what affects somebody else quite severely might have be quite easily processed by another person. And there is so much within that and why that is there's very famous twin studies, for example, about two sets of twins, how they could experience very similar traumatic experiences. One goes on to lead a very successful life. The other is beset with mental health problems and typical sort of trauma symptomatology.

When I do training programs and CBT events on defining what trauma is, I often steal a quote from somebody called Herman who wrote in ‘97 that at the moment of trauma, the victim is rendered helpless by overwhelming force.

Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection and meaning. The severity of traumatic events cannot be measured on any single dimension. Simplistic efforts to quantify trauma ultimately lead to meaningless comparisons of horror. The salient characteristic of the traumatic event is its power to inspire helplessness and terror.

Both, as beautiful as it is terrifying, I think as a quote really, yeah, what he's saying is, similar to how I see things and many other trauma therapists, EMDR therapists, it really is it's meaningless, it's pointless to compare it. The question for me is - is that person, or is one, traumatized by that event?

If so, what can we do about it? Obviously, the hope is that one isn't, but I think you'll find that trauma is far more widespread than we probably realize. And a traumatic event can include all kinds of difficult circumstances. You've got more sort of obvious type one traumas, like witnessing war, genocide, being, experiencing physical, sexual abuse.

But actually, it's more, much more widespread than that. It might be that we witnessed those events. Domestic violence, sexual assault, emotional abuse can cause trauma. Neglect, both emotional and physical. Parental mental health issues like chronic depression, suicides, parental institutionalization or incarceration.

Addictions and substance misuse in parents or caregivers. Or maybe more grief related, like the sudden or violent death of a loved one. Studies have shown that adverse childhood experiences are vastly more common than acknowledged. And that most of these exposures occur within the child's caregiving system.

Van der Kolk suggests that about 80 percent of people responsible for child maltreatment are the children's own parents. Now I think it's important to note this does not equate to parents or carers intentionally causing trauma for the child. In many cases this can happen as a direct result of parents trying to provide care in difficult circumstances and being unable to, or not having the resources to.

In short, trauma is everywhere and we're going to break that down across this series and we're going to look at identifying PTSD, complex PTSD and complex trauma and starting to explore not only what to do if one has these conditions or these problems, how to manage the symptoms, but also to helpfully try and steer you towards the right support if that is something that's going on for you.

I hope it helps. Take care.