Traumatic events are scary, dangerous, or shocking experiences that affect us physically, emotionally, mentally, spiritually, or socially.1 Examples of traumatic events include natural disasters, wars, terrorist attacks, mass shootings, serious illnesses, car accidents, workplace accidents, rape, abuse, and other experiences that affect our sense of well-being.2
Trauma affects us in various ways. In the short term, it can cause emotional reactions such as terror, confusion, shock, isolation, and dissociation, whereas in the long run, it can affect our behavior, mental state, and ability to function.3
Trauma can also put the body in a state of stress and causes physical symptoms such as a racing heartbeat, headaches, nausea, digestive difficulties, poor sleep quality, and a tendency to startle easily.4
Unresolved trauma occurs most commonly when rather than processing the traumatic event, the person tries to forget it and suppress it instead, by pushing it down into an internal ‘black box’ that only grows over time, says Judith Zackson, PhD, Founder and Clinical Director of Zackson Psychology Group. Sometimes this process is conscious and sometimes it is unconscious.
Unresolved trauma causes the person to experience disruptive physical and emotional reactions in the present as their body and mind continue to defend against a threat that belongs in the past, Dr. Zackson explains.
This article explores the symptoms, causes, diagnosis, and treatment of unresolved trauma.
Symptoms of Unresolved Trauma
These are some of the common symptoms of unresolved trauma, according to Dr. Zackson:
- Hypervigilance and inability to let one’s guard down5
- Lack of trust and difficulty opening up to other people6
- Dissociation and a persistent feeling of numbness7
- Control issues, to overcompensate for feeling helpless during the traumatic incident8
- Low self-esteem and feelings of worthlessness9
- Anger issues and difficulty regulating emotions8
- High blood pressure and cortisol levels10
- Sleep difficulties, including insomnia and nightmares11
- Headaches, nausea, sweating, or digestive issues12
- Tightness in the chest or a pit in the stomach
- Somatic preoccupation (excessive focus and extreme distress about physical symptoms)13
- Bodily memories that cause physical flashbacks of the sensations, smell, taste, pain, and pressure of the traumatic experience14
- Mental health conditions such as anxiety, depression, substance use disorder, or post-traumatic stress disorder (PTSD)15
Unresolved trauma is an invisible illness. To others, you may seem fine, but in reality, you are stuck in the past, battling emotional and physical symptoms that make it challenging to live a quality life, says Dr. Zackson.
Causes of Unresolved Trauma
Unresolved trauma occurs when the person has experienced an overwhelming event—or series of events—outside their brain’s window of tolerance, Dr. Zackson explains. “The survivor protects themselves from the pain by repressing and avoiding the disturbing emotions and trying to get over the trauma by pushing it down.”
The problem is that buried trauma doesn’t go away. It remains and continues to grow, until ultimately, it surfaces in unexpected and disproportionate ways.
Impact of Unresolved Trauma
Unresolved trauma can cause the person to feel threatened long after the incident occurs, according to Dr. Zackson. “Every new experience is tainted by the past, as if the trauma is still happening.”
Even positive gestures from an intimate partner, family members, friends, colleagues, or passersby on the street may be interpreted as hostile or threatening because the brain perceives threats in benign circumstances as well, Dr. Zackson explains.
“Essentially, the survivor’s energy is geared toward remaining in control at the cost of living a spontaneous and enjoyable life. The impact can be broken relationships, stalled careers, substance use, and other physical and emotional symptoms,” says Dr. Zackson.
Dr. Zackson notes that unresolved trauma can also be passed down generations to one’s children and grandchildren.16
Diagnosing Unresolved Trauma
According to Dr. Zackson, diagnosing unresolved trauma requires an in-depth assessment by a skilled clinician who will evaluate the person’s:
- Symptoms
- Past experiences
- Medical history
- Coping skills
- Internal and external resources
A thorough assessment is essential as individuals with unresolved trauma could be misdiagnosed with depression, anxiety, or adjustment disorder when their symptoms may be better explained by the unresolved trauma, says Dr. Zackson.
Treating Unresolved Trauma
Treating unresolved trauma is important, because without treatment and healthy coping skills, it’s likely that it will never be fully resolved.
Below, Dr. Zackson outlines the therapeutic process of treating unresolved trauma and the different forms of therapy that may be helpful.
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Therapeutic Process
Treatment for unresolved trauma begins with creating a safe and nurturing environment where the survivor feels safe enough to process the trauma that has been repressed and pushed into the ‘black box’.
The clinician carefully and safely opens this ‘box,’ allowing patients to become aware of their experiences. The clinician works with the patient to develop a perspective on and integrate their inner experiences into their life.
There is no specific time frame for recovery from unresolved trauma. However, the good news is that healing from trauma is not an endpoint; survivors are capable of far more than merely healing. They can look back on their traumatic experience and learn that they are stronger than they ever imagined. With a strong mentality and supportive environment, they can transform trauma and pain into resilience and growth.
Types of Therapy
According to Dr. Zackson, these are some forms of therapy, ideally conducted by experienced trauma specialists, that can help treat unresolved trauma:
- Trauma-focused cognitive behavioral therapy (TF-CBT)17
- Eye movement desensitization and reprocessing (EMDR)18
- Dialectical behavior therapy (DBT)19
- Psychodynamic therapy20
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