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Great. Let's make a start. Thanks so much for joining us this morning.
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My name's Kathy Creswell. I'm from the departments of Experimental Psychology and Psychiatry here at the University of Oxford.
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And I'm really delighted to be hosting this series, which is hosted by the Department of Experimental Psychology.
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We're on our mental wellness.
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We've had a really great series of talks so far, and I'm delighted to introduce this one, which is focussed on coping with trauma.
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So just to tell you a little bit about how this all works, we'll have about 15 or 20 minutes talk, first of all,
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and then we're going to open up for a panel discussion because of the nature of the subjects that we're talking about,
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because we know there are a lot of questions and because we record and share this on YouTube, we don't have a live question answer session.
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So many thanks to those of you who've submitted questions in advance.
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We've collated those and pulled them together into themes that we'll be presenting to our panel.
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We'll be finishing at about quarter to eleven. And we deliberately leave it as 15 minutes to the hour.
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So there's a bit of time at the end, hopefully, for you to have a bit of a break before your next appointment or activity starts up,
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because obviously the issues that we are covering in this series, we understand,
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may raise difficulties for some people and give people lots to think about.
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So we want to give you a chance to take a bit of time, encourage you to give yourself a bit of a break,
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go for a bit of a walk or whatever would be helpful for you just to give yourself a little bit of time at the end of the session.
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Before we start, I also just want to highlight that we've had previous talks on some fantastic topics,
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including overcoming stress and anxiety, overcoming depression and low mood, overcoming problems with sleep and also with eating.
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So please do have a look at the Department of Experimental Psychology website or our YouTube channel,
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where you can watch back those talks, which have all been really, really useful and interesting sessions.
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And we also have another tool coming up shortly, which is focussed on overcoming paranoia,
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which will be led by Dan Freeman from the Department of Psychiatry.
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So please do so. Join us for that one.
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But without further ado, I'm really delighted to introduce Professor Anker, LSD from the Department of Experimental Psychology.
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Anchor is professor of Experimental Psychopathology and the Wellcome Trust Principal Research Fellow here,
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and is also co-director of the Oxford Centre for Anxiety Disorders and Trauma.
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Thanks ever so much for joining us today, anchor. Thank you very much, Kathy.
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Will your introduction and thanks everybody for joining us today.
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I'll quickly go to share my screen. And.
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Yes, so my topic is coping with trauma. But let's first look at what what do what do we understand what a trauma is in everyday language?
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We use of a broad definition of I don't talk about upsetting events, such as losing a job,
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failing a exam or a divorce as potentially as traumatic and met in medical science of trauma often refers to a physical injury.
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What I'm going to talk about is slightly different. It's a kind of narrower definition of upsetting events that cause a psychological trauma.
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And those traumas are extremely threatening events.
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So it can be a series of repeated events that often involve the threat to one owns one's own life or physical integrity or that of other people.
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And examples would be interpersonal violence, such as assault, torture and so on,
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severe accidents, natural and manmade disasters or war zone experience.
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But it's very broad. What what type of events that that's can can be called trauma because they involve the spread to life or physical integrity.
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And what is really important to highlight here is that what matters is the subjective experience at that time.
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So even people who are in the in the same event differ in whether they experience the event as a trauma.
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And to give you an example. And so let's say somebody is threatened with a toy gun in a mugging or something like that.
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And if the person at the time believes that's a real gun and they are about to be shot,
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this could be a psychological trauma, even though they might find out shortly afterwards that it was just a toy gun.
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So whether it's subjectively perceived as a threat to life or physical integrity.
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So my next question is, how common is this type of excrete appearance?
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And we have a quick poll prepared for you to get your opinion.
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Well, how many people do you think have experienced such an event in their lifetime?
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Thank you very much. The results coming in now, so so we we can see that most of you estimated between 30 and 60 percent.
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That's a very good guess. It is a common experience.
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And some of the second largest guess was between 60 and 90 percent.
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So. So you are very much on target. It is actually, even though these are extreme events.
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They are actually common. And if we are now go to two.
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Oh, my. Next. Next slide. Then we we can sew it.
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I can't. So hopefully you see that.
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See, you know, some examples from from recent events that were reported widely in the media.
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So you from accidents, from fire, terrorist attacks, natural disasters and so on are very common.
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And the research actually shows that most people will experience at least one traumatic event in their lifetime.
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For example, a large study recently contacted by the World Health Organisation interviewed
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nearly 70000 people in 24 countries and 70 percent in the studies reported trauma.
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And actually, on average, it was three traumas per person. The most common events reported were in this survey were unexpected death of
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a loved one or witnessing happen to other people and road traffic accidents.
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How do people respond to trauma? What happens in the aftermath?
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There is a set of typical symptoms and this is one of the reasons why the definition of trauma in psychology and psychiatry is quite,
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quite and has been narrowed down.
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But amongst the most common symptoms after such events are re experiencing symptoms where people experience moments from the event memories,
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dreams or just the emotions of body sensations from the trauma as if they are ever happening again right now.
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So people that may have pictures from the event popping into their mind or they may dream about them.
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And amongst body sensations, they experience could be that like the heart racing or death, the physiological responses during the event.
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And it really feels as if the trauma is happening now. And if you have such unpleasant memories of the event that are highly distressing,
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it is very understandable that people will go out of their way to avoid reminders of the event.
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This could be similar situations like going to the site of the event.
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People who were involved or even thinking or talking about the event is extremely distressing and therefore is avoided very commonly.
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And finally, there's many symptoms of being in a state of high alert, being on edge,
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looking out for danger, being easily started with also difficulty sleeping and concentrating.
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And that's very understandable after an upsetting event such as the ones I described.
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And what is important to emphasise here that these symptoms are entirely normal after a traumatic event.
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And most people will have some re experiencing symptoms soon after the event and some avoidance and some might how arise?
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That doesn't mean necessarily that this is a clinical condition developing.
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It's just a normal response to an abnormal situation.
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But for some people, it can become a more chronic problem that they have these kinds of symptoms.
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And this is what we then call post-traumatic stress disorder.
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And this disorder is characterised by exactly the same symptoms that everybody would
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experience and also offer negative thoughts about the self or feeling quite numb,
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being losing interest and things people used to enjoy and having lots of negative emotion,
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including sadness, anger, feeling guilty or ashamed and so on.
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But none of that immediately after the trauma is is is is a cause of concern, because as you will see on my next slide,
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that people are often resilient and recover from these symptoms on their own devices.
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And a slide from the same study, study that I just mentioned from the World Health Organisation.
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And people were answering questions of how long after the event their symptoms persisted and what you can see.
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And the plot just highlights different types of trauma. So let's just look at the overall picture.
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You can see that in the first year. And what's plotted here is years after the traumas in the first year, we see a really very steep recovery.
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So so quite of lot of people, 25 to 40 percent,
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will fully recover from the PTSD symptoms in the first year after the trauma and even after that recovery is still ongoing.
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You see a one as one group where whether the recovery takes longer.
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And this is from was on related trauma. So, so but for all other traumas, it's quite a fast recovery in the first year.
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So this now raises the question so.
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So if we see that many of these symptoms are quite normal after the event, it's an abnormal event and we react to that.
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We have to readjust our lives after having feelings like this.
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And many people will recover on their own.
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So what do we know about what helps recovery so that we that what prevents people from being stuck in this recovery process,
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which is while we understand developing PTSD? So one big factor there is support from family, friends and colleagues.
