Trauma Assessment

[AnotherRound]

In doing some recent research I came across this trauma assessment. Several have asked that I share it. It is fairly in depth, and I want to warn anyone before hand that it WILL bring up some nasty emotions if you have suffered trauma. Of course, that is necessary to process and work through things, but if you are not in a good place to handle some of these things, please think long and hard prior to attempting this exercise. If you have a counselor, please discuss with them as they may be able to help you ascertain if you are in a good place to attempt this. If you do not have a counselor, please make sure that you have a supportive system in case it does bring up anything (and it will) that you may have to deal with.

 

This exercise is basically just a guide on how to identify the trauma in your life. It is a processing exercise, it will allow you to write it all down, as neat and orderly as is possible with this sort of thing. It will help you identify your trauma, those responsible for the trauma - and the length of the trauma. It is from a book titled "The Betrayal Bond - Breaking Free of Exploitive Relationships" by Patrick J. Carnes, PhD. The Betrayal Bond is similar to a sort of Stockholm Syndrome, but explained a bit differently. The book is aimed at those with PTSD, and is worth the read and the exercises for anyone who has suffered a trauma at any time. It does go into detail about prolonged trauma (not always necessary for PTSD, but exacerbates it extensively). I will try to lay it out here as well as a I can. Again, please be prepared for the emotions that it may (will!) stir up.

 

Post-Traumatic Stress Index (page 37, Carnes)

The following statements typify reactions trauma victims often have to child abuse. Please check those you believe apply to you. Although the statements are written in the present tense, if the statements have EVER applied to your life, then place a check next to that item. Statements are considered false only if they have NEVER been a part of your life. If in doubt, let your first reaction be your guide. Given these guidelines, place a check mark next to the statements you feel apply.

 

Also, set up your answers as follows:

1. 2. 3. 4. 5. 6. 7. 8.

9. 10. etc. all the way to the last one

 

