We have all heard of the word trauma in one context or another. You may have heard it in casual conversation, where someone says: “And then I realized I’d been talking for 5 minutes with food all over my face, and it was super traumatic.” Or, you may have heard it in a different context, when someone speaks about the trauma they experienced as a refugee. Or even still, you may have heard about trauma when there is a discussion around military personnel or first responders, and how there is not enough trauma support readily available. And so you may think to yourself, “How can those all of these things refer to trauma?” And it’s a great question. Let’s get into it.
In the mental health world, there is something called the Diagnostic and Statistical Manual of Mental Health Disorders or the DSM-5. This manual outlines and defines the criteria required for an official mental health diagnosis, including the diagnosis for Post Traumatic Stress Disorder (PTSD). The DSM-5 defines trauma as having been directly exposed to, threatened with, or personally witnessed: death, serious physical injury, sexual violence, or exposure to adverse details or experiences.
Each of these elements refer to probably the most common understanding of trauma – the big "T" Traumas. Generally speaking, most of us tend to think of trauma as it relates to war or combat; natural disasters such as hurricanes or tornadoes; sexual, physical or verbal abuse; or in regards to a death that occurs suddenly and perhaps violently.
However, as our understanding about mental health has improved, so has our understanding of trauma. Researchers and professionals are now beginning to acknowledge something they refer to as little "t" traumas, which still fall under the greater trauma umbrella. When we talk about little "t" traumas, we might talk about the distress caused by a failed relationship, maybe with a family member, or in the case of divorce. A little "t" trauma may also refer to a prolonged situation of bullying for example, or gender discrimination. The miscarriage of a child or the difficult birth of a child, could also be considered trauma. Or. Any other medical experience that could produce distress, like a cancer diagnosis for example, a difficult surgery, or a chronic illness. There are numerous examples of little "t" traumas throughout our lives, and it is likely that each and every one of us will experience at least one, if not many, over the course of our lifetime.
So you might be asking – “Does that mean we are all traumatized? Am I traumatized and I don’t know it?” – The short answer is, “Maybe…. But maybe not”. Here’s why:
In order for a situation or experience to be considered a trauma, big "T" or little "t", it is actually our reaction to the event that defines it as such. For example, not everyone who experiences a difficult event will experience it as trauma. But some individuals will.
If we go through a difficult experience and we are then able to process (or make sense of) that experience through discussion, thought, and emotional expression, then we may be able to continue with our day-to-day lives in a relatively functional manner.
Trauma, on the other hand, occurs when our reaction to a situation turns away from this positive processing and daily functioning, and towards a more difficult existence. For example, we must react to a trauma with some kind of avoidance to the situation, whether it is an avoidance to thinking about it, or putting ourselves physically in situations that remind us of that event.
Further, the event itself must produce negative thoughts or feelings that begin or worsen after the event: for example, there may be an inability to recall key features of the trauma (essentially blocking it out from our minds), we might start to blame ourselves or others for causing or being responsible for the trauma, we may begin to display a negative affect, feel isolated, have a decrease in our interest in activities, or have difficulty feeling anything positive at all. We might also start to feel more irritable or aggressive, hyper vigilant, have difficulty concentrating or sleeping, or develop a heightened startle reaction. And so, as you can see, it is our reaction to the event that makes it a trauma; If any of these things develop after a difficult experience, they negatively impact your life, and last for longer than 1 month, then you have experienced trauma.
Taking this one step further - Because it is our reaction to an event that defines our trauma for us, and not the event itself, it is obvious that different experiences will be considered traumatic for different people. Even if you did not react to a difficult event in a certain way, doesn’t mean that it won't be experienced as trauma to someone else. Or vice versa. Now, it is critical to note here that the reasons for the differences in reactions from person to person are not only numerous and extremely complex, but also largely out of our control. Therefore, if you experience an event as traumatic (as many of us will), understand that it is not your fault. Let me repeat: It is not your fault. It also stands to follow then, that when you encounter someone who has experienced trauma, understanding and compassion will go a long way in supporting them through it. No one actively "chooses" trauma. Remember that.
What else can we do if one of us or someone we know has been through a traumatic event? For starters, talking to someone is important – whether it be a family member or friend, communicating our experiences to someone else can often leave us feeling less alone and a lot less scared. Seeking out professional help in the form of a psychologist or psychotherapist is also important, since they can assist you in working through your experiences, thoughts, behaviours, and emotions, as they directly relate to your trauma. A professional can also help you to build the skills you need in order to function more successfully in your everyday life. Cognitive Behavioural Therapy and EMDR are two of the most empirically effective modes of therapy in treatment of trauma and PTSD, so that may be a good place to start. If you are experiencing depression or anxiety as a result of the trauma, medication can sometimes be effective as well, and can potentially be worth exploring. There may also be group meetings for trauma survivors in your area, where you can gain a sense of community and belonging if you feel alone. In every case, there are a number of options available to those who have been through trauma, so do not feel like you need to force yourself to attend one thing or another – try out the different options, and continue with the one that feels right to YOU.
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'Till next time -
Take care of yourself first, and then one another.