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So if we have support from other people that are close to us, that care about us, that that will be helpful.
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Also generally looking after ourselves, self care.
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So really watching out to eat eat well after an event like this, to not use substances excessively, not to let not drink too much alcohol and so on.
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Get some exercise and also generally be kind to yourself.
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And don't don't feel you have to really back to and be back to normal in a few days.
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This isn't a very upsetting event that shakes people up and.
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And we won't be able to overcome it in a day.
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But as if we let the natural recovery with the support of our friends and colleagues and and family take place,
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then then then we have a good chance of recovering. The other tip I would give from our clinical work on post-traumatic stress disorder.
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That often people who end up having a post-traumatic stress disorder give up a lot of activities that were important to them before and they enjoyed.
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And that could be a direct effect of the trauma. Let's say they were injured and can't do certain activities.
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But even then, if the injuries are healed and they can could resume this active often, then don't quite get around to doing this.
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And so what one of advice I would give is step by step, trying to reclaim activities that bring meaning and enjoyment to our lives.
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And even if one might not feel like this immediately after an event, you might feel, oh, it's it's there's no point to it.
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I really getting back into a daily routine where this is a part and this may need to do involves finding some alternatives.
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If if you can't do certain things any longer after trauma.
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So for so for instance, let's say somebody has a leg injury and can't play football any longer.
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They may still be able to do some form of exercise, like go to the gym or go swimming and so on,
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that that really ticks the same box in in and bringing meaning and enjoyment to their lives.
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That's obviously easier said than done. But so it takes a little bit of a decision to get going again with these activities.
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But we find them extremely helpful. The other point I wanted to consider is what gets in the way we weigh in the way of recovery.
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So how do some people get stuck and develop PTSD after trauma?
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And one thing I wanted to mention is that people can get stuck in vert,
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vicious cycles between the threat that they've taken from the trauma threatening meanings of the trauma.
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And it's and and also its aftermath, including the symptoms of PTSD themselves.
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So I will give some examples in a minute. And the second is, when you have one, you feel that trauma is still posing a threat in your life.
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So let's say you feel you're going to be attacked again. You will take measures to prevent this.
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And and the crux here is that some of these very understandable strategies
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that people take to control the threat they are now perceiving in their life,
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too, will actually backfire and either increase symptoms or or maintain the problems or so that you kind of keep stuck in this vicious circle.
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And as an odd way to introduce us, I just wanted you to do a little experiment with me for just a short moment.
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So if in the next few moments, I would like you to you can think about anything you like,
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but there is one particular thing I would add under no circumstances should think about.
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And this is a black and white cat sitting on my shoulder so you can think about anything else.
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But don't think about that cat. So what?
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What happened? I would hope that it would have illustrated to you that it's really hard not to think about it,
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something so many people who do this experiment will say, well, immediately an image of a cat popped into my mind.
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And this is exactly what what seems to be going on in people who develop PTSD after trauma as well,
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that they will have many unwanted memories of the trauma popping into my mind, as I explained.
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This is a normal experience after trauma.
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But if they then think this means something bad about themselves, for instance, they might think I'm going crazy.
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I'm not. I'm losing it. I won't be able to my do my job and ever again, they will then try very hard to push these memories out of their mind.
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But as hopefully you will explain yourself. This actually has a paradoxical effect that actually these these memories pop into your mind more.
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So it kind of increases the chances of finding unwanted memories, which then confirms them.
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And that idea that they might be going crazy and losing it.
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And it's why push even harder. And and they got tons of get stuck in this vicious circle.
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So so we would want to break through these these vicious circles after trauma.
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Another example here where it's more about some a meaning that a person took from from that trauma.
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In this case, let's imagine somebody who was treated in hospital during the course of a pandemic.
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In an ICU unit. And nobody was allowed to visit them.
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As you well know. But people when they are sick and in a state of being being very sick and also having lots of medication and so on.
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They might get into a kind of confusion state and be very confused about what's happening and not fully understand why nobody came to visit them.
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And they might feel quite abandoned. And they may take from this fear the meaning or do what he really cares about me.
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They would have come if they cared about me.
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And then in the aftermath, when friends were trying to reach out to them and invite them or phone them, they may actually avoid them.
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And made really was drawn socially and and not returned phone calls,
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which then means the friends will take that as a sign that this contact is unwanted and they get fewer
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invitations and fewer fewer calls and which then confirms for for this person or nobody cares about me.
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So they might get in a vicious cycle like that. And we see that a lot of us people that we treat for post-traumatic stress disorder,
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that breaking through these vicious cycles about meanings that people take from the
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trauma then influences understandably and a logical way you could say that behaviours.
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But that then prevents them. We only fight from protesting out that that that meaning and finding evidence against it.
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So it seems to confirm the behaviour seems to lead to to a confirmation of these these meanings, just distressing meanings.
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So breaking through this vicious cycles, spotting them and breaking through these vicious cycles and then behaving
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differently to test out these meanings is an important way to get over trauma.
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One more example. What gets in the way of recovery?
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I don't have a lot of time to think about it, to talk about the nature of trauma memories.
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That would be a lot to say about that. But but of we we don't have time for going into debt discussions about that.
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But what I would like to highlight is the sense of fear now that trauma memories have soon after the trauma.
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And and if people have chronic PTSD continuing for years and years, moments on the trauma popping into their mind when they don't want one, too.
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And one important lesson we learnt when treating patients with this disorder and also from research is that it is useful to know about
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the triggers of these memories because they can be quite difficult to spot because they often don't have meaningful relationships.
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It's just about sensations that were around at the time.
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And and it's it's really often just one particular sensation.
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So it could be a particular colour, a particular smell, a sound or taste.
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It could be it touches someone, the body or a particular movement that they perceived or that they made themselves.
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And these can automatically trigger these very distressing memories that appear to be in here now.
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And it's also the case that because these memories are so distressing, people would usually then look away or try to avoid this situation.
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And that makes it very difficult for them to spot any differences between the reminder that that's in the current situation,
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that that's not dangerous. And the original trauma KUZE.
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And what we can do then and that's what we would also do in treatment when we treat people with PTSD,
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is really working with the person on what are the the individual triggers.
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So and something we can see, hear, smell, taste or feel in our body when a memory is triggered.
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And let's say was the example of the person who was treated in intensive care.
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So if there were many, many triggers, what one of them, for instance, was the blue colour that the NHS logo has.
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As a kind of particular type of blue and red.
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And for this person, anything that had this colour blue would trigger intrusive memories of the I say use this day.
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So, for instance, somebody walking on the street with a t shirt and the same colour would be a trigger.
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But there is no meaningful connexion that the t shirts are not dangerous.
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And but still,
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spotting this relationship then would would then help us to really look at what are the differences between them then the time of trauma.
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And now a person with a blue t shirt. And and it's a completely different situation.
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They are now recovered of it and they are better.
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They are not ill. It's a person on the street. They are not in hospital.
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So lots of differences. And and then so.
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So really, zooming in, directing our attention to the differences can be really helpful in overcoming this
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automatic reaction of being triggered by these cues in everyday life at a harmless.
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And and I linked with a trauma through this kind of sensory connexion that we want to break.
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And this takes some practise. But but people find it really helpful.
