A carer’s guide to coping with trauma
Content warning - Trauma is a big word and not one to be taken lightly. Just talking or reading about trauma can be triggering for some of us. Before we dive in, we may wish to check in with ourselves to see if we are in an emotional place to even think about the topic.
Due to the nature of our roles, there is unlikely to be a carer who doesn't have some degree of trauma. Trauma massively impacts our ability to cope with day-to-day life, and we might not even know it’s there. Because taking care of someone we love can be so emotionally and physically consuming, even if we are aware there is an issue, it can feel impossible to find the time or energy to work on it.
Keeping busy with our caring role, or even finding new caring roles may also become a coping mechanism. Something else to focus on as a distraction from how we feel inside.
“We can run from or ignore our feelings by keeping busy - but eventually they hit you like a ton of bricks.”
Unpaid carer from the Mobilise Community
It might be beneficial to take some time to slow down and consider if it may be something we are carrying with us. And if we could, and should, carve out some time to put some of the weight down.
Some of us may have hidden traumas, be experiencing traumatising experiences regularly, or not have a clue what trauma actually means. Wherever we are in our understanding of trauma, hopefully we will find something useful in this guide. We may wish to read the whole thing at once, chip away a section at a time, or skip the definitions and get straight to the coping strategies.
The different types of trauma
How do I know if I have unprocessed trauma?
Why are carers more likely to experience trauma?
What are the impacts of caring with trauma?
OK, I have trauma. What can I do?
Spotlight from an expert - trauma and parent carers
What is trauma?
What comes to mind when you think of the word trauma?
The chances are, it will bring up something for all of us. Maybe we’ve heard terms thrown around, such as ‘childhood trauma’ or ‘generational trauma’. Or maybe we might get a specific memory, or an emotional response. Trauma is often hiding in plain sight. But it is something very few of us have a deep understanding of.
As Dr Gabor Maté said in his work on trauma:
“Trauma is an invisible force that shapes our lives. It shapes the way we live, the way we love and the way we make sense of the world. It is the root of our deepest wounds.”
It is caused by a deeply distressing or disturbing experience, often known as something traumatising, and the trauma itself is the wound, or scar, left by that experience. The lasting impact on how our brains are wired.
“It's not what's wrong with you, it's what happened to you” - Trauma Research UK
If not dealt with, a trauma response can be triggered by anything that reminds us of that experience, such as a sight, smell, location, or emotion. When a trauma response is triggered we can be left feeling profoundly unsafe. Like our life, and very existence is in danger, even if logically we know it isn’t.
“I burst into tears, the first time I went back to the hospital. It caught me totally off guard”
Unpaid carer from the Mobilise Community
The different types of trauma
As well as there being multiple causes of trauma, there is also more than one type:
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Acute trauma - a single incident such as an accident, experiencing violence, or being in a natural disaster
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Chronic trauma - a repeated and prolonged experience to a distressing situation, such as domestic violence or abuse. Or ongoing distress from caring for a friend or family member for a long period of time
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Complex trauma - exposure to varied and multiple traumatic events which build layers of trauma and triggering factors
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Secondary trauma - a process, rather than an event like typical trauma. It comes from being in close proximity to someone suffering and grows over time
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Post traumatic stress disorder (PTSD) - an anxiety disorder caused by experiencing or witnessing trauma, which can result in intense flashbacks and other symptoms.
We could have one, or a combination of any of these types of trauma. And the same type of trauma can also look completely different person to person.
How do I know if I have unprocessed trauma?
So, if trauma looks different in everyone, how do we know if we have it? The specifics of trauma can vastly vary for each of us. It can also come through in a similar way to other conditions such as anxiety, burnout, or depression. Ultimately, we need a professional to diagnose us. But there are some common signs that show we might be living with unprocessed trauma.
“The impact of trauma can be subtle, insidious, or outright destructive. How an event affects an individual depends on many factors, including characteristics of the individual, the type and characteristics of the event(s), and developmental processes.” Understanding the Impact of Trauma NIH
Before we jump in, we should be mindful not to over-focus on trauma. We may have experienced traumatic things in our lives that have not left us traumatised - a traumatic event does not always equal a trauma wound. It is also worth noting that while there can be a lot of crossover between trauma and other physiological wounds such as grief, not all negative emotions or responses are going to be trauma.
