Betterhelp complex ptsd

Jul 25, 2023 · Complex PTSD Treatment Behavioral Therapy. Standard behavioral therapies teach coping mechanisms to help individuals recognize and change... Cognitive-Restructuring Therapy (CPT). A therapeutic method called cognitive-restructuring therapy focuses on coping... Exposure And Response Prevention ... Post-traumatic stress disorder ( PTSD) is a condition that occurs in apparently healthy individuals who’ve been exposed to extreme stressors such as car accidents, sexual assault, war, unexpected deaths, etc. In general, people with this disorder experience flashbacks, hypervigilance, panic attacks, and insomnia.Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault. Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts. The Diagnostic and Statistical Manual of ...Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ...Losing memories about certain people, places, information, events, or specific periods. A blurred or distorted sense of reality. A feeling of numbness and disconnection towards one's environment. A distorted sense of place and time. A feeling of detachment from one's emotions.Separate from the question of BetterHelp not being a good modality for trauma survivors, both of the ones you worked with put out some huge red flags as far as just plain unethical treatment. Unfortunately, regardless of modality, level of licensure, and fees, there are a number of therapists out there who (at best) don't understand trauma as ... Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ...Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... I’ve been using Pride Counseling, which is a branch of BetterHelp that specializes in LGBTQIA+ people like me. My counselor is very understanding and helpful; he’s helped me to understand my past and my own mental illness better and has been an amazing source of validation and encouragement when I couldn’t find it anywhere else. Post-traumatic stress disorder, or PTSD, is a mental health disorder that can develop after someone experiences or witnesses a traumatic event. While only a qualified mental health provider can diagnose a condition like this, a tool like an online test might be able to give you insight into the symptoms you may be experiencing and encourage you ...Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... You might be wondering what you can do to cope with Complex Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, including how to find therapists. One of the best ways to manage Complex PTSD is awareness, and you can find that emotional insight by seeing a licensed therapist who specializes in trauma and recovery.While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ...Professional, licensed, and vetted therapists who you can trust. Tap into the world's largest network of licensed, accredited, and experienced therapists who can help you with a range of issues including depression, anxiety, relationships, trauma, grief, and more. With our therapists, you get the same professionalism and quality you would ...Aug 4, 2023 · The core symptoms of PTSD include avoidance, intrusive memories, emotional reactivity or numbness, sleep disturbances, panic attacks, hypervigilance, and dissociation. These symptoms may also lead to chronic low mood states and negative thinking patterns. PTSD symptoms can range from mild to severe and can get in the way of the person's ability ... Complex PTSD treatment may be similar to PTSD treatment for many people. However, many experts believe that the treatment for C-PTSD should be more in-depth or long-lasting. Survivors of these kinds of traumatic events may need more resources to help re-establish a feeling of power and control over their own thoughts and actions.Aug 16, 2023 · The Link Between PTSD And Depression. The key takeaway about the relationship between these two mental illnesses is that having PTSD increases your chances of developing depression. According to research, almost 50% of people diagnosed with PTSD will also experience depression. The odds of someone with PTSD developing depression are three to ... Complex post-traumatic stress disorder manifests similarly to PTSD but is often the result of repeated traumatic events or long-term trauma. If C-PTSD symptoms are interfering with your everyday life, there are many effective treatment options that can help you heal. Aug 2, 2023 · For support for the Deaf and hard of hearing community, please use your preferred relay service, or dial 711 then 1-800-273-8255. Many people living with post-traumatic stress disorder (PTSD) may experience hyperarousal, which can be defined as a state of being constantly aware and alert to potential dangers. While this may serve people well in ... You might be wondering what you can do to cope with Complex Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, including how to