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The last one I wanted to mention is dwelling on the trauma. And I think Jennifer Wilde has already talked about the negative effects of dwelling.
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People may, after trauma, think about the questions like why did it happen to me?
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What if I only hadn't done this or if I had done this?
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And this can be a fear, quite compelling. They feel they should really to think about it more.
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And it can kind of to come back in the kind of circular thinking about the trauma,
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which can really negatively affect people's mood and also can keep them and risk going.
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And we advise to to try to spot that when you're getting into these ruminative circles early,
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because it's easier to interrupt them when you're when you're early on.
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We do spot them and then take them as a sign to get active. So even if it's something simple,
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like getting a cup of tea or doing a little bit of exercise and to really get out of the vicious circle of a dwelling,
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and some people find it really useful to label that, like I have a picture of a carousel because as somebody who thought that was a good image.
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All of that thoughts go in circles or so I get to you, thinking was was another good label, somebody that we saw came up with.
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It's kind of all twisted up and and leads nowhere. It's kind of all of the spaghetti together.
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So so spotting dwelling can be very helpful.
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But I would also I would like to finish now with saying if if somebody gets stuck in this natural recovery,
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that is that is a very and also very understandable consequence of trauma.
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And the good news is that help is available.
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So effective psychological treatments are available in the NHS and psychological treatments, other first-line treatments for this condition.
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If you're interested in and in that, those are the nice guidelines have been published in 2018.
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You can look them up on the Internet if you want.
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I think you might need some help. You can discuss with those your GP who can advise about the best options.
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You can also self refer to your local. Improving access to psychological therapy service in Oxford.
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That's called talking space plus. And there's a service finder on the Internet.
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If you Google, I services NHS and then you can find a website where you put in your postcode and find your the services that are closest to you.
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And there's also various specialist trauma services and psychological treatment services in the NHS, depending on where.
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You live?
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Oh, well, they can offer longer treatments, especially for people who have very severe post-traumatic stress disorder or more complex problems,
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was with several, several problems that need to be addressed. Thank you very much for your attention.
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Great. Thank you ever so much indeed. I'm now delighted to introduce our fellow panel members.
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So I'd like to introduce you to Maine if it's our who's associate professor in
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child and adolescent psychiatry in the Department of Psychiatry here in Oxford,
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and also Morten Cringle back.
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He's associate professor of neuroscience at the Department of Psychiatry and Senior Research Fellow at Queens College, London.
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Thanks for Queenscliff chocs. Sorry. Thanks for joining us.
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I think I've read them in different made their apologies.
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And so we've received a number of questions which we're going to talk through.
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So just to start with, I'd like to come to you,
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Morten and Backspaces picks up on what Frank was saying about the range of different traumatic experience that people may happen,
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the different effects they may have on different people. And so there were some questions about what distinguishes kind of trauma with a capital
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T and other distressing experiences that we might not typically classes trauma.
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And the labour questions really about what research can tell us about this.
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So are there specific effects of the sort of capital T traumas?
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And I guess ultimately, would we need to manage these different sorts of distressing events differently?
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I mean, I think these are great questions. And, of course, we are still looking at them.
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And it is wonderful talk sort of gets to the heart of that.
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Remember when she showed the first slide, she said trauma is the psychological experience of having trauma.
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Obviously, there are degrees of the kind of trauma that you can go through if you see it in a in an accident.
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You may also hit your hit.
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So, of course, that could both be the things that changes your brain, but also the things that changes your brain structurally.
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So obviously that would have a larger impact. And May could well be what some people will classes trauma with a capital T.
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But the other thing that Oncor so pointed out in our talk, which I think is a very important one, is the natural course of the disease,
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namely that lots of lots of traumas will eventually go away or at least become better with time.
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And so what can neuroscience tell about it? Well, again, unclear.
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It provided a wonderful sort of answer to that, namely that one of the things that goes away is the enjoyment of things.
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And one of the best things one can do is to actually enjoy things in psychological lingo, we call it.
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And he donia and a volition the the lack of pleasure and the leg up wanting to do anything.
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And of course, what is happening in the brain is that those circuits are being changed.
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And the question, of course, then is, are they changed differently because you may have hit your head at the same time.
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There may be structural consequences of that.
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And the answer is absolutely certain things where you experience trauma potentially on a daily basis, like the military experience.
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It's really a difficult one.
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And of course, I think the key issue here, depending on what it is that we experience, is how do we avoid going from acute to chronic.
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And this is exactly where the kinds of of treatments that the uncle has outlined is exactly what is needed.
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Then, of course, it's very different if you trying to treat somebody who is experiencing a chronic
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trauma every day of the week compared to somebody who's only had a one off.
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So those are the kind of research questions that we are actively pursuing. Thanks very much.
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What's it mean? I don't know if you want to add anything in relating this question about different thoughts.
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The former and distressing events? Well, absolutely.
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So I think what I talked about, about the subjective experience being crucial is that, you know,
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there are so many different events that could potentially lead one to subjectively experience that it's traumatic.
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And I do think that it's an incredibly exciting time for research as well, because I think research is something that has always played a key role.
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But it's really started to help unpack in the natural course of what people experience.
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And also the different types of interventions that might be able to help.
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And this is that's really grabbing. They're really incredible innovations and we're learning a lot.
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They're not set as well as kind of across different institutions. And so I think it's a key time for research to have different vulnerabilities.
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There's also kind of neurodiversity and had different types of kind of brains and personality types might react to different events.
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And then, you know, what I'm interested in is then what does that mean on the ground?
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Interventions like what does that mean for how services can better adapt so that we become easier for a person who, as I can really clearly described,
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is in avoidance is such a key part of this study that no matter how much we understand about what's going on,
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if a person is just going to avoid coming through the door to get an intervention, what can we do to help that side?
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I think there's so much so many different ways that present in our society, so much we can learn about how we can tailor interventions to really help.
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Thank you. Martin. He told there about neuroscience and the contribution of neuroscience to our understanding of trauma.
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I wondered if there anything else you wanted to add on that,
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because we did certainly have some specific questions about the contribution of neuroscience,
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sort of as distinct from psychology and how it is contributing to our understanding.
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One of my former students now postdoctoral Marina Bulkier Ballester Shakira was also a student of Ankit.
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So we supervised a project which she'd taken some of anxious interventions,
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and uncle had scanned the participants patients before and after the intervention.
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So now we were able to track over time what happened to the brains as they were initially just looking at what
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happened when they had a traumatised images and then happened after they had successfully been been changed.
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And very much like what Uncap demonstrated with that wonderful example with the black cat,
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which of course, one of the key issues in trauma is that you keep basically doing what?
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And of course, biggity thinking this this idea that you are stuck in a rut.
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And the interesting thing was that once you had carried out this very carefully.
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And what you found in the brain was that suddenly the patients were able to disconnect
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from these traumatising pictures instead of just taking over like the black. They went away.
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And of course, we now know exactly where that is happening in the brain.
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And we not only do we know where it's happening, but we also know the networks of how different things are communicating.
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And then I think it's an exciting piece of work that should be replicated in those communities.
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It's important that this actually has real effect on the ground.
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But again, taking into account the more diversity the media mentioned, I think it's crucially important and key, a really fascinating area.
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And I mean, there are a lot of questions really about the variation of experiences, the variation.
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The trick is both of the variation of people's responses and say there were particular questions about
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psychosomatic symptoms and whether we might see the impacts of trauma three psychosomatic symptoms,
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for example, pain. And if so, how best to cope with that?
