Trauma: Definition, Symptoms, Examples, Treatments
Reviewed by therapist.com Team
What Is Trauma?
Trauma is an emotional response to a horrifying, stressful, or dangerous event, relationship, or circumstance that threatens or harms a person’s health and safety. Far from being a rare occurrence, most people will experience at least one form of trauma in their lifetime. According to the U.S. Department of Veterans Affairs, about 60% of men and 50% of women will experience trauma at some point in their lives.
In the initial aftermath of a traumatic event, you may experience psychological shock, also known as an acute stress response. Psychological shock occurs when your body is overwhelmed with emotion, which can manifest itself in a variety of physical symptoms.
In particular, your body will experience a rush of adrenaline, resulting in shakiness, rapid heartbeat, difficulty breathing, nausea, and chest tightness. These physical symptoms represent your body’s fight-or-flight response, which prepares your body to take immediate action that prioritizes your survival.
However, more recently, researchers have expanded this idea of “fight” or “flight” to include four response choices instead of two:
- Fight: Becoming aggressive, screaming
- Flight: Running away
- Freeze: Staying still, avoiding decisions, feeling numb or out of body
- Fawn: Trying to please others to avoid conflict
Following your emergency response, you will transition into short-term processing. In the days and weeks that follow your trauma, you will return to some sense of normalcy or routine. During this adjustment period, you may experience grief, stress, or flashbacks. You may also develop a trauma or stressor-related disorder.
Months later, you will transition from short-term processing into long-term recovery. This is the time in which you learn to make meaning from your trauma and integrate what has happened to you into your life story. You’re able to accept what has happened without reliving your trauma endlessly.
- Acute trauma: Develops in response to a single event (e.g., car accident, sexual assault, natural disaster)
- Complex trauma: Develops in response to a variety prolonged and repeated traumatic events (e.g., child abuse or neglect, domestic violence, civil unrest)
- Secondary/vicarious trauma: Develops in response to witnessing someone else’s trauma (typical among therapists, first responders, healthcare providers, etc.)
- Intergenerational trauma: Refers to trauma that is passed down across generations, particularly when it is experienced by a collective group (e.g., slavery, genocide)
Trauma relies on an individual’s perception of danger and safety. This means that multiple people can undergo the same stressful experience and have different trauma responses.
For example, let’s say three roommates are at home when an earthquake hits. The first roommate may develop trauma symptoms that resolve in a few days or weeks. The second roommate’s symptoms may linger for months, eventually developing into posttraumatic stress disorder (PTSD). The third roommate may not be traumatized at all, having lived in an earthquake-prone area their entire life.
Perception also plays a big role in trauma. Let’s say the earthquake was minor. The third roommate had experience with and context for what was happening and remained calm. The second roommate, however, didn’t realize the earthquake was minor and thought they were going to die. Even though they were never technically in any danger, their perception of danger still caused a trauma response.
Because trauma depends on an individual’s emotional response, many different circumstances can “count” as trauma. Therapists often use the idea of big “T” trauma and little “t” trauma to help individuals understand how they may have been traumatized by seemingly “small” things.
Big “T” trauma refers to the extreme events that our culture already tends to associate with the word “trauma.” Big “T” traumas include events that are obviously life-threatening and dangerous. Examples of big “T” trauma include:
- Natural disasters
- Sexual violence
- Physical abuse
- Mass shootings
- Terrorist attacks
- Severe car accidents
Little “t” trauma refers to events and circumstances that are not life-threatening, but instead life-altering. These situations may appear ordinary, but they can still produce a trauma response. Examples of little “t” traumas include:
- Getting fired
- Unresolved relational conflicts
- Financial or legal difficulties
It’s important to expand our definition of trauma beyond just big “T” trauma to also include the little “t” traumas that can be just as damaging to our mental health. Multiple little “t” traumas can build up over time and cause severe symptoms normally associated with big “T” traumas.
Trauma harms or threatens to harm our physical, mental, and/or emotional well-being. Different kinds of traumatic events may jeopardize different areas of our health. Generally, most forms of trauma affect us in multiple ways.
Let’s say you get into a car accident and break your leg. The physical trauma of your broken leg is visible and obvious. However, the emotional trauma of going through that experience may be less tangible. These unresolved emotions may affect you psychologically and express themselves as fear and panic any time you get into a car.
Emotional or psychological trauma can also express itself in physical ways. For example, if you are struggling with the psychological trauma of going through a divorce, you may develop physical symptoms, such as insomnia, changes in eating habits, or muscle tension.
Sometimes, the way we respond to trauma affects our mental health. These are known as trauma and stressor-related disorders. Common trauma disorders include:
- Posttraumatic stress disorder (PTSD): Occurs when trauma symptoms persist more than a month after the trauma occurred; characterized by intrusive memories, avoidance, cognition and mood changes, and heightened arousal and reactivity
- Acute stress disorder (ASD): Occurs when trauma symptoms persist for less than a month after the trauma occurred
- Adjustment disorders: Characterized by difficulty adjusting to a stressful event; persist for up to six months after the stressor stopped
Experiencing or witnessing trauma in childhood can have long-lasting effects on a person’s development. Certain mental health disorders and developmental disorders may arise in response to trauma, especially if a child does not have access to treatment, resources, and support to process the trauma in a healthy way.
Common ways that trauma expresses itself in childhood development include:
- Developmental trauma disorder (DTD): DTD is a potential diagnosis for children with complex trauma histories, proposed by Dr. Bessel van der Kolk. Although it is not currently included in the DSM-5, its usefulness as a diagnosis is the subject of discussion and debate among experts.
- Oppositional defiant disorder (ODD): ODD is a childhood behavior disorder characterized by anger, defiance, and spite. Children may develop ODD in response to trauma, abuse, or other family issues.
- Dissociation: Many children dissociate as a way to cope with trauma. Dissociation involves detaching from oneself or from reality as a form of self-protection. One type of dissociative disorder commonly displayed in response to trauma is depersonalization/derealization disorder.
- Cognitive struggles: If you experience or witness trauma as a child, you may struggle cognitively. For example, if you are repressing memories of your childhood trauma, you may struggle to remember not just those memories, but also other details and information unrelated to your trauma.
Trauma can affect, interact with, trigger, and even exacerbate other mental health disorders, such as:
The following treatment options are reliable, evidence-based therapies that can help survivors of trauma see great improvements:
- Cognitive behavioral therapy (CBT): With a trauma-informed CBT therapist, you can learn to identify unhelpful thought patterns at the root of your emotions and behaviors.
- Prolonged exposure therapy: Exposure therapy allows survivors of trauma to confront their trauma memories and emotions in a safe, controlled environment.
- Eye movement desensitization and reprocessing (EMDR): EMDR helps survivors process their traumatic memories in a way that encourages new connections and rapid processing. Click here to find an EMDR-licensed therapist near you.
- Somatic therapies: Somatic therapies, also known as body-based therapies, can help reconnect the mind and the body after trauma. People who feel “out of body” after trauma may benefit from somatic therapies in particular. Some common somatic therapies include somatic experiencing, sensorimotor psychotherapy, and the Hakomi method.
- Medication: Antidepressants may help to ease or alleviate some trauma symptoms.
With treatment, trauma survivors can learn to practice different forms of self-care, like mediation and mindfulness, that can help them navigate their trauma symptoms in healthy ways. They can also learn how to better regulate their emotions when trauma symptoms feel overwhelming.
If you are struggling with your mental health after experiencing trauma, help is available now:
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