1. I have recurring memories of painful experiences.

2. I am unable to stop a harmful childhood pattern.

3. I sometimes obsess about people who have hurt me and are now gone.

4. I feel bad at times about myself because of shameful experiences I believe were my fault.

5. I am a risk taker.

6. At times, I have difficulty staying awake.

7. I sometimes feel separate from my body as a reaction to a flashback or memory.

8. I deny myself basic needs at times, like groceries, shoes, books, medical care, rent and heat.

9. I have distressing dreams about experiences.

10. I repeat painful experiences over and over.

11. I try to be understood by those who are incapable or don't care for me.

12. I have suicidal thoughts.

13. I engage in high-risk behaviors.

14. I eat excessively to avoid problems.

15. I avoid thoughts or feelings associated with my trauma experiences.

16. I skip vacations because of lack of time or money.

17. I have periods of sleeplessness.

18. I try to re-create an early trauma experience.

19. I keep secrets for people who have hurt me.

20. I have attempted suicide.

21. I am sexual when frightened.

22. I drink to excess when life is too hard.

23. I avoid stories, parts of movies or reminders of early painful experiences.

24. I avoid sexual pleasure.

25. I sometimes feel like an old painful experience is happening now.

26. There is something destructive I do over and over from my early life.

27. I stayed in a conflict with someone when I could have walked away.

28. I have suicidal thoughts.

29. I often feel sexual when I am lonely.

30. I use depressant drugs as a way to cope.

31. I am unable to recall important details of painful experiences.

32. I avoid doing "normal" activities because of fears I have.

33. I have sudden, vivid or distracting memories of painful experiences.

34. I attempt to stop activities I know are not helpful.

35. I go overboard to help people who have been destructive.

36. I often feel lonely and estranged from others because of painful experiences I have had.

37. I feel intensely sexual when violence occurs.

38. My procrastinating interferes with my daily life.

39. I sometimes withdraw or have no interest in important activities because of my childhood experiences.

40. I will hoard money and not spend money on legitimate needs.

41. I am upset when there are reminders of abusive experiences like anniversaries, places or symbols.

42. I compulsively do things to others that were done to me as a young person.

43. I sometimes help those who continue to harm me.

44. I feel unable to experience certain emotions (love, happiness, sadness, etc.)

45. I feel sexual when degraded or used.

46. Sleep is a way for me to avoid life's problems.

47. I have difficulty concentrating.

48. I have attempted diets repeatedly.

49. I have difficulty sleeping.

50. My relationship are the same story over and over.

51. I feel loyal to people even though they have betrayed me.

52. I have a dim outlook on my future.

53. I feel sexual when someone is "nice" to me.

54. At times I am preoccupied with food and eating.

55. I experience confusion often.

56. I refuse to buy things even when I need them and have the money.

57. I have difficulty feeling sexual.

58. I know that something destructive I do repeats a childhood event.

59. I remain a "team" member when obviously things are becoming destructive.

60. I feel as if I must avoid depending on people.

61. I sometimes feel bad because I enjoyed experiences that were exploitive of me.

62. I abuse alcohol often.

63. I tend to be accident-prone.

64. I spend much time performing underachieving jobs.

65. Sometimes I have outbursts of anger or irritability.

66. I do things to others that were done to me in my family.

67. I make repeated efforts to convince people who were destructive to me and not willing to listen.

68. I engage in self-destructive behaviors.

69. I get "high" on activities that are dangerous to me.

70. I use TV, reading and hobbies as ways to numb out.

71. I go into a fantasy world when things are tough.

72. I am underemployed.

73. I am extremely cautious of my surroundings.

74. I have thoughts and behaviors repeatedly that do not feel good to me.

75. I attempt to be liked by people who are clearly exploiting me.

76. I engage in self-mutilating behaviors (cutting self, burning, bruising, etc.)

77. I use drugs like cocaine or amphetamines to speed things up.

78. I put off certain tasks.

79. I use "romance" as a way to avoid problems.

80. I feel very guilty about any sexual activity.

81. I often feel that people are out to take advantage of me.

82. I revert to doing things I did as a child.

83. I am attracted to untrustworthy people.

84. I endure physical or emotional pain most people would not accept.

85. I like "living on the edge" of danger or excitement.

86. When things are difficult, I will sometimes binge.

87. I have a tendency to be preoccupied with something other than what I need to be.

88. I have a low interest in sexual activity.

89. I am distrustful of others.

90. Some of my recurring behavior comes from early life experiences.

91. I trust people who have proved to be unreliable.

92. I try to be perfect.

93. I am orgasmic when hurt or beaten.

94. I use drugs to escape.

95. I use marijuana or psychedelics to hallucinate.

96. I sometimes spoil success opportunities.

97. I am startled more easily than others.

98. I am preoccupied with children of a certain age.

99. I see people whom I know will cause me pain.

100. I avoid mistakes at any cost.

101. I love to gamble on outcomes.