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I mean it. Can I come to a festival? Yes. So, you know, as we become aware today,
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there's all these emotional and cognitive reactions within these expenses can also cause physical symptoms such as headaches,
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digestive problems, nausea or diarrhoea or fatigue or feeling jumpy.
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So there's a whole range of ways that the body can also kind of respond.
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And I think the first thing that I would say is that, you know,
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if you're getting headaches because of this, that these are really painful, truly experience symptoms.
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And so pleasant is that this is not to dismiss this idea that this is not a real headache because it's causes to get some organic psycho pathology.
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And so the first thing is that you need to be aware that trauma can affect everybody differently.
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And for some people, that might have manifestations in these physical symptoms.
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But then what to do about it? I think to know that there's no magic bullet that actually understanding that this is actually quite common, isn't it,
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in a helpful what we call psycho education is such a basic part of starting to address it that we often say this is really you think,
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well, it's a software problem rather than a hardware problem.
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And so, you know, we can actually through a range of different methods and in a way, a very multidisciplinary approach.
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We would talk about it in services, really help a person overcome it.
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And so a lot of our uncle already talked about, said not to kind of forget the really important,
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just basic principles of the importance of all those self things,
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the importance of interpersonal relationships and the roles of friends of fabric,
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maintaining your social networks, but also just believing that these kind of ways just help adapt, adapt better.
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It's not saying that that headache isn't that is not saying that it's not painful.
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It's just saying the way we can help the body cope better, the way we can shift that software in a problem a little bit is by ensuring that you
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maintain that breadth of other activities that could maybe a system that overall recovery.
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Thanks very much. We have several questions about issues relating to stigma.
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And I mean,
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that's something that obviously comes up across a lot of sessions that people may feel stigma themselves because of that the experiences that the
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traumatic events they've had and or because of the expenses they've had
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subsequently or may feel that they've experienced stigma from others around them.
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Say there were some questions really about what research can tell us about the
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impact of stigma associated with trauma and what people can do to be able to,
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say, capable or overcome that same anchor. Can I come to you first for your thoughts on this?
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So I think we can look at it at two levels, as you said.
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One is the perceived stigma that the person themselves, as they may feel that what if they talk about the trauma to others,
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that maybe they might feel quite ashamed about it and might then not disclose it to other people and they might think people would look down on them?
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That's maybe a common and understandable. And and what we would advise that is that a.
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It is possible that that is one of a vicious cycle that I talked about that that we just
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assume that people would look down on us or would would not think about it so and so,
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too, to really cheque it out and and and try to talk to some trusted friend and and do and
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often you people will find that people are much more understanding than they thought.
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But I don't want to deny that there is still some society to a stigma.
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I think it's getting better about mental health in general and also particularly about trauma.
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Many people start not speaking out about 12 months they experienced.
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And I think this will cause a shift in the perception of trauma.
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And also, I think the numbers that we've seen that it will happen to most people in their lifetime.
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So it's not and only happened to a few a few people.
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So it is. It is. But that's. That needs more work.
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And also, the reactions of other people are not always helpful.
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I mean, most most people will be happy.
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But we can't deny that some of the people, at least the ones that we've seen and treatment, have reported with negative actions from other people.
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And I think education about the effect of trauma has to be also part of a packet.
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Thank you. Thanks very much.
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We've got one last question and not to come to each of you feel for any final thoughts and reflections stimulated by this question.
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So I'll come to Mina Moulton and then anchor. And this was really relating to the question about recovering it.
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Obviously, Yankee presented that said graph, which very clearly showed the sort of natural pattern of recovery.
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But I but one question that we received was whether it's ever possible to really
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reach a stage where your unaffected by severe trauma that you've experienced,
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including possibly trauma that you've experienced in childhood,
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and whether you can ever get to a point where you're unaffected by that and say it mean it.
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Can I come to a festival for your thoughts on that? Yeah, those really important question.
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I think it comes at the heart of know many people have experienced children that they might
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be more worried about hearing that it's always going to affect them negatively rather than,
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you know, just looking at the reality of their life and how it's affected them.
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I would say that, you know, all experience affects you.
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So I would be really nervous to say you're unaffected. But the assumption that that effect is negative, we just have to question.
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So I do think that we don't want to minimise people's pain and suffering of the impact of losses that might have caused trauma.
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And many people are very negatively affected. But we also have to respect the fact that some people, as a result of terrible events,
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do shift their world view in a way that they later perceive in a more positive light.
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So so I think everyone is likely to be affected. I'm affected by almost everything that happens.
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Good, bad. Sue somewhat Monday. So not to worry about being affected them.
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And I'm also not a psychiatrist like we all traditions here.
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So I do actually think that in the most severe cases are there are treatments that exist that are incredibly effective.
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And so even you know, that that actually is is it?
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These are, you know, interventions that can help.
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But it's important that people who are the most negatively affected.
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Often, you know, are able to access these treatments because I do think that can help.
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Thanks so much, man there, Martin. Yeah, I think neuroscience clearly shows that your brain will be changed by everything.
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Some others. But I think the evidence is also that you can shift constantly thinking about that cat on your shoulder to actually use that something.
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And I think it's also important, like Mina said, to remember that true flourishing is often very closely associated with suffering.
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It's often by going through terrible things that we come to new ways of actually appreciating.
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And flourishing in this life. So, yes, I think they are very effective treatments.
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We need to know more. Obviously more research is needed. But I think there is a possibility to change.
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Thank you. And finally to you, Frank. Yeah, I agree. I agree with being on boards.
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Said you can't really race. Well, always it will always stay a memory of a bad event.
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And I think what I can add is that it might also be helpful to be prepared that
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that there might be particular reminders like the anniversaries and so on,
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that will come with a temporary phase. Well, one thinks more about it and feel and remember the bad events,
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but then also take us as a sub taking that as a sign we engaged with life and and and what what life brings now and and also some potential growth.
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Like Morton said, people report that they feel they are more they've seen positive changes in themselves,
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like being more empathetic of other people, enjoying the good times more.
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So that can also be an outcome and that's important.
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Obviously, we also have to acknowledge that some people lost in the trauma may loss, have lost people they loved and and that will always be lost.
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That has changed our life forever. We have to accept reality.
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But that doesn't mean that we have to be stuck in the intrusive memories and the symptoms of PTSD much.
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Sure. That brings us to claeys today. So I'd just like to say huge.
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Thank you to all our speakers and panellists for joining us today for a really
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interesting and I hope very useful session for everyone who has joined us.
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Also here, thanks to everybody who joined us and also to Caia and Hally,
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who've done lots of work behind the scenes to make this whole run really smoothly.
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And, of course, thanks to the pattern of experimental psychology for hosting this series.
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As I mentioned, do you have a look at the experimental psychology department Web site?
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To our YouTube channel, four past talks and this tool will also be available there.
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And just the last reminder that on the 20th of May at 2:00 p.m., we'll be running the next session on overcoming mistrust and paranoia.
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So please stay join us for that. I'm sure it'll be a really interesting session. Thank you so much.
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Please do take a little break now before you move on to what you need to be doing
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next and give yourself a bit of time for a scratch or a walk or a cup of tea,
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whatever would be good for you. And we look forward to seeing you again. Thanks ever so much.
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Goodbye.