The mental signs of trauma:
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Lowered concentration
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Less motivation to do the things we used to enjoy
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Withdrawal from friends and family
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An inability to make decisions
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Flash backs
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Hypervigilance - jumpy, wired, or feeling ‘always on’
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Panic attacks - racing pulse, hard to breathe, weight on chest, dizzy, sweaty
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Unable to think clearly, a constant brain fog
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Being unable, or unwilling, to think about the future
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Avoidance - putting off things linked to our trauma, such as carer admin
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Nightmares
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Impaired memory, difficulty in remembering tasks
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An excessive focus on work or making money
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Over or under eating
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Feeling the need to self soothe/ addictive tendencies such as over spending, drinking too much alcohol, taking drugs, or something else
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A focus on routine as it feels safe which can then become obsessive
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A regular feeling of paranoia, as if something bad might happen
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A compulsive need to know every detail of something to feel more in control
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In severe cases, unprocessed trauma can result in suicidal ideation
The emotional signs of trauma:
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Anxiety, such as feeling nervous or racing thoughts
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Guilt
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Numbness or depression
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Intense fear
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Anger
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Feeling hopeless
The physical signs of trauma:
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Chronic fatigue
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Tension in body
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Frequent headaches
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An impaired immune system, often getting sick
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Feelings of panic, such as a tight chest or racing heart
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Spikes of adrenaline which cause bursts of energy and productivity, followed by extreme exhaustion
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Chronic pain
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Shakes or trembling
We aren’t likely to experience every one of these, but rather a combination of several. And while many of us might feel these in our day to day lives, the importance is the severity, and that it lasts for a prolonged period of time - such as months or years.
Why are carers more likely to experience trauma?
We might wish to pause at this point and reflect on how we are feeling. While it is really helpful to understand what we are dealing with, ‘Oh, this is me’, moments can bring up a lot of complex emotions. We might be feeling relieved to have a possible understanding of what we’ve been experiencing, but it can also feel like the first step down an intimidating path.
There are a number of reasons why we, as carers, might be more likely to be living with trauma. This is in part due to our situation, but also to do with the personal qualities we may have that allowed us to take on caring for another person in the first place.
“My Grandmother went into a care home with dementia. She didn’t understand why she was there and thought she had been kidnapped. She kept trying to escape each time someone opened the door. It was painful to see her that frightened. I felt like I could feel her fear. But I knew I had to stay calm and composed for her. It was exhausting.”
We have empathy
Empathy is a quality which many unpaid carers have. It allows us to want to support another person, and to feel concern about their needs. Someone with empathy tends to feel things deeply, and can be susceptible to taking on other people’s suffering. Both of which can make us more likely to experience a trauma.
There is no time to process emotions
When we look after someone it can be full on. We often don’t get the time or space to process our emotions. There is little chance to pause and catch our breath.
For many of us, our caring role may well be the traumatising event we are experiencing. And often it’s not something that happens, and is then over quickly. Some of us can be providing care for decades. It can feel nearly impossible to work on resolving something caused by a situation that is still going on around us, possibly evolving or getting worse over time.
“My life has been consumed with caregiving for the last three years. It is draining me slowly but surely.” Unpaid carer from the Mobilise Community
We see a lot of traumatic situations
Regardless of our situation, caring for someone can often come with more than its fair share of upsetting experiences and crisis situations. This might be having to make the decision to move our parent or partner to a care home.
Seeing them looking weak and broken in hospital. Constantly waiting for things to get worse for them. Watching your child's mental health suffer again and again, as they try to fit into a 'normal' system. The person we love not knowing who we are. Seeing them experience intense illness, or lose themselves to it. Their grief as they come to terms with the situation. Their death.
While trauma and a crisis situation can overlap, they are still distinct. We can find tips specifically for healing and recovery after a caring crisis.