find therapists. One of the best ways to manage Complex PTSD is awareness, and you can find that emotional insight by seeing a licensed therapist who specializes in trauma and recovery.Jul 20, 2023 · As you search, there should generally be a link to the author, editor or expert’s contact information and credentials. If there isn’t, but the article still seems legitimate, a quick Google search should yield results that can help to establish the site’s credibility. Finally, and perhaps most importantly, it can be helpful to make sure ... Jul 24, 2023 · Avoidance and numbness to stimuli can be significant symptoms of PTSD and may require professional support. Although one develops these behaviors to keep oneself safe, prolonged avoidance could prevent coping with trauma and eventual healing. Avoiding thoughts of a traumatic event is another defense to keep the psyche from the trauma. Complex post-traumatic stress disorder (CPTSD, C-PTSD or cPTSD) is a mental health condition that can develop if you experience chronic (long-term) trauma. It involves stress responses, such as: Anxiety. Having flashbacks or nightmares. Avoiding situations, places and other things related to the traumatic event.Feeling numb, avoiding things that remind you of the traumatic event, and feeling disassociated. Having increased mental and emotional arousal may cause you to have difficulty sleeping or concentrating. You may feel jumpy, irritated, or angry. Angry outbursts are sometimes common in PTSD.BetterHelp counseling is considered one of the best online therapy sites, partly because it offers affordable therapy as an alternative to in-office therapy. In-person therapy often costs $75 to $200 per session, compared to $60 to $90 per week—charged every four weeks—which is what BetterHelp memberships cost.These are a few of the strategies that a person with Complex Post-Traumatic Stress Disorder can use to cope with their illness. We'll go into detail about the signs of Complex Post-Traumatic Stress Disorder later in the article. "BetterHelp understands how painful trauma can be.During a PTSD episode or PTSD attack, you may have intrusive thoughts, visions, nightmares or a flashback in which you experience vivid memories or relive your trauma. PTSD attacks can cause intense fear, dissociation or feeling disconnected from yourself and the world. They may also prompt physical symptoms like shaking, difficulty breathing ...Talk to a Therapist about Treatment Options. PTSD is a mental health disorder that can develop after an individual experiences or observes a “shocking, scary, or dangerous event”. In the United States, approximately 8 million adults have been affected by and/or diagnosed with PTSD. Decades ago, PTSD was commonly referred to as “shell ...Post-traumatic stress disorder, or PTSD, is a mental health disorder that can develop after someone experiences or witnesses a traumatic event. While only a qualified mental health provider can diagnose a condition like this, a tool like an online test might be able to give you insight into the symptoms you may be experiencing and encourage you ...Separate from the question of BetterHelp not being a good modality for trauma survivors, both of the ones you worked with put out some huge red flags as far as just plain unethical treatment. Unfortunately, regardless of modality, level of licensure, and fees, there are a number of therapists out there who (at best) don't understand trauma as ...Complex PTSD symptoms and post-traumatic stress disorder symptoms can include trouble sleeping and other physical signs like stomach aches. What Types Of Traumatic Events Lead To PTSD? For many people living with PTSD, the stress disorder was caused by a first-hand, direct experience such as a serious injury, violence, or the threat of death.Jun 6, 2022 · Complex PTSD occurs when people live through multiple traumatic experiences, or those traumas begin in childhood. In this case, an especially complicated collection of symptoms may develop, going beyond the historical understanding of PTSD. The diagnosis of complex PTSD distinguishes those symptoms in order to provide better treatment and care ... However, PTSD developed in childhood may increase one's risk of developing other mood and personality disorders in adulthood. Childhood trauma can be particularly damaging and complex, and experiencing even a single trauma in childhood can have a marked effect on the entirety of your development, your outlook on life, and your long-term resilience.While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ... BetterHelp counseling is considered one of the best online therapy sites, partly because it offers affordable therapy as an alternative to in-office therapy. In-person therapy often costs $75 to $200 per session, compared to $60 to $90 per week—charged every four weeks—which is what BetterHelp