How well do you understand trauma? A therapist explains

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When trauma was first conceptualized, it was defined as a ‘’catastrophic event outside the usual human experience”. At the time, people linked trauma with specific events such as war, torture, and the Holocaust. However, more research on neurobiology, the human experience, and even current events have open the door to a broader conversation about how many of us are truly exposed to trauma.

So, what is trauma? And who gets to decide?

I offer my patients this explanation: trauma is any event or experience that overwhelms the brain’s ability to cope, and shapes our beliefs or behaviors going forward. Even more simply, it is anything that causes an individual deep, lasting distress during and/or after the event has taken place. Ultimately, trauma is less about what happened, and more about one’s subjective experience of it.

Thanks to experts in the field of research, we know a lot more about trauma then we used to. Dr. Peter Levine in his book Waking the Tiger writes, “What most people don’t know is that many seemingly benign situations can be traumatic… The consequences of trauma can be widespread and hidden.”

Here are a few common misconceptions about trauma, debunked.

Trauma is the same thing as PTSD

Many people believe that trauma and PTSD are synonymous. Post-traumatic stress disorder is a psychiatric disorder for which certain diagnostic criteria must be met.

Although experiencing a trauma is a precursor for receiving a PTSD diagnosis, one can experience trauma and not meet criteria for a PTSD diagnosis. In fact, research estimates that 70% of people experience at least one traumatic event in their lives, yet only 20% of those people (about 5-7% of total population at a given time) are diagnosed with PTSD.

Similarly, Dr. Bessel Van Der Kolk, an expert in trauma field, found that in one major study of traumatized children, 82% of the children did not meet criteria for PTSD.

Trauma is one rare event

There are many different forms of trauma. The helping profession often uses the language of ‘big T’ or ‘little t’ trauma. ‘Big T’ traumas are typically synonymous with what is known as shock trauma- for example, rape, assault, natural disaster, interpersonal violence.

‘Little t’’ traumas are events that exceed our typical capacity to cope by causing a disruption in emotional functioning. These events are not necessarily life threatening, but still cause distress and at times impairments in our ability to function. Examples may include divorce, loss of job, or unexpected financial hardship.

Another category of trauma is known as developmental or relational trauma, which gives name to trauma that occurs in childhood as a result of chronic abuse, neglect, or other adversity. A recent and groundbreaking study conducted by the CDC confirmed that about two-thirds of adults have experienced at least one or more adverse childhood experience.

Fight or Flight are the only responses to trauma

Most people are familiar with the ‘fight or flight’ response to acute stress. It references our automatic, involuntary physiological response to any real or perceived threat. There is less reference to our third (and equally involuntary) physiological response to threat: freeze.

Think about a zebra who is being attacked by a lion. The zebra either: fights the lion, runs away to safety, or immobilizes and ‘plays dead’. The zebra does this without stopping and pondering which option is in its best interest- it acts automatically. Humans operate in the same way.

Dr. Stephen Porges explains how human and animals are essentially “fight or flight” machines, meaning that we are designed for movement and action. When fight or flight are unavailable (for instance, if someone is confined, isolated or trapped) we can experience the freeze response. Freeze often happens in more extreme situations where a person or animal unconsciously ‘numbs out’ or dissociates in order to avoid the magnitude of terror they are faced with.

We have control over our fight/flight/freeze response

Perhaps the most important thing to know about trauma is that we cannot control how we respond in the moment. When faced with life threatening or other traumatic experiences, access to our rational, thinking brain is blocked. Our fight/flight/freeze survival circuitry takes over and chooses for us. This process is adaptive, protective, and involuntary.

Humans naturally seek out meaning as a way to make sense of the world. The trouble with trauma is that survivors often ascribe false meaning to what the experience means about them. Many people blame themselves for what happened, or feel ashamed at how they reacted during the event. Additionally, unlike ordinary memories which tend to have a logical narrative, traumatic memories are often stored in the brain as fragments. That is why people often experience triggers through smell, sound, or imagery that doesn’t necessarily ‘make sense’.

Only ‘at risk’ populations experience trauma

WIthout question, there are varying degrees of severity when it comes to trauma. While it is unhelpful to compare someone who lived through a school shooting or sexual assault to someone who went through a tough breakup, it is also unhelpful to keep ‘othering’ people who experienced trauma. When we separate, we shame people. Expanding the discourse about trauma opens the door to connection, empathy, and compassion.

The CDC study referenced earlier was conducted primarily among white, middle-class, educated adults. It classifies adverse childhood experiences (ACE) as things such as emotional/sexual/physical abuse, divorce, and various forms of household dysfunction. In the past 8 years, in data collected across 33 different states, 20% of adults reported an ACE score of 3 or more.

A friend of mine put it most brilliantly when she said, “who among us hasn’t experienced some form of trauma throughout their lives? That person would have to be a unicorn”.