Often during these difficult times our brains will shut down our emotional side to protect us, and allow us to deal with the situation at hand. But that doesn’t mean it’s not impacting us. That it hasn’t hurt us. The trauma wound can lie dormant within us, and then manifest or be triggered down the line in a number of ways.
“I cared for my Nan in her final months. I helped her get washed and dressed. Cleaned up after her when she had an accident. Held her hand and told her it was all ok. I watched this amazing strong woman who helped raise me slowly deteriorate. At the time, I knew it was hard, but I just didn’t have the time to deal with that. I had to be strong for her. Now, years later, I’m constantly in fear the same thing will happen to another loved one. I'm always feeling anxious and have lost a lot of confidence. I think I might have PTSD and it’s only just catching up with me.”
A particularly difficult situation can be if the person we care for is our child. The person we feel we should be able to protect from anything. Those of us going through this can find more on the topic below, and support in ‘Recognising trauma, healing and growth in parent carers’.
We’re living in a type of limbo
Taking care of someone can often have a lot of unknowns. What will happen when we are no longer around? How will their condition decline? How long do they have? We might even be wondering when we will get our lives back (which might also bring some uncomfortable feelings).
However we feel, living in limbo can be deeply unsettling and make it difficult to work through, or process, our emotions.
“We've been told "this is it" several times, then Mum recovers enough and we keep going. With her seriously ill, but not really knowing how long until the next "this is it" moment. Meanwhile trying to keep normal life going. If we knew we only had a week left, we’d take time off work and spend it together - but when time drifts, you're left in a weird hybrid space - feeling like every decision is wrong…”
We are close to a lot of intense emotions
Along with our own emotions and experiences, the person we care for may well be going through their own deeply traumatic time. This can leave us close to their intense emotions, which is not only deeply upsetting, but can sometimes cause secondary trauma.
As Dr. Rachel Naomi Remen said in her research, ‘The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to walk through water without getting wet.’
“My mum has anxiety about going into hospital due to operations that have gone badly or post surgery infections. When she does need to go into hospital I now feel anxious about it too.”
“It does scare me. He gets momentarily angry sometimes. He was so mild mannered before.”
It is not uncommon for someone going through an intense health concern or diagnosis to become angry, violent, lost, or sad. This can be even more likely if they have a degenerative condition such as Alzheimer's disease or Dementia.
As hard as it can be, it is important we take care of ourselves. We should speak to social services or our local council immediately and consider bringing in safeguarding measures if we ever feel in danger. If danger is immediate do reach out for urgent support.
We are living closely with grief
When we take care of someone we will often experience feelings of grief. This could be around a diagnosis for someone we love, the loss of the person we knew, or loss of the life we thought we might have. While trauma and grief symptoms and treatments can overlap, they are distinct experiences.
Our carer’s guide to experiencing grief explores the feelings and physical symptoms that can be triggered by grief in more detail. Along with how to start processing them.
"I was on autopilot doing and saying all the right things. I was keeping busy - too scared to stop in case it all caught up with me. My body felt so heavy, my shoulders and jaw were tight and I found myself saying "we're fine" a lot, through a wide, fixed smile. I now know this was my body storing unprocessed grief. It was utterly exhausting."
We have lost touch with the people or things that bring us joy
When we are always on the go and rushed for time, often the first things to come off our schedule are the ones for us. The things that bring us joy, or remind us who we are. It can feel hard to make time, (or have the motivation or energy) for seeing friends, doing a hobby, working at a job we love, or just curling up with a good book. But these are the things that can protect us from intense emotions and can help a little towards healing a trauma wound.
Caring can also be very isolating. Over a quarter of carers (29%) reported feeling lonely often or always - Carers UK, State of Caring 2022. But if we can find ways to make connection happen, it can be that time with family or friends that anchors us and provides a form of respite and recovery.
What are the impacts of caring with trauma?
We might be thinking, ok I know I have trauma. But so what? What impact does it actually have on me and my ability to care for someone?
As well as the mental, emotional, and physical symptoms listed of trauma, there are a number of ways living with unprocessed trauma can impact us in our caring role.
