What Is Trauma?
"Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think."
-Bessel van der Kolk, MD The Body Keeps the Score
Culturally, the word “trauma” has very serious undertones. Many people only think of trauma as the absolute worst of the worst experiences.
Some examples include veterans or survivors of war, and those who've survived physical or sexual abuse/assault.
As a result, many do not consider their own experiences to be "serious enough" to qualify or justify how they're struggling now.
Another way to think about trauma is as an event, or series of events that overwhelm our ability to cope.
This can include experiences of ongoing emotional abuse or neglect, grief and loss, one's own chronic illness or caregiving for another's to name a few.
A shared example is the impact of the COVID-19 pandemic; the grief, fear, uncertainty and mandated social isolation impacted many throughout the world.
The less control we have over whatever "it" is and the less emotional support we have around it, the more it's likely it is to haunt us later.
How Do I know If I Have Trauma?
"The survivor's intimate relationships are driven by the hunger for protection and care and haunted by the fear of abandonment or exploitation."
-Judith Herman, MD Trauma and Recovery
The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR) defines trauma as “exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: direct experiencing, witnessing the event(s), learning that the traumatic event(s) occurred to a close family member or friend, or experiencing repeated or extreme exposure to negative details of traumatic events (i.e. first responders).”
In more plain language, to meet conditions for a diagnosis of Posttraumatic Stress Disorder (PTSD), first, this definition of trauma must be met. Then too, one must identify several symptoms from four distinct categories referenced on the first page, that have caused significant distress long after the event.
However, that doesn't necessarily capture the full scope of traumatic experiences, nor people's responses to them! Particularly those of complex trauma, which while recognized by most clinicians, is still not in the DSM. Complex PTSD has additional unique symptoms like lacking a baseline state of physical calm or comfort, this can translate into physical symptoms and complaints, flashbacks are often emotional in nature, dissociation is common, forming and maintaining meaningful and reciprocal relationships can be very challenging, and many report long periods of missing memory.
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C-PTSD results from the cumulative effects of repeated abuse and/or emotional/physical neglect usually beginning in childhood. Other types which compound these affects include intergenerational trauma (how the experiences of previous generations are passed down in behavioral and biological ways), as well as systemic abuse (political, educational and occupational policies that limit access to resources or opportunities for education or other advancement) which is often part of cultural trauma (that includes microaggressions-less overt ways of putting down or excluding) targeted toward specific racial, ethnic, sexual, gender and religious groups.
Some of the ways people cope and/or avoid processing their traumatic experiences are more obviously unhealthy, like abusing alcohol and other drugs, or self-harm (cutting, burning, or other ways of physically hurting oneself). Other unhealthy strategies are less obvious but can still interfere with relationships and health. These include but are not limited to: working or staying overly busy all the time, driving recklessly, taking up dangerous hobbies, or engaging in high-risk sexual behaviors.
While it is a natural and understandable response to want to avoid reminders of painful experiences, it's usually when people avoid thinking and talking about them that they find it hardest to truly move forward.
By using a more inclusive definition, most of us have experienced trauma at least once in our lives. And while that doesn't mean we all have PTSD, these experiences can still be very challenging to overcome, and have likely left a mark on how we see ourselves and the world.
Now What?!
The good news is that there is hope! Human beings are remarkably resilient!
We survive. We adapt.
Our brains and beings can heal.
With the right support, we have the ability to endure painful things and still go on to live happy, healthy and productive lives.
There are multiple paths to healing.
Jennifer Brey would be honored to help you on your journey.