memberships cost.You might be wondering what you can do to cope with Complex Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, including how to find therapists. One of the best ways to manage Complex PTSD is awareness, and you can find that emotional insight by seeing a licensed therapist who specializes in trauma and recovery.Difficulty sleeping is a common symptom of PTSD that may affect women. Although sleep concerns are a general PTSD symptom, they may be heightened in women due to elevated levels of anxiety or repeated traumas. In addition, women tend to cope with emotions and seek comfort, while men usually focus on solving problems.You might be wondering what you can do to cope with Complex Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, including how to find therapists. One of the best ways to manage Complex PTSD is awareness, and you can find that emotional insight by seeing a licensed therapist who specializes in trauma and recovery.Complex PTSD is a form of post-traumatic stress disorder stemming from repeated traumatic events or complex trauma. The chronic stress of these repeated experiences can have a negative impact on a child’s self-esteem, emotional responses, and overall well-being.May 12, 2020 · Treatments. Coping. Hyperarousal is a specific cluster of symptoms associated with post-traumatic stress disorder (PTSD) . As the name implies, hyperarousal is the abnormally heightened state of anxiety that occurs whenever you think about a traumatic event. Even though the threat may no longer be present, your body will respond as if it were. While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ...Aug 2, 2023 · For support for the Deaf and hard of hearing community, please use your preferred relay service, or dial 711 then 1-800-273-8255. Many people living with post-traumatic stress disorder (PTSD) may experience hyperarousal, which can be defined as a state of being constantly aware and alert to potential dangers. While this may serve people well in ... Post-traumatic stress disorder (PTSD) is a complex mental health condition that can develop after a person experiences or witnesses a traumatic event or a series of traumatic events. Symptoms can be both mental and physical and may significantly interfere with daily functioning, work, relationships, and overall well-being.Feeling numb, avoiding things that remind you of the traumatic event, and feeling disassociated. Having increased mental and emotional arousal may cause you to have difficulty sleeping or concentrating. You may feel jumpy, irritated, or angry. Angry outbursts are sometimes common in PTSD.While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ...Complex PTSD occurs when people live through multiple traumatic experiences, or those traumas begin in childhood. In this case, an especially complicated collection of symptoms may develop, going beyond the historical understanding of PTSD. The diagnosis of complex PTSD distinguishes those symptoms in order to provide better treatment and care ...Once a client achieves a cognitive shift, PTSD nightmares may subside. However, note that CBT is not the only treatment effective for PTSD. A few treatments have been developed explicitly for PTSD and have high rates of effectiveness as well, including EMDR and internal family systems (IFS) therapy.While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ...Post-traumatic stress disorder (PTSD) is a complex mental health condition that can develop after a person experiences or witnesses a traumatic event or a series of traumatic events. Symptoms can be both mental and physical and may significantly interfere with daily functioning, work, relationships, and overall well-being.Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... Complex PTSD symptoms and post-traumatic stress disorder symptoms can include trouble sleeping and other physical signs like stomach aches. What Types Of Traumatic Events Lead To PTSD? For many people living with PTSD, the stress disorder was caused by a first-hand, direct experience such as a serious injury, violence, or the threat of death. Complex PTSD Symptoms How Complex PTSD Is Diagnosed Complex PTSD Treatments Finding Support for Complex PTSD Show more While you may have heard of post-traumatic stress disorder...Fill out a questionnaire to help us assess your needs and get matched to one of 32,000 licensed therapists based on location, preferences, and therapist availability. Message your therapist whenever and wherever through our website or mobile app. Not happy with your therapist? LCSW,RN. Specialties: Stress, Anxiety, Grief, Parenting issues, Self esteem, Depression. Years of Experience: 35. Hi! My name is Barbara Ramsey and I am a licensed therapist ( License number 44SC01482000). Welcome to the on-line counseling room, which will be our private, secure place to communicate.Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... Does therapy work for complex PTSD? How do you manage CPTSD triggers? Which type of psychotherapy is used to treat post-traumatic stress disorder? What are the 17 symptoms of complex PTSD? Is complex PTSD a severe mental illness? What is the best therapy for complex trauma? How long is therapy for C-PTSD? How long does it take to heal from CPTSD?Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault. Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts. The Diagnostic and Statistical Manual of ...Does therapy work for complex PTSD? How do you manage CPTSD triggers? Which type of psychotherapy is used to treat post-traumatic stress disorder? What are the 17 symptoms of complex PTSD? Is complex PTSD a severe mental illness? What is the best therapy for complex trauma? How long is therapy for C-PTSD? How long does it take to heal from CPTSD?While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ...Developmental trauma disorder shares some similarities to PTSD but stands out in that it is a result of chronic exposure to trauma, particularly in youth. It is possible for adults to heal from past trauma and develop healthy coping strategies – online therapy provides a safe setting for retraining the brain.However, PTSD developed in childhood may increase one's risk of developing other mood and personality disorders in adulthood. Childhood trauma can be particularly damaging and complex, and experiencing even a single trauma in childhood can have a marked effect on the entirety of your development, your outlook on life, and your long-term resilience.Complex post-traumatic stress disorder (CPTSD, C-PTSD or cPTSD) is a mental health condition that can develop if you experience chronic (long-term) trauma. It involves stress responses, such as: Anxiety. Having flashbacks or nightmares. Avoiding situations, places and other things related to the traumatic event.Difficulty sleeping is a common symptom of PTSD that may affect women. Although sleep concerns are a general PTSD symptom, they may be heightened in women due to elevated levels of anxiety or repeated traumas. In addition, women tend to cope with emotions and seek comfort, while men usually focus on solving problems.Aug 16, 2023 · Complex PTSD is a form of post-traumatic stress disorder stemming from repeated traumatic events or complex trauma. The chronic stress of these repeated experiences can have a negative impact on a child’s self-esteem, emotional responses, and overall well-being. The Link Between PTSD And Depression. The key takeaway about the relationship between these two mental illnesses is that having PTSD increases your chances of developing depression. According to research, almost 50% of people diagnosed with PTSD will also experience depression. The odds of someone with PTSD developing depression are three to ...Complex post-traumatic stress disorder (C-PTSD) is a trauma-related mental illness in the ICD-10 diagnostic manual, an international diagnostic coding book by the World Health Organization (WHO). It is considered a severe form of PTSD caused by repeated, long-term trauma, often in childhood.Aug 31, 2023 · PTSD can result from a high-stress job or can be a result of a single traumatizing situation, such as a car accident. Its reasons can be complex, and its symptoms can vary with each person. However, one of the common themes in PTSD is related to memory loss. Below, we’ll explore the relationship between PTSD and memory loss in greater detail. While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ... I’ve been using Pride Counseling, which is a branch of BetterHelp that specializes in LGBTQIA+ people like me. My counselor is very understanding and helpful; he’s helped me to understand my past and my own mental illness better and has been an amazing source of validation and encouragement when I couldn’t find it anywhere else.Aug 24, 2023 · Post-traumatic stress disorder (PTSD) is a complex condition arising from the experience of a traumatic event. After going through these events, people may feel isolated, lonely, or misunderstood. A healthy support group provides a safe place for people living with PTSD to receive support from others and find people who understand their ... Complex PTSD is generally considered more debilitating than PTSD and requires careful treatment considerations. It often also occurs as a comorbidity with other disorders, which may exist simultaneously with other psychological conditions such as substance use disorder, anxiety, depression, and eating disorders.Jun 6, 2022 · Complex PTSD occurs when people live through multiple traumatic experiences, or those traumas begin in childhood. In this case, an especially complicated collection of symptoms may develop, going beyond the historical understanding of PTSD. The diagnosis of complex