We can become less able to complete caring tasks
We might actually be putting ourselves or the person we care for in danger by not dealing with the complex emotions around trauma.
This might look like a number of different things. We might be so removed from our emotions we don’t realise if either them, or us, are in a dangerous situation. Or the symptoms such as lack of sleep, forgetfulness, or feeling like we are constantly in a state of brain fog can cause us to forget important aspects of our caring role, such as giving them their medication.
Avoidance can also become an issue, such as putting off opening an important letter or email about their diagnosis because of the feelings it may trigger.
We might become emotionally shut off to the person we care for
When we are dealing with complex emotions such as those around trauma, sometimes our minds can shut off to protect us. This is known as dissociation.
We might also be more likely to experience compassion fatigue. Similar to carer burnout, compassion fatigue can be common in carers, and in simple terms is the feeling that we have no more empathy left.
It becomes harder for us to control our own emotions
On the flip side of our emotions becoming shut off, trauma can also make them bubble to the surface unpredictably. Even if we are usually the calmest, most emotionally regulated person, trying to push down something like trauma can make us more likely to have extreme emotional reactions to certain situations.
"I squashed down all my feelings with each bad thing that happened, in the end just being asked to make a cup of tea would result in me bursting into tears or even shouting at him."
We may become unable to continue providing care
The physical and emotional side effects of keeping trauma in our bodies can be detrimental. This can ultimately mean we become genuinely unable to carry on providing care. Or, that we end up requiring care ourselves.
OK, I have trauma. What can I do?
Working through unprocessed trauma is no easy feat. And ultimately, not something we want to face without an expert. We often don’t have the time to fall apart. Or consider dealing with our emotions a luxury we can’t afford.
This is ok for the short term, and can actually help us get through a crisis, but eventually our minds or bodies will make us confront it through illness, anxiety, depression and so on. It is amazing what our minds can do when it is trying to get us to take note of a problem.
We also shouldn’t be tempted to tackle anything that could bring up intense memories or emotions alone. If we choose, or are encouraged to, re-live and share our experiences repeatedly it can actually just leave us stuck in that place of trauma.
It can also reinforce thought patterns and behaviours we might be trying to work past. A trauma informed therapist is trained to revisit the trauma with us in a skillful and supported way, before moving us forwards to conversations and tools that work on our automatic responses, and ultimately our healing.
It might be a long journey to fully recover from our trauma, but there are things we can do on our own, or with support from our friends and family. And every small step will make a difference. For those of us who do feel that we are in a place to start soothing or unpicking these complex emotions and triggers, here are some ways to get started.
Try to get a diagnosis
While this is not always an easy process, having a diagnosis such as PTSD can not only help us in understanding what we are experiencing, but also open up more access to support.
The first step here is to speak to our local GP, we might want to request one we have met before and know we are conformable with, and explain what’s been going on.
Depending on our symptoms and their severity, our GP may refer us to a mental health specialist for further assessment. This could be a psychologist, psychiatrist, or a specialist trauma service.
Speak to a trauma specialist
With or without an official diagnosis, it can be helpful to speak to a trauma therapist. Our GP can provide us with some contacts, or the NHS talking therapist service will show what options are available in our area. Our guide to therapy for carers might give us a good starting point.
If we do not feel comfortable with therapy but want to try something, there are a number of alternatives. We could look at meditation for trauma, somatic exercises, deep tissue massage, acupuncture, breathwork, seeing a chiropractor, tapping, eye movement desensitisation and reprocessing (EMDR), or Reiki. These are not just for self care. A lot of emotion and stress is stored in the body, and all of these can help us start to shift that.
‘The traumatic events in childhood at the root of a young person’s anxiety, depression, addiction, or other behaviours can’t be resolved through the mind alone. The body also needs ways to release these memories. Otherwise, the nervous system remains stuck in “fight or flight” response mode.’ Newport Institute
Be aware of our triggers
Once we’ve started to come to terms with the fact we are carrying trauma around with us, it can be helpful to recognise what our triggers for that trauma are. Effectively, the things that poke that trauma wound (or wounds).
