Throughout my time as a therapist, I have noticed that when people speak about the term “trauma”, they often do so with a very limited definition of the word—and usually in a manner that discounts their own experiences. There are a few events, such as war and natural disasters, that seem to be universally accepted as distressing and horrifying “enough” to be categorized as traumatic, likely because these events are seen as—even to the unknowing outsider—as extraordinarily distressing. These are some of the most acutely profound experiences one may live through. However, one does not have to go endure an event of such magnitude for it to impact them.
What is trauma?
It is worth taking a moment to flush out the definition of trauma. According to the American Psychological Association, trauma is “an emotional response to a terrible event.” Trauma events are experienced as deeply disturbing and distressing, but because everyone’s experiences are inherently subjective, trauma is much less about a specific event and much more about one’s psychological reaction to it.
There are a variety of factors that determine how someone will interpret and internalize a potentially traumatizing event, including predisposing factors (e.g.: individual’s past experiences, distress tolerance, expectations, perceptions, spiritual/religious beliefs and values, cultural beliefs and values, and morals) and an individual’s ability to process their experience in a healthy manner. That said, it should be noted that developing trauma symptoms should never be viewed as a personal failure.
Big “T” Trauma
Big “T” trauma refers to events many initially think of when they hear the word “trauma”: war, natural disasters, plane accidents, terrorist attacks, sexual assault, and so on. These events are associated with the threat of serious injury, sexual violence, or death, and are considered traumatic even if the individual is never actually physically harmed. They are extraordinary, and often leave people with a significant sense of powerlessness, lack of control, and helplessness.
Big “T” traumas are also most commonly associated with post-traumatic stress disorder (PTSD). PTSD is a psychiatrist disorder marked by “intense, disturbing thoughts and feelings related to [a traumatic] experience long after the traumatic event has ended” (American Psychiatric Association, 2020). There are four main categories of PTSD symptoms: intrusion, avoidance, alterations in cognition and mood, and alterations in arousal and reactivity.
Intrusive symptoms refer to repeated, unwanted, and involuntary thoughts, dreams, or flashbacks of the traumatic event—sometimes so vivid that individuals experiencing them may feel like they are reliving the traumatic event. When it occurs, individuals’ avoidance may be of anything that may act as a reminder of the traumatic event, including people, places, objects, and activities. People may also avoid thinking about or talking about their experience. Alterations in cognition and mood may present as an inability to remember important details about the traumatic event or irrational thoughts about the cause or consequences of the event that may result in wrongly blaming one’s self or others. People may experience negative thoughts and feelings about themselves or others (e.g.: “I am a terrible person”, “The world cannot be trusted”), persistent fear, anger, guilt, or horror. It is also not uncommon for people to lose interest in activities and hobbies they once found enjoyable, feel detached from people they were once close to, or feel unable to express positive emotions such as happiness or excitement. Lastly, alterations in arousal and reactivity may present as increased irritability, reckless or self-destructive behavior, inability to concentrate or fall sleep. People may also seem to be more aware of their surroundings in a suspecting way or be more easily startled. (American Psychiatrist Association, 2002)
Little “t” Trauma
Little “t” trauma refers to events that occur on a personal level and exceed one’s ability to cope. Some examples may include bullying or harassment, the loss of a significant relationship (e.g.: infidelity, divorce, death, etc.), financial hardships, sudden and/or extended relocation, and legal troubles. These experiences do not involve a threat of bodily harm or death, nor are they commonly associated with PTSD, but that does not mean they should be discounted as unimportant. Little “t” traumas can be extremely upsetting, cause significant trouble with emotional functioning, and often elicit a feeling of helplessness.
People sometimes find it difficult to accept and empathize with the impact that little “t” trauma can have on their lives and often overlook the affect that an accumulation of little “t” traumas—whether condensed or over the course of lifetime—can have on an individual.
This is due to the tendency to rationalize these experiences as “normal” and any reaction as “dramatic” or “over the top”, which may be a form of avoidance. When unacknowledged, minimized, or unaddressed, the emotional distress from little “t” traumas can cause an individual to develop maladaptive coping mechanisms, such as invalidating their emotions, bottling up their feelings, and attempting to manage their symptoms in unhealthy ways.
If you have experience big “t” trauma, little “t” trauma, or a combination of both, it may be worth seeking out psychotherapy. Trauma symptoms can be confusing and overwhelming to those experiencing them, and the process of understanding them and integrating the traumatic experience into your narrative can be difficult to do without support. Trauma-informed therapists utilize evidence-based treatment modalities—such as cognitive processing therapy, prolonged-exposure therapy, and EMDR—to help individuals reduce or possibly eliminate the trauma symptoms they are experiencing and gain back control over their lives.
Trauma work is not easy, nor is it quick, but it is likely worth it. If any part of this blog resonated with you, it may be worth reaching out to a therapist about your experiences. While engaging in such deeply personal and intense therapeutic work, it is important to feel safe and supported in your therapeutic relationship. Many times, therapists, such as the team at Gateway to Solutions, offer free introductory calls (about 1-10 minutes) for prospective clients. This gives the client and therapist the opportunity to get to know each other’s personality, ask any questions, and determine if they may be a good fit. If a therapist does not outwardly offer this, it is always worth asking if they would be willing to have a quick phone call.