102. I work too hard to I won't have to feel.

103. I will often lose myself in fantasies rather than deal with real life.

104. I go without necessities for periods of time.

105. I get physical reactions to reminders of abuse experiences (breaking out in cold sweat, trouble breathing, etc.)

106. I engage in abusive relationships repeatedly.

107. I have difficulty distancing myself from unhealthy relationships.

108. I sometimes want to hurt myself physically.

109. I need lots of stimulation so I will not be bored.

110. I get "lost" in my work.

111. I live a "double life".

112. I vomit food or use diuretics to avoid weight gain.

113. I feel anxious about being sexual.

114. There is a certain age of children or adolescents that is sexually attractive to me.

115. I continue to have contact with a person who has abused me.

116. I often feel unworthy, unlovable, immoral or sinful because of experiences I have had.

117. I like sex when it is dangerous.

118. I try to "slow down" my mind.

119. I like "compartments" that others do not know about.

120. I experience periods when I'm not interested in eating.

121. I am scared about sex.

122. There are activities that I have trouble stopping even though they are useless or destructive.

123. I am in emotional fights (divorces, lawsuits) that seem endless.

124. I often feel I should be punished for past behavior.

125. I do sexual things that are risky.

126. When I am anxious, I will do things to stop my feelings.

127. I have a fantasy life that I retreat to when things are hard.

128. I have difficulty with play.

129. I wake up with upsetting dreams.

130. My relationships seem to have the same dysfunctional pattern.

131. There are certain people whom I always allow to take advantage of me.

132. I have a sense that others are always better off than me.

133. I use cocaine or amphetamines to heighten high-risk activities.

134. I don't tolerate uncomfortable feelings.

135. I am a daydreamer.

136. At times, I see comfort, luxuries and play activities as frivolous.

137. I hate it when someone approaches me sexually.

138. Sometimes I find children more attractive than others.

139. There are some people in my life who are hard to get over, thought they hurt or used me badly.

140. I feel bad when something good happens.

141. I get excited/aroused when faced with dangerous situations.

142. I use anything to distract myself from my problems.

143. Sometimes I live in an "unreal" world.

144. There are long periods of time with no sexual activity for me.

 

After checking each one that applies/applied to you, add the lines up. The first column starting with #1 and ending with #137, and so on.

 

You will end up with 8 different columns, and a total of each column, where each X counts as 1 point. 18 possible for each column.

 

The columns are as follows.

 

TRT TR TBD TS TP TB TSG TA

 

These are your assessments - each representing a different "type" of trauma assessment. If anyone completes the exercise and wants their assessment, let me know and I will add the assessments. I don't want to give them before hand for a reason - but also, it's a LOT more to type if nobody is going to do the exercise.

 

As an aside, if anyone is having suicidal/homicidal thoughts or urges, please contact a professional immediately.

[2sunny]

I would find it interesting to have answered these questions when I was an active drinker (I'm a recovered alcoholic - one day at a time) - and then answer them now while in a totally different mindset.

 

I can see I was participating in very risky behavior back then due to trauma - things I would never consider now.

 

My trauma counselor was awesome! I couldn't have made the quick strides I did without her. Those decisions I made back then changed my life and changed the core being of me.

 

It's freedom now!

[amaysngrace]

I still forget to eat sometimes (but usually its cause I'm too busy) and still procrastinate but there's a lot of things I use to tolerate that I simply have no time for anymore.

 

I'm like you 2sunny...I wouldn't be where I am mentally today if I didn't have such a great counselor. She was awesome and it IS freedom.

 

My main issue was that I was raped at seven and never told anyone. It messed me up and messed with my perception. I internalized it all but boy am I glad I got it out. It's a whole new world.

 

[gamman]

Hey, AnotherRound. Thanks for posting this.

 

I'd be interested in the seeing the assessments.

 

Thanks again.

Edited October 8, 2012 by gamman

[Exit]

I just filled mine out. Would like to know how to assess.

[AnotherRound]

This is the first part to actually writing out your "trauma history", but since a couple of people are interested, I will spend the time typing it out. Here goes...

 

From the book, verbatim:

 

Match your scores with the appropriate capitalized code. Behind each score is an explanation of what the score measures. Also included are some recommendations for actions that would be appropriate for you to take. If your score is LOW (0-3), this is not an area of concern for you. If your score is moderate (3-6), you should discuss with friends or a therapist what strategies would now help you. If your score is higher than 6, this should be an area of intense focus for you. You may wish to discuss with a therapist a series of target activities to help you with these trauma patterns. Remember, this is only a paper and pencil instrument to help you think about the role of trauma in your life. Only you and your therapist can see if the results fit your experience.