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Great. Let's make a start. Thanks so much for joining us this morning.
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My name's Kathy Creswell. I'm from the departments of Experimental Psychology and Psychiatry here at the University of Oxford.
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And I'm really delighted to be hosting this series, which is hosted by the Department of Experimental Psychology.
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We're on our mental wellness.
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We've had a really great series of talks so far, and I'm delighted to introduce this one, which is focussed on coping with trauma.
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So just to tell you a little bit about how this all works, we'll have about 15 or 20 minutes talk, first of all,
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and then we're going to open up for a panel discussion because of the nature of the subjects that we're talking about,
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because we know there are a lot of questions and because we record and share this on YouTube, we don't have a live question answer session.
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So many thanks to those of you who've submitted questions in advance.
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We've collated those and pulled them together into themes that we'll be presenting to our panel.
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We'll be finishing at about quarter to eleven. And we deliberately leave it as 15 minutes to the hour.
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So there's a bit of time at the end, hopefully, for you to have a bit of a break before your next appointment or activity starts up,
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because obviously the issues that we are covering in this series, we understand,
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may raise difficulties for some people and give people lots to think about.
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So we want to give you a chance to take a bit of time, encourage you to give yourself a bit of a break,
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go for a bit of a walk or whatever would be helpful for you just to give yourself a little bit of time at the end of the session.
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Before we start, I also just want to highlight that we've had previous talks on some fantastic topics,
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including overcoming stress and anxiety, overcoming depression and low mood, overcoming problems with sleep and also with eating.
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So please do have a look at the Department of Experimental Psychology website or our YouTube channel,
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where you can watch back those talks, which have all been really, really useful and interesting sessions.
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And we also have another tool coming up shortly, which is focussed on overcoming paranoia,
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which will be led by Dan Freeman from the Department of Psychiatry.
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So please do so. Join us for that one.
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But without further ado, I'm really delighted to introduce Professor Anker, LSD from the Department of Experimental Psychology.
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Anchor is professor of Experimental Psychopathology and the Wellcome Trust Principal Research Fellow here,
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and is also co-director of the Oxford Centre for Anxiety Disorders and Trauma.
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Thanks ever so much for joining us today, anchor. Thank you very much, Kathy.
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Will your introduction and thanks everybody for joining us today.
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I'll quickly go to share my screen. And.
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Yes, so my topic is coping with trauma. But let's first look at what what do what do we understand what a trauma is in everyday language?
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We use of a broad definition of I don't talk about upsetting events, such as losing a job,
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failing a exam or a divorce as potentially as traumatic and met in medical science of trauma often refers to a physical injury.
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What I'm going to talk about is slightly different. It's a kind of narrower definition of upsetting events that cause a psychological trauma.
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And those traumas are extremely threatening events.
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So it can be a series of repeated events that often involve the threat to one owns one's own life or physical integrity or that of other people.
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And examples would be interpersonal violence, such as assault, torture and so on,
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severe accidents, natural and manmade disasters or war zone experience.
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But it's very broad. What what type of events that that's can can be called trauma because they involve the spread to life or physical integrity.
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And what is really important to highlight here is that what matters is the subjective experience at that time.
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So even people who are in the in the same event differ in whether they experience the event as a trauma.
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And to give you an example. And so let's say somebody is threatened with a toy gun in a mugging or something like that.
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And if the person at the time believes that's a real gun and they are about to be shot,
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this could be a psychological trauma, even though they might find out shortly afterwards that it was just a toy gun.
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So whether it's subjectively perceived as a threat to life or physical integrity.
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So my next question is, how common is this type of excrete appearance?
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And we have a quick poll prepared for you to get your opinion.
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Well, how many people do you think have experienced such an event in their lifetime?
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Thank you very much. The results coming in now, so so we we can see that most of you estimated between 30 and 60 percent.
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That's a very good guess. It is a common experience.
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And some of the second largest guess was between 60 and 90 percent.
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So. So you are very much on target. It is actually, even though these are extreme events.
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They are actually common. And if we are now go to two.
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Oh, my. Next. Next slide. Then we we can sew it.
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I can't. So hopefully you see that.
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See, you know, some examples from from recent events that were reported widely in the media.
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So you from accidents, from fire, terrorist attacks, natural disasters and so on are very common.
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And the research actually shows that most people will experience at least one traumatic event in their lifetime.
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For example, a large study recently contacted by the World Health Organisation interviewed
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nearly 70000 people in 24 countries and 70 percent in the studies reported trauma.
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And actually, on average, it was three traumas per person. The most common events reported were in this survey were unexpected death of
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a loved one or witnessing happen to other people and road traffic accidents.
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How do people respond to trauma? What happens in the aftermath?
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There is a set of typical symptoms and this is one of the reasons why the definition of trauma in psychology and psychiatry is quite,
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quite and has been narrowed down.
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But amongst the most common symptoms after such events are re experiencing symptoms where people experience moments from the event memories,
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dreams or just the emotions of body sensations from the trauma as if they are ever happening again right now.
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So people that may have pictures from the event popping into their mind or they may dream about them.
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And amongst body sensations, they experience could be that like the heart racing or death, the physiological responses during the event.
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And it really feels as if the trauma is happening now. And if you have such unpleasant memories of the event that are highly distressing,
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it is very understandable that people will go out of their way to avoid reminders of the event.
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This could be similar situations like going to the site of the event.
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People who were involved or even thinking or talking about the event is extremely distressing and therefore is avoided very commonly.
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And finally, there's many symptoms of being in a state of high alert, being on edge,
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looking out for danger, being easily started with also difficulty sleeping and concentrating.
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And that's very understandable after an upsetting event such as the ones I described.
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And what is important to emphasise here that these symptoms are entirely normal after a traumatic event.
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And most people will have some re experiencing symptoms soon after the event and some avoidance and some might how arise?
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That doesn't mean necessarily that this is a clinical condition developing.
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It's just a normal response to an abnormal situation.
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But for some people, it can become a more chronic problem that they have these kinds of symptoms.
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And this is what we then call post-traumatic stress disorder.
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And this disorder is characterised by exactly the same symptoms that everybody would
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experience and also offer negative thoughts about the self or feeling quite numb,
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being losing interest and things people used to enjoy and having lots of negative emotion,
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including sadness, anger, feeling guilty or ashamed and so on.
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But none of that immediately after the trauma is is is is a cause of concern, because as you will see on my next slide,
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that people are often resilient and recover from these symptoms on their own devices.
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And a slide from the same study, study that I just mentioned from the World Health Organisation.
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And people were answering questions of how long after the event their symptoms persisted and what you can see.
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And the plot just highlights different types of trauma. So let's just look at the overall picture.
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You can see that in the first year. And what's plotted here is years after the traumas in the first year, we see a really very steep recovery.
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So so quite of lot of people, 25 to 40 percent,
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will fully recover from the PTSD symptoms in the first year after the trauma and even after that recovery is still ongoing.
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You see a one as one group where whether the recovery takes longer.
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And this is from was on related trauma. So, so but for all other traumas, it's quite a fast recovery in the first year.
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So this now raises the question so.
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So if we see that many of these symptoms are quite normal after the event, it's an abnormal event and we react to that.
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We have to readjust our lives after having feelings like this.
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And many people will recover on their own.
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So what do we know about what helps recovery so that we that what prevents people from being stuck in this recovery process,
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which is while we understand developing PTSD? So one big factor there is support from family, friends and colleagues.