This could be reading emails or doing admin that reminds us of our caring role. Being near the intense emotions of the person we care for. Going into hospitals. Anniversaries of a diagnosis or death. Having strangers come into our homes to provide paid care. Or even a change in routine.
While we might not be able to do anything to prevent ourselves from coming into contact with these triggering experiences, even recognising them can take away a little of their power. We can also then start to be more mindful of their impact on us. If we know we will be physically and emotionally exhausted after a hospital visit, maybe we can plan a phone call with our friend for when we get home. Or avoid carer paperwork on a day we are already feeling drained or emotional. Focusing on the things we can change, rather than what we can’t, gives us back a sense of power and control.
Talk to the person we care for
Talking to the one we look after about how we feel might not always be possible. But if it is, it might bring intense relief to both us and them.
We might find talking to them about our fears helps them to realise how much we care, deepening our connection. Or telling them things we are finding triggering might allow us to work on a solution together, or just to both have more awareness.
"She admitted that she found how we’d all been hiding our emotions really difficult - that whilst we tried to pretend everything was fine, it made her fear that no one cared she was dying."
Connect with other people
Connection is one of the best ways to help with healing the symptoms of trauma. Caring can be very isolating, and sometimes we have to work to find connection. Whilst trauma support groups can be helpful, in some cases other more day to day connections with people are just as important. This might look like connecting with new friends over hobbies, exercise, joining the Mobilise Hub, volunteering, work, music and other shared passions or joyful distractions. Or spending quality time with our loved ones or good friends.
We might feel resistant to the idea that just spending time with friends will make any difference, but it is actually backed up by research. It’s called polyvagal theory, which provides a framework for understanding the connection between our autonomic nervous system, social behaviours, and emotional regulation. Directly connecting how we respond to stress, trauma, and social interactions.
‘Stuck in the sympathetic state, those with unhealed trauma may carry a story of fear, distrust, dysregulation, and anxiety, while those stuck in the dorsal vagal state may carry one of loneliness, disconnection, and numbness. When survivors heal and reside in the ventral vagal state, they are able to let go of these stories and become more connected and attuned with others.’
Reconnect with the things that bring us joy
Spending time doing positive things, no matter how small, can have a real impact on us and support post traumatic healing and growth. As well as connecting with other people and our surroundings, support from our peers (such as other carers on the Mobilise Hub), time with a good book, or doing a hobby we enjoy, can all help to soften and heal us a little. We explore this further in five ways to mental wellbeing.
If we are looking for ideas of things to help us feel more connected or joyful, our community of carers shared 30 simple things that can help us feel great.
Find a way to process our thoughts and feelings
We might need to give ourselves permission to prioritise finding time to start to work through some of our emotions. There are a number of ways to start to process the inner workings of our minds. This might look like talking to someone, saying them outloud, writing letters we will never post, or a great option is journaling.
However we do want to be mindful here of not writing things down in a way that might end up in just causing us to relive a difficult memory or experience. Or bringing up complex emotions without a way to sooth them. This guide from Choosing Therapy can help to steer us through the process, with helpful prompts and guidance on how to use journaling to help us process our trauma.
Work on our resilience
Resilience can be a term that puts a lot of us off, but ultimately it is working on our ability to cope with stress. While this won’t help us with healing, it can help us to continue functioning in our day to day lives in a way that won’t make our trauma symptoms worse.
There are a number of ways to work on improvising our resilience:
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Through movement
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Practising meditation
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Finding moments of micro respite
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Improving our sleep
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Prioritising our own physical and mental health
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Breathe
While being told to ‘just breathe’ can feel like the most frustrating advice in the world, there are actually a lot of benefits to be had from focusing on our breath.
Making sure our exhale is longer than our inhale will stimulate the vagus nerve, which connects our mind and body. It will send signals for relaxation, and tells us subconsciously we are safe. As well as soothing our emotions, this can help reduce some of the symptoms such as anxiety and hypervigilance.
Taking a moment to breathe can also help us to be more present, bringing us back to the here and now, and give us a second of calm to think before reacting.