 

Scores:

 

TRT ____ Trauma Reactions: (First column, starts with #1, ends with #137) Experiencing current reactions to trauma events in the past. THERAPY STRATEGIES: Study ways you are still reacting. Write letters to your perpetrators telling them of the long-term impact you are experiencing. Also write amends letters to those you know you have harmed. Dedie with therapist what is appropriate to send.

 

TR ____ Trauma Repetition: (Second column, starts #2, ends #138) Repeating behaviors or situations that parallel early trauma experiences.

THERAPY STRATEGIES: Understand how history repeats itself in your life experiences. Develop habits that help to center yourself (e.g. breathing, journaling), so that you are doing what you intend, not the cycles of old. Work on boundaries. Boundary failure is key to repetition compulsion.

 

TBD ___ Trauma Bonds: (Third column, starts #3, ends #139) Being connected (loyal, helpful, supportive) to people who are dangerous, shaming, or exploitive.

THERAPY STRATEGIES: Learn to recognize trauma bonds by identifying those in your life. Look for patterns. Use "detachment" strategies for difficult people. Use a First Step if necessary. *First Step as used in AA programs.

 

TS ___ Trauma Shame: (Fourth column, starts with #4, ends #140) Feeling unworthy and having self-hate because of trauma experience. THERAPY STRATEGIES: Understand the shame dynamics of your family. Why was it important to you that you feel shame? Start reprogramming yourself with affirmations.

 

TP ___ Trauma Pleasure: (Fifth column, starts #5, ends #141) Finding pleasure in the presence of extreme danger, violence, risk or shame. THERAPY STRATEGIES: Do a history of how excitement and shame are hooked up to your trauma past. Note the costs and dangers to you over time. Do a First Step and relapse-prevention plan about how powerful this is in your life.

 

TB ___ Trauma Blocking: (Sixth column, starts #6, ends #142) A pattern exists to numb, block out or overwhelm feelings that stem from trauma in your life. THERAPY STRATEGIES: Work to identify experiences that caused pain or diminished you. Reexperience feelings and makes sense of them to help. This will reduce the power they have had. Do a First Step if appropriate.

 

TSG ___ Trauma Splitting: (7th column, starts #7, ends #143) Ignoring traumatic realities by dissociating or "splitting" off experiences or parts of self. THERAPY STRATEGIES: Learn that dissociating is a "normal" response to trauma. Identify ways you split reality and the triggers that cause that to happen. Cultivate a caring adult who stays present you can stay whole. Notice any powerlessness you feel.

 

TA ___ Trauma Abstinence: (8th and final column, starts #8, ends #144) Depriving yourself of things you need or deserve because of traumatic acts. THERAPY STRATEGIES: Understand how deprivation is a way to continue serving your perpetrators. Write a letter to the victim that was you about learning to tolerate pain and deprivation. Work on strategies to self-nurture, including inner-child visualizations.

 

For most people, completing the Traumatic Stress Index provides much to think about. First of all, you may have noticed patterns that were clear to you before. This will help lay the groundwork for change. Sometimes people are anxious because they scored high on some of the scales. Take comfort in knowing that you have identified where some of the issues are. Pinpointing the problem means you can take the action your worksheet (above) suggested.

 

Perhaps you disagree with the results. Or maybe nothing significant or new emerged. That sometimes happens. Remember, this was only a paper and pencil exercise to help give you clarity. It may not have a been a good match for your experiences. What is important is to understand what trauma can do to you.

 

 

**** I can post the work through of the traumas if anyone is interested. It gets far more involved, and brings up things and forces some processing for most people. The book is available still I'm guessing though, and it probably isn't very expensive if anyone wants to purchase it and work it through from beginning to end. I have no connection to the author or the book, just found it while researching and am going to begin using some of the trauma work with some of my clients.

[Exit]

Thanks for the info.

 

Heh... all 8 columns of mine added up to higher than 6. My lowest were an 8 and a 9. Everything else was 12 and above.

 

I will see if I can track down the book rather than asking you to keep typing out more of it.