Common Reactions to Trauma

Long-term reactions to trauma are unique, personal, and often painful. Sometimes the reactions seem random as if they have little to do with the trauma. Other times, they are simply too much. They are vivid, painful, and overwhelming. A step in many trauma interventions involves normalizing these reactions, and showing that a person is not broken, wrong, or alone.

Re-experiencing the Trauma

Trauma survivors may re-experience their trauma through thoughts, feelings, memories, and other means. Re-experiencing a trauma can be very distressing, and may trigger uncomfortable emotions such as fear, anger, or sadness.

• Nightmares
• Flashbacks (uncontrollable vivid images and memories of the trauma)
• Distressing thoughts and feelings about the trauma
• Emotional distress or physical responses after experiencing a trauma reminder

Avoidance of Trauma Reminders

Because reminders of trauma can be so distressing, it is common for trauma survivors to use avoidance to control these reactions.

• Using drugs or alcohol to suppress uncomfortable thoughts and emotions • Avoidance of activities related to the trauma
• Avoidance of people, places, or things related to the trauma
• Suppressing thoughts related to the trauma

• Avoidance of conversations about the trauma

Negative Thoughts or Feelings

Negative thoughts or feelings may begin or worsen after experiencing trauma. Some of these thoughts and feelings might not seem to relate directly to the trauma.

• Excessive blame toward oneself or others related to the trauma • Loss of interest in activities
• Feelings of isolation or disconnection from surroundings
• Difficulty experiencing positive feelings

• Loss of memory related to the trauma
• Excessive negative thoughts about oneself or the world


Reactivity, or a feeling of being “on edge”, may begin or worsen after experiencing a trauma. This category includes a broad range of physical and psychological symptoms.

• Becoming irritable, quick to anger, or aggressive
• Heightened startle reaction
• Difficulty concentrating
• Frequently scanning the environment or watching for trauma reminders • Difficulty sleeping

• Feelings of anxiety, and related symptoms such as a racing heart, upset stomach, or headaches • Risky or impulsive behaviors

The information in this post is provided by the resource and Research: Foa, E. B., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences, Therapist Guide (Treatments that work). New York: Oxford University Press.


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