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So if we have support from other people that are close to us, that care about us, that that will be helpful.
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Also generally looking after ourselves, self care.
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So really watching out to eat eat well after an event like this, to not use substances excessively, not to let not drink too much alcohol and so on.
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Get some exercise and also generally be kind to yourself.
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And don't don't feel you have to really back to and be back to normal in a few days.
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This isn't a very upsetting event that shakes people up and.
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And we won't be able to overcome it in a day.
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But as if we let the natural recovery with the support of our friends and colleagues and and family take place,
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then then then we have a good chance of recovering. The other tip I would give from our clinical work on post-traumatic stress disorder.
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That often people who end up having a post-traumatic stress disorder give up a lot of activities that were important to them before and they enjoyed.
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And that could be a direct effect of the trauma. Let's say they were injured and can't do certain activities.
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But even then, if the injuries are healed and they can could resume this active often, then don't quite get around to doing this.
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And so what one of advice I would give is step by step, trying to reclaim activities that bring meaning and enjoyment to our lives.
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And even if one might not feel like this immediately after an event, you might feel, oh, it's it's there's no point to it.
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I really getting back into a daily routine where this is a part and this may need to do involves finding some alternatives.
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If if you can't do certain things any longer after trauma.
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So for so for instance, let's say somebody has a leg injury and can't play football any longer.
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They may still be able to do some form of exercise, like go to the gym or go swimming and so on,
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that that really ticks the same box in in and bringing meaning and enjoyment to their lives.
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That's obviously easier said than done. But so it takes a little bit of a decision to get going again with these activities.
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But we find them extremely helpful. The other point I wanted to consider is what gets in the way we weigh in the way of recovery.
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So how do some people get stuck and develop PTSD after trauma?
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And one thing I wanted to mention is that people can get stuck in vert,
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vicious cycles between the threat that they've taken from the trauma threatening meanings of the trauma.
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And it's and and also its aftermath, including the symptoms of PTSD themselves.
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So I will give some examples in a minute. And the second is, when you have one, you feel that trauma is still posing a threat in your life.
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So let's say you feel you're going to be attacked again. You will take measures to prevent this.
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And and the crux here is that some of these very understandable strategies
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that people take to control the threat they are now perceiving in their life,
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too, will actually backfire and either increase symptoms or or maintain the problems or so that you kind of keep stuck in this vicious circle.
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And as an odd way to introduce us, I just wanted you to do a little experiment with me for just a short moment.
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So if in the next few moments, I would like you to you can think about anything you like,
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but there is one particular thing I would add under no circumstances should think about.
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And this is a black and white cat sitting on my shoulder so you can think about anything else.
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But don't think about that cat. So what?
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What happened? I would hope that it would have illustrated to you that it's really hard not to think about it,
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something so many people who do this experiment will say, well, immediately an image of a cat popped into my mind.
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And this is exactly what what seems to be going on in people who develop PTSD after trauma as well,
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that they will have many unwanted memories of the trauma popping into my mind, as I explained.
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This is a normal experience after trauma.
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But if they then think this means something bad about themselves, for instance, they might think I'm going crazy.
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I'm not. I'm losing it. I won't be able to my do my job and ever again, they will then try very hard to push these memories out of their mind.
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But as hopefully you will explain yourself. This actually has a paradoxical effect that actually these these memories pop into your mind more.
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So it kind of increases the chances of finding unwanted memories, which then confirms them.
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And that idea that they might be going crazy and losing it.
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And it's why push even harder. And and they got tons of get stuck in this vicious circle.
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So so we would want to break through these these vicious circles after trauma.
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Another example here where it's more about some a meaning that a person took from from that trauma.
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In this case, let's imagine somebody who was treated in hospital during the course of a pandemic.
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In an ICU unit. And nobody was allowed to visit them.
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As you well know. But people when they are sick and in a state of being being very sick and also having lots of medication and so on.
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They might get into a kind of confusion state and be very confused about what's happening and not fully understand why nobody came to visit them.
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And they might feel quite abandoned. And they may take from this fear the meaning or do what he really cares about me.
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They would have come if they cared about me.
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And then in the aftermath, when friends were trying to reach out to them and invite them or phone them, they may actually avoid them.
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And made really was drawn socially and and not returned phone calls,
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which then means the friends will take that as a sign that this contact is unwanted and they get fewer
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invitations and fewer fewer calls and which then confirms for for this person or nobody cares about me.
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So they might get in a vicious cycle like that. And we see that a lot of us people that we treat for post-traumatic stress disorder,
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that breaking through these vicious cycles about meanings that people take from the
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trauma then influences understandably and a logical way you could say that behaviours.
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But that then prevents them. We only fight from protesting out that that that meaning and finding evidence against it.
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So it seems to confirm the behaviour seems to lead to to a confirmation of these these meanings, just distressing meanings.
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So breaking through this vicious cycles, spotting them and breaking through these vicious cycles and then behaving
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differently to test out these meanings is an important way to get over trauma.
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One more example. What gets in the way of recovery?
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I don't have a lot of time to think about it, to talk about the nature of trauma memories.
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That would be a lot to say about that. But but of we we don't have time for going into debt discussions about that.
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But what I would like to highlight is the sense of fear now that trauma memories have soon after the trauma.
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And and if people have chronic PTSD continuing for years and years, moments on the trauma popping into their mind when they don't want one, too.
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And one important lesson we learnt when treating patients with this disorder and also from research is that it is useful to know about
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the triggers of these memories because they can be quite difficult to spot because they often don't have meaningful relationships.
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It's just about sensations that were around at the time.
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And and it's it's really often just one particular sensation.
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So it could be a particular colour, a particular smell, a sound or taste.
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It could be it touches someone, the body or a particular movement that they perceived or that they made themselves.
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And these can automatically trigger these very distressing memories that appear to be in here now.
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And it's also the case that because these memories are so distressing, people would usually then look away or try to avoid this situation.
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And that makes it very difficult for them to spot any differences between the reminder that that's in the current situation,
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that that's not dangerous. And the original trauma KUZE.
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And what we can do then and that's what we would also do in treatment when we treat people with PTSD,
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is really working with the person on what are the the individual triggers.
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So and something we can see, hear, smell, taste or feel in our body when a memory is triggered.
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And let's say was the example of the person who was treated in intensive care.
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So if there were many, many triggers, what one of them, for instance, was the blue colour that the NHS logo has.
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As a kind of particular type of blue and red.
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And for this person, anything that had this colour blue would trigger intrusive memories of the I say use this day.
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So, for instance, somebody walking on the street with a t shirt and the same colour would be a trigger.
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But there is no meaningful connexion that the t shirts are not dangerous.
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And but still,
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spotting this relationship then would would then help us to really look at what are the differences between them then the time of trauma.
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And now a person with a blue t shirt. And and it's a completely different situation.
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They are now recovered of it and they are better.
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They are not ill. It's a person on the street. They are not in hospital.
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So lots of differences. And and then so.
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So really, zooming in, directing our attention to the differences can be really helpful in overcoming this
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automatic reaction of being triggered by these cues in everyday life at a harmless.
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And and I linked with a trauma through this kind of sensory connexion that we want to break.
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And this takes some practise. But but people find it really helpful.
