An interview with Victoria M. Follette, author of Finding Life Beyond Trauma

New Harbinger Publications: Could you explain what a traumatic event is? What are some examples?

Victoria M. Follette: Trauma can be considered in a variety of ways. Generally we consider trauma to be an event that would lead to significant symptoms of distress in most people. Usually there is a sense of overwhelming emotional reactions, including feelings of fear, helplessness or horror. A wide range of experiences can be labeled as traumatic, ranging from combat to natural disasters. Additionally, a number of interpersonal experiences including child physical and sexual abuse, domestic violence, and rape are all considered as potentially traumatic experiences.

NHP: What are some of the effects of trauma?

VMF: There is a great deal of research into the impact of trauma. Post-traumatic stress disorder is most frequently associated with trauma. Symptoms of this include increased emotional arousal, re-experiencing the traumatic event, and feeling numb or avoiding the reminders of the trauma. However, there are other problems we see such as depression, suicidal thoughts and feelings, and interpersonal problems.

NHP: What are some of the myths surrounding trauma?

VMF: One big myth about traumatic events is that they are rare and few people will experience them. In fact, a wide range of studies show that many people will experience a traumatic even in their lifetime. Another myth is that everyone will need therapy after a traumatic event. A lot of research is going into understanding why some people recover from trauma without treatment. Some of the ideas in this book come from learning about those people.

NHP: What is acceptance and committment therapy (ACT)? Why is it effective in treating those suffering the effects of trauma?

VMF: ACT is a treatment that was developed by Steve Hayes specifically to target problems of avoidance. Given that avoidance is at the core of many problems associated with trauma, it is especially well suited to trauma survivors. The goals of ACT are to help people to learn to accept their history and to identify their value and goals. We work with people to let go of the struggle to avoid thoughts and feelings associated with the trauma. At the same time, it is important to help people to start engaging in activities that enrich their lives.

NHP: What is acute stress disorder (ASD) and how does it differ from post-traumatic stress disorder (PTSD)? What are some symptoms of each?

VMF: The main difference between these two disorders is one of time. ASD is present when the symptoms last at least two days but not longer that one month. At one month, the diagnosis of PTSD is used. We see symptoms of dissociation, such as loss of time and re-experiencing of trauma through dreams or flashbacks. Symptoms of avoidance and increased anxiety are also associated with these disorders as well as distress associated with the trauma. However, one difference in our approach is that we look at ways that trauma can have an influence that go far beyond the symptoms of PTSD. Some of the problems can involve substance abuse, relationship difficulties and problems identifying and labeling feelings.

NHP: In your book you say “avoid avoidance”. Why is that important?

VMF: Our clinical experience, as well as the research, suggests that avoidance can increase a number of the symptoms associated with trauma. As people try not to think about things, those thoughts can become even more frequent and troubling. We also find that if people avoid feelings, they tend to feel increasingly isolated and cut off from living a valued life.