Have a plan for what’s next
If we know that our caring role might come to an end, we might want to start preparing for this. While there are a lot of other things to think about if end of life care, or a transition to someone else providing care is on the horizon, it is also worth acknowledging that this is the time when everything we’ve been pushing down or suppressing might rush to the surface.
“Everyone is so happy I can get 'back' to living life. This new Everest - building a new life and new identity - I haven't got anything left for this. My grit, determination, confidence, fight...its been all used up.”
We might want to write ourselves out a plan beforehand, if we are able, to remind ourselves of a toolkit on how we will cope. This might include any of the ideas mentioned above, such as planning in time with friends, getting back into activities that bring us joy and remind us of who we were before becoming a carer. If we’ve felt like we just didn’t have the time or energy so far, this might also be the perfect opportunity to speak to a professional and begin working through our experiences.
Next steps
If we’ve got to the end of this guide we might be feeling some fairly intense emotions. Trauma is not an easy subject to think about, and even reading about it can bring up a lot. We might be feeling resistance towards the idea of starting to unpack this, or overwhelmed by the idea. Or we might feel hopeful that there is a solution out there, or comforted to know that we are not alone.
However we feel, allow those emotions. Accept them. And then, if we can, give ourselves time to have a little reset before tackling the next thing on our todo list. This might look like doing some deep breathing, a meditation, stepping outside for a moment and feeling the fresh air, doing a quick yoga session or other workout to shift us from our minds to our bodies, or having a cup of tea with a biscuit.
We’ve suggested a lot of things here to help us start our healing journey, but it won’t happen overnight. We might want to pick just one thing to bring into our daily lives from tomorrow. Or perhaps just reading this article was the start we needed for now. And that’s ok! Remember, there are professionals out there and ultimately their help might be what we need, but there are some things in our control. It’s just taking that first step.
If we would like to share our own stories, or how reading this has made us feel, we can start a discussion over on the Mobilise Hub.
Spotlight from an expert - trauma and parent carers
We've been chatting with Assistant Professor (University of Warwick) and creator of the website Affinityhub.uk, Dr Joanna Griffin, about the role of trauma in parent carers. As well as being a counselling psychologist, Jo is a parent carer herself, and runs a parent carer trauma working group which has carried out extensive research in this area. Here's what she had to say…
Parent Carer Trauma working group
A group of professionals and parent carers established a Parent Carer Trauma working
group to discuss trauma in parents of disabled children.
We felt that this was a group of carers that were experiencing trauma more commonly than
is often recognised by professionals and parents themselves. We have been working on a
discussion document to raise awareness of this topic.
Different experiences of trauma
As the trauma experienced by carers may not always fit neatly into current diagnoses, such
as PTSD, it may be missed.
For example, for many parent carers the ‘trauma’ is not past – in fact it may continue to
happen on a daily basis and may be predicted to carry on into the future. Furthermore,
carers may not always have experienced a ‘big T’ traumatic event (such as a road traffic
accident) rather, they may experience cumulative ‘small t’ traumas over a long period of
time. This is not always recognised by professionals as being ‘trauma’.
Rather than PTSD, the experience (for some people) may be better described by other
definitions, such as ‘complex trauma’ or ‘Prolonged duress stress disorder’. Both diagnoses
are not always recognised by health professionals in the UK. Therefore, the chance to
support and offer treatment are missed. For example, diagnostic tools for PTSD often list
having ‘flashbacks’ as part of the criteria, but this is not always the experience for parent
Carers.
Why timely support is necessary
Without appropriate and timely support – as and when it is needed by carers – it may mean
that parent carers are often living in a traumatised state and further appointments and
experiences can build on top of this – retriggering and retraumatising them. This is complex
when the services that are supposed to support us, actually end up making us feel worse.
We wrote an article for the British Association for Counselling and Psychotherapy on this
topic which you can read here.
The Working Group discussion document will be shared in April 2024. Please sign up to the
Affinity Hub newsletter to receive further updates.
You can read more about our work here:
We can read more from Jo Griffin on trauma in parent carers in ‘Recognising trauma, healing and growth in parent carers’.