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The last one I wanted to mention is dwelling on the trauma. And I think Jennifer Wilde has already talked about the negative effects of dwelling.
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People may, after trauma, think about the questions like why did it happen to me?
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What if I only hadn't done this or if I had done this?
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And this can be a fear, quite compelling. They feel they should really to think about it more.
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And it can kind of to come back in the kind of circular thinking about the trauma,
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which can really negatively affect people's mood and also can keep them and risk going.
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And we advise to to try to spot that when you're getting into these ruminative circles early,
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because it's easier to interrupt them when you're when you're early on.
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We do spot them and then take them as a sign to get active. So even if it's something simple,
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like getting a cup of tea or doing a little bit of exercise and to really get out of the vicious circle of a dwelling,
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and some people find it really useful to label that, like I have a picture of a carousel because as somebody who thought that was a good image.
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All of that thoughts go in circles or so I get to you, thinking was was another good label, somebody that we saw came up with.
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It's kind of all twisted up and and leads nowhere. It's kind of all of the spaghetti together.
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So so spotting dwelling can be very helpful.
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But I would also I would like to finish now with saying if if somebody gets stuck in this natural recovery,
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that is that is a very and also very understandable consequence of trauma.
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And the good news is that help is available.
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So effective psychological treatments are available in the NHS and psychological treatments, other first-line treatments for this condition.
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If you're interested in and in that, those are the nice guidelines have been published in 2018.
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You can look them up on the Internet if you want.
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I think you might need some help. You can discuss with those your GP who can advise about the best options.
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You can also self refer to your local. Improving access to psychological therapy service in Oxford.
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That's called talking space plus. And there's a service finder on the Internet.
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If you Google, I services NHS and then you can find a website where you put in your postcode and find your the services that are closest to you.
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And there's also various specialist trauma services and psychological treatment services in the NHS, depending on where.
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You live?
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Oh, well, they can offer longer treatments, especially for people who have very severe post-traumatic stress disorder or more complex problems,
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was with several, several problems that need to be addressed. Thank you very much for your attention.
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Great. Thank you ever so much indeed. I'm now delighted to introduce our fellow panel members.
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So I'd like to introduce you to Maine if it's our who's associate professor in
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child and adolescent psychiatry in the Department of Psychiatry here in Oxford,
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and also Morten Cringle back.
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He's associate professor of neuroscience at the Department of Psychiatry and Senior Research Fellow at Queens College, London.
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Thanks for Queenscliff chocs. Sorry. Thanks for joining us.
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I think I've read them in different made their apologies.
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And so we've received a number of questions which we're going to talk through.
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So just to start with, I'd like to come to you,
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Morten and Backspaces picks up on what Frank was saying about the range of different traumatic experience that people may happen,
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the different effects they may have on different people. And so there were some questions about what distinguishes kind of trauma with a capital
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T and other distressing experiences that we might not typically classes trauma.
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And the labour questions really about what research can tell us about this.
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So are there specific effects of the sort of capital T traumas?
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And I guess ultimately, would we need to manage these different sorts of distressing events differently?
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I mean, I think these are great questions. And, of course, we are still looking at them.
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And it is wonderful talk sort of gets to the heart of that.
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Remember when she showed the first slide, she said trauma is the psychological experience of having trauma.
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Obviously, there are degrees of the kind of trauma that you can go through if you see it in a in an accident.
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You may also hit your hit.
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So, of course, that could both be the things that changes your brain, but also the things that changes your brain structurally.
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So obviously that would have a larger impact. And May could well be what some people will classes trauma with a capital T.
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But the other thing that Oncor so pointed out in our talk, which I think is a very important one, is the natural course of the disease,
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namely that lots of lots of traumas will eventually go away or at least become better with time.
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And so what can neuroscience tell about it? Well, again, unclear.
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It provided a wonderful sort of answer to that, namely that one of the things that goes away is the enjoyment of things.
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And one of the best things one can do is to actually enjoy things in psychological lingo, we call it.
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And he donia and a volition the the lack of pleasure and the leg up wanting to do anything.
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And of course, what is happening in the brain is that those circuits are being changed.
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And the question, of course, then is, are they changed differently because you may have hit your head at the same time.
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There may be structural consequences of that.
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And the answer is absolutely certain things where you experience trauma potentially on a daily basis, like the military experience.
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It's really a difficult one.
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And of course, I think the key issue here, depending on what it is that we experience, is how do we avoid going from acute to chronic.
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And this is exactly where the kinds of of treatments that the uncle has outlined is exactly what is needed.
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Then, of course, it's very different if you trying to treat somebody who is experiencing a chronic
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trauma every day of the week compared to somebody who's only had a one off.
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So those are the kind of research questions that we are actively pursuing. Thanks very much.
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What's it mean? I don't know if you want to add anything in relating this question about different thoughts.
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The former and distressing events? Well, absolutely.
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So I think what I talked about, about the subjective experience being crucial is that, you know,
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there are so many different events that could potentially lead one to subjectively experience that it's traumatic.
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And I do think that it's an incredibly exciting time for research as well, because I think research is something that has always played a key role.
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But it's really started to help unpack in the natural course of what people experience.
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And also the different types of interventions that might be able to help.
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And this is that's really grabbing. They're really incredible innovations and we're learning a lot.
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They're not set as well as kind of across different institutions. And so I think it's a key time for research to have different vulnerabilities.
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There's also kind of neurodiversity and had different types of kind of brains and personality types might react to different events.
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And then, you know, what I'm interested in is then what does that mean on the ground?
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Interventions like what does that mean for how services can better adapt so that we become easier for a person who, as I can really clearly described,
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is in avoidance is such a key part of this study that no matter how much we understand about what's going on,
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if a person is just going to avoid coming through the door to get an intervention, what can we do to help that side?
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I think there's so much so many different ways that present in our society, so much we can learn about how we can tailor interventions to really help.
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Thank you. Martin. He told there about neuroscience and the contribution of neuroscience to our understanding of trauma.
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I wondered if there anything else you wanted to add on that,
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because we did certainly have some specific questions about the contribution of neuroscience,
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sort of as distinct from psychology and how it is contributing to our understanding.
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One of my former students now postdoctoral Marina Bulkier Ballester Shakira was also a student of Ankit.
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So we supervised a project which she'd taken some of anxious interventions,
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and uncle had scanned the participants patients before and after the intervention.
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So now we were able to track over time what happened to the brains as they were initially just looking at what
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happened when they had a traumatised images and then happened after they had successfully been been changed.
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And very much like what Uncap demonstrated with that wonderful example with the black cat,
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which of course, one of the key issues in trauma is that you keep basically doing what?
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And of course, biggity thinking this this idea that you are stuck in a rut.
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And the interesting thing was that once you had carried out this very carefully.
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And what you found in the brain was that suddenly the patients were able to disconnect
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from these traumatising pictures instead of just taking over like the black. They went away.
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And of course, we now know exactly where that is happening in the brain.
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And we not only do we know where it's happening, but we also know the networks of how different things are communicating.
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And then I think it's an exciting piece of work that should be replicated in those communities.
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It's important that this actually has real effect on the ground.
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But again, taking into account the more diversity the media mentioned, I think it's crucially important and key, a really fascinating area.
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And I mean, there are a lot of questions really about the variation of experiences, the variation.
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The trick is both of the variation of people's responses and say there were particular questions about
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psychosomatic symptoms and whether we might see the impacts of trauma three psychosomatic symptoms,
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for example, pain. And if so, how best to cope with that?