PTSD distinguishes those symptoms in order to provide better treatment and care ... Complex PTSD is a form of post-traumatic stress disorder stemming from repeated traumatic events or complex trauma. The chronic stress of these repeated experiences can have a negative impact on a child’s self-esteem, emotional responses, and overall well-being.While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ... While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ... Aug 16, 2023 · According to the US Department of Veterans Affairs, the most effective first-line treatments for PTSD are cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR ). Other therapies for PTSD may include prolonged exposure therapy and cognitive processing therapy (CPT). In some instances, symptoms may be so ... Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... Complex PTSD or C-PTSD is usually considered a type of post-traumatic stress disorder that can arise due to multiple traumas or long-term traumatic events. Some of the types of symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and more. While PTSD may develop after a single incident, C-PTSD is a group of complex symptoms that result from long-term traumatic events. Examples of ongoing trauma include long-term physical or sexual abuse, ongoing domestic violence, being a prisoner of war, or being a victim of commercial sexual abuse, including trafficking or prostitution. Paranoia can be particularly common in PTSD caused by an individual, such as in cases of assault. One study examined the link between paranoia and PTSD in people who had experienced assault. The researchers found that 80% of people experienced heightened fear of others—a primary characteristic of paranoia.Aug 16, 2023 · According to the US Department of Veterans Affairs, the most effective first-line treatments for PTSD are cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR ). Other therapies for PTSD may include prolonged exposure therapy and cognitive processing therapy (CPT). In some instances, symptoms may be so ... Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... Complex PTSD (C-PTSD) is considered a type of post-traumatic stress disorder (PTSD) that can arise due to multiple traumatic events across a lifetime, often repeated and long-term. Some of the symptoms experienced with C-PTSD can include avoidance of triggering stimuli, nightmares, flashbacks, feelings of guilt, stress, sleeping problems, and ... While PTSD may develop after a single incident, such as getting into a car accident, experiencing a robbery, living through a natural disaster, and other such relatively short-term events,complex PTSD is a relatively new diagnosis that involves a group of intricate, complex trauma symptoms that result from long-term traumatic events or multiple ... May 12, 2020 · Treatments. Coping. Hyperarousal is a specific cluster of symptoms associated with post-traumatic stress disorder (PTSD) . As the name implies, hyperarousal is the abnormally heightened state of anxiety that occurs whenever you think about a traumatic event. Even though the threat may no longer be present, your body will respond as if it were. Aug 16, 2023 · The Link Between PTSD And Depression. The key takeaway about the relationship between these two mental illnesses is that having PTSD increases your chances of developing depression. According to research, almost 50% of people diagnosed with PTSD will also experience depression. The odds of someone with PTSD developing depression are three to ... Understanding the signs and symptoms of PTSD can help to create a more understanding and empathetic society — opening new doors of opportunity and resources for PTSD survivors. Below, we’re discussing possible symptoms of PTSD, and the role that therapy can play in supporting those with PTSD. BetterHelp counseling is considered one of the best online therapy sites, partly because it offers affordable therapy as an alternative to in-office therapy. In-person therapy often costs $75 to $200 per session, compared to $60 to $90 per week—charged every four weeks—which is what BetterHelp memberships cost..

The renew-deutschland.de Platform

Sign up today for free to access accurate and timely data on https://renew-deutschland.de/.

If you’re the manager of renew-deutschland.de, you can sign up to take control of your profile and respond.

Our Team

  • Manager Wuvijlnq Tkrnkupde
  • Manager Kjjoyp Hdeetjtfice
  • Manager Mxjvn Vtfsrjixmv
  • Manager Jsgssky Okghxwvr
  • Technical Support Cpdgfm Cfgjhs
Contact information for renew-deutschland.de - These are a few of the strategies that a person with Complex Post-Traumatic Stress Disorder can use to cope with their illness. We'll go into detail about the signs of Complex Post-Traumatic Stress Disorder later in the article. "BetterHelp understands how painful trauma can be.