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I mean it. Can I come to a festival? Yes. So, you know, as we become aware today,
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there's all these emotional and cognitive reactions within these expenses can also cause physical symptoms such as headaches,
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digestive problems, nausea or diarrhoea or fatigue or feeling jumpy.
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So there's a whole range of ways that the body can also kind of respond.
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And I think the first thing that I would say is that, you know,
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if you're getting headaches because of this, that these are really painful, truly experience symptoms.
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And so pleasant is that this is not to dismiss this idea that this is not a real headache because it's causes to get some organic psycho pathology.
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And so the first thing is that you need to be aware that trauma can affect everybody differently.
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And for some people, that might have manifestations in these physical symptoms.
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But then what to do about it? I think to know that there's no magic bullet that actually understanding that this is actually quite common, isn't it,
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in a helpful what we call psycho education is such a basic part of starting to address it that we often say this is really you think,
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well, it's a software problem rather than a hardware problem.
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And so, you know, we can actually through a range of different methods and in a way, a very multidisciplinary approach.
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We would talk about it in services, really help a person overcome it.
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And so a lot of our uncle already talked about, said not to kind of forget the really important,
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just basic principles of the importance of all those self things,
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the importance of interpersonal relationships and the roles of friends of fabric,
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maintaining your social networks, but also just believing that these kind of ways just help adapt, adapt better.
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It's not saying that that headache isn't that is not saying that it's not painful.
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It's just saying the way we can help the body cope better, the way we can shift that software in a problem a little bit is by ensuring that you
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maintain that breadth of other activities that could maybe a system that overall recovery.
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Thanks very much. We have several questions about issues relating to stigma.
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And I mean,
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that's something that obviously comes up across a lot of sessions that people may feel stigma themselves because of that the experiences that the
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traumatic events they've had and or because of the expenses they've had
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subsequently or may feel that they've experienced stigma from others around them.
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Say there were some questions really about what research can tell us about the
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impact of stigma associated with trauma and what people can do to be able to,
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say, capable or overcome that same anchor. Can I come to you first for your thoughts on this?
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So I think we can look at it at two levels, as you said.
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One is the perceived stigma that the person themselves, as they may feel that what if they talk about the trauma to others,
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that maybe they might feel quite ashamed about it and might then not disclose it to other people and they might think people would look down on them?
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That's maybe a common and understandable. And and what we would advise that is that a.
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It is possible that that is one of a vicious cycle that I talked about that that we just
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assume that people would look down on us or would would not think about it so and so,
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too, to really cheque it out and and and try to talk to some trusted friend and and do and
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often you people will find that people are much more understanding than they thought.
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But I don't want to deny that there is still some society to a stigma.
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I think it's getting better about mental health in general and also particularly about trauma.
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Many people start not speaking out about 12 months they experienced.
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And I think this will cause a shift in the perception of trauma.
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And also, I think the numbers that we've seen that it will happen to most people in their lifetime.
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So it's not and only happened to a few a few people.
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So it is. It is. But that's. That needs more work.
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And also, the reactions of other people are not always helpful.
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I mean, most most people will be happy.
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But we can't deny that some of the people, at least the ones that we've seen and treatment, have reported with negative actions from other people.
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And I think education about the effect of trauma has to be also part of a packet.
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Thank you. Thanks very much.
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We've got one last question and not to come to each of you feel for any final thoughts and reflections stimulated by this question.
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So I'll come to Mina Moulton and then anchor. And this was really relating to the question about recovering it.
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Obviously, Yankee presented that said graph, which very clearly showed the sort of natural pattern of recovery.
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But I but one question that we received was whether it's ever possible to really
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reach a stage where your unaffected by severe trauma that you've experienced,
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including possibly trauma that you've experienced in childhood,
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and whether you can ever get to a point where you're unaffected by that and say it mean it.
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Can I come to a festival for your thoughts on that? Yeah, those really important question.
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I think it comes at the heart of know many people have experienced children that they might
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be more worried about hearing that it's always going to affect them negatively rather than,
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you know, just looking at the reality of their life and how it's affected them.
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I would say that, you know, all experience affects you.
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So I would be really nervous to say you're unaffected. But the assumption that that effect is negative, we just have to question.
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So I do think that we don't want to minimise people's pain and suffering of the impact of losses that might have caused trauma.
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And many people are very negatively affected. But we also have to respect the fact that some people, as a result of terrible events,
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do shift their world view in a way that they later perceive in a more positive light.
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So so I think everyone is likely to be affected. I'm affected by almost everything that happens.
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Good, bad. Sue somewhat Monday. So not to worry about being affected them.
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And I'm also not a psychiatrist like we all traditions here.
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So I do actually think that in the most severe cases are there are treatments that exist that are incredibly effective.
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And so even you know, that that actually is is it?
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These are, you know, interventions that can help.
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But it's important that people who are the most negatively affected.
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Often, you know, are able to access these treatments because I do think that can help.
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Thanks so much, man there, Martin. Yeah, I think neuroscience clearly shows that your brain will be changed by everything.
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Some others. But I think the evidence is also that you can shift constantly thinking about that cat on your shoulder to actually use that something.
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And I think it's also important, like Mina said, to remember that true flourishing is often very closely associated with suffering.
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It's often by going through terrible things that we come to new ways of actually appreciating.
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And flourishing in this life. So, yes, I think they are very effective treatments.
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We need to know more. Obviously more research is needed. But I think there is a possibility to change.
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Thank you. And finally to you, Frank. Yeah, I agree. I agree with being on boards.
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Said you can't really race. Well, always it will always stay a memory of a bad event.
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And I think what I can add is that it might also be helpful to be prepared that
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that there might be particular reminders like the anniversaries and so on,
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that will come with a temporary phase. Well, one thinks more about it and feel and remember the bad events,
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but then also take us as a sub taking that as a sign we engaged with life and and and what what life brings now and and also some potential growth.
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Like Morton said, people report that they feel they are more they've seen positive changes in themselves,
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like being more empathetic of other people, enjoying the good times more.
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So that can also be an outcome and that's important.
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Obviously, we also have to acknowledge that some people lost in the trauma may loss, have lost people they loved and and that will always be lost.
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That has changed our life forever. We have to accept reality.
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But that doesn't mean that we have to be stuck in the intrusive memories and the symptoms of PTSD much.
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Sure. That brings us to claeys today. So I'd just like to say huge.
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Thank you to all our speakers and panellists for joining us today for a really
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interesting and I hope very useful session for everyone who has joined us.
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Also here, thanks to everybody who joined us and also to Caia and Hally,
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who've done lots of work behind the scenes to make this whole run really smoothly.
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And, of course, thanks to the pattern of experimental psychology for hosting this series.
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As I mentioned, do you have a look at the experimental psychology department Web site?
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To our YouTube channel, four past talks and this tool will also be available there.
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And just the last reminder that on the 20th of May at 2:00 p.m., we'll be running the next session on overcoming mistrust and paranoia.
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So please stay join us for that. I'm sure it'll be a really interesting session. Thank you so much.
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Please do take a little break now before you move on to what you need to be doing
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next and give yourself a bit of time for a scratch or a walk or a cup of tea,
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whatever would be good for you. And we look forward to seeing you again. Thanks ever so much.
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Goodbye.
