Understanding Trauma

Whatever brought you here, I’m glad you made this choice. There’s a part of me that wishes you weren’t, and that you didn’t need to be, and that the awful thing you’ve been through hadn’t happened. But, it did, and here you are, taking the first steps toward healing.

Getting information is a great place to start and that’s why I’ve created this page. My hope is that after reading, you will have a better understanding of trauma and how it impacts people.

Some basic facts

• The likelihood of experiencing a traumatic event (defined as experiencing or witnessing a life-threatening event, serious injury, or sexual abuse/violence) is about 90%. In other words, 9 out of 10 people will experience a traumatic event at some point in their life.
• The lifetime prevalence rate of PTSD is about 8%, meaning that of those people who have experienced a trauma, 8% will end up developing PTSD.
• On average, about 20% of people will experience sexual abuse or assault before the age of 18. More specifically, 1 in 4 girls and 1 in 6 boys. And due to lack of reporting, these numbers could be higher.
• According to the Adverse Childhood Experiences (ACE) study, about 28% of people experienced physical abuse as a child.
• About 13% of adults witnessed domestic violence as a child.

The incidence of trauma is much higher than most people think. And that’s only focused on the “big T” traumas (e.g., sexual abuse/assault, domestic violence, physical assault, any life-threatening event). Most of the people you have met likely have been through something traumatic. You are, most definitely, not alone in having experienced a trauma.

What is trauma?

There are multiple definitions and it can depend on context. For example, in the medical field, a trauma might be defined as a wound or shock produced by sudden physical injury, such as from violence or an accident. The American Psychological Association defines trauma as: “any disturbing experience that results in significant fear, helplessness, dissociation, confusion or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, or other aspects of functioning.” The APA definition also recognizes that trauma can be caused by human behavior, natural disasters, etc. When diagnosing PTSD, the definition becomes more specific: Exposure to actual or threatened death, serious injury, or sexual violence by direct experience, witnessing the event, or learning that it occurred to a close family member or close friend. But, in its most simple definition, a trauma can be anything that is beyond a person’s control and overwhelms the ability to cope effectively.

Traumas come in a variety of forms and events

“Big T” traumas are events that are truly horrible, terrifying, and overwhelming. They are situations that are unexpected and over which you have no control. They can ultimately leave you feeling like you might be broken and damaged forever. The “big T” traumas are those that everyone would agree are traumatic: sexual abuse and assault, being in a war, physical assault or abuse, serious car accidents, being a victim of a violent crime, natural disasters, and serious injury. The “big T” traumas share three common elements: it is an unexpected event; we are unprepared for it; nothing can be done to stop it

“Little t” traumas are events that not everyone would experience as traumatic. Their impact on a person can be subtler. These events are not life threatening and not horrifying like the “big T” events. However, they are still disruptive and may overwhelm our ability to cope. Some examples of “little t” traumas include: bullying, sexual harassment, chronic medical illnesses, frequent or repeated shaming (including name calling and put downs), living in an unsafe neighborhood, listening to parents arguing, infidelity, divorce, witnessing a fight, etc.

Trauma can be a one-time experience (e.g., car accident, rape) or a series of events that occur over a period of time (e.g., domestic violence, child abuse). Sometimes, people experience a one-time trauma multiple times (e.g., being raped multiple times by different people years apart). Some experience multiple types of traumas (e.g., physical assault and serious medical illness).

It’s possible you read this and still aren’t sure if what you’ve been through “counts” as a trauma. This often can be the case for sexual experiences. Maybe what you’re thinking about is a sexual experience that was really uncomfortable and unwanted, but you’re not sure it would count as assault or a trauma. While I can’t answer that for you without more information, I would say that if you think it might have been, and it has continued to stick with you, it probably was traumatic. Also consider this – if your best friend (or spouse, or sibling) came to you and told you this happened to them, what would you tell them? If you would tell them it wasn’t okay and was traumatic, it shouldn’t be any different for you.

The impact of trauma on the body

When someone is experiencing a trauma, the sympathetic nervous system gets activated. This is the system that is responsible for keeping us alive. In a trauma, the brain instinctively makes shifts in our body to ensure our survival. It turns off any functions unnecessary to immediate survival – these include things like digestion, long-term planning, and rational thought. Our brain will automatically retain the information it needs to determine the best course of action to keep us safe and alive. This system is also known as our fight-flight-freeze response. What the brain does is based on instinct, and not a conscious thought process. The emotional and survival centers are activated while the thinking, learning, and language centers decrease activity. Once the danger passes, this system settles back down to allow for the other functions to come back online.

The more often a person experiences a dangerous, traumatic situation, the harder it is for the brain to settle back down. Ultimately, it can end up staying on high alert. Someone who is repeatedly traumatized is primed to perceive threat and danger when there isn’t any actual danger. Their brain can also become more sensitive and more easily triggered in response to imaginary or perceived threats. Over time, it gets harder and harder for the brain to reset once it is triggered. With therapy, it is possible to recalibrate the system back to its typical balance – it will trigger only when it picks up on an actual threat. And when it is triggered, it will reset itself more quickly and effectively.

There also are significant long-term effects of trauma on health and well-being. Those with a history of childhood trauma have a higher risk of injury, sexually transmitted diseases, and teen pregnancy. They have a higher incidence of chronic diseases, including heart disease, diabetes, and cancer. People with a history of trauma have a higher rate of suicide. Those who have experienced early trauma also have more difficulty making and keeping stable, healthy relationships. They have more difficulty at work, and there is a higher rate of depression, anxiety, eating disorders, and substance use.

What is PTSD and how do I know if I have it?

PTSD is a diagnosis that is given when someone has experienced a specific type of traumatic event (most of the “big T” traumas) and shows a consistent group of symptoms. While it is normal for a person to experience some disruption and dysregulation after experiencing a traumatic event, PTSD is diagnosed when those difficulties don’t resolve. Some common PTSD symptoms include nightmares, uncontrollable memories and unwanted images of the event, and significant emotional distress or physical reaction when reminded of the event. Other symptoms include attempts to avoid thoughts, feelings, or memories about what happened or by avoiding anything associated with the event. Many people have trouble remembering parts of what happened. Other common symptoms include negative beliefs about yourself, others, and the world. Many struggle with experiencing unpleasant emotions (e.g., anger, shame, guilt, fear) more often and more intensely. This further increases the struggle to feel happiness and joy. For many, there is a loss of interest in previously enjoyed activities and a disconnection from others. It is also common to have difficulty with paying attention and to have trouble sleeping. After going through a trauma, people are often more vigilant and aware of their surroundings and may easily startle or become scared.

All of the symptoms noted above can be common after someone experiences a trauma. Often, these symptoms decrease naturally and resolve on their own. However, for many, they don’t resolve and people get stuck in recovery. Some will develop PTSD, and some won’t. This does not mean that just because you might not meet the exact criteria for PTSD that you aren’t having a significant trauma reaction. It doesn’t lessen your experience or the impact this event and your symptoms are having on your life. Regardless of whether or not you have PTSD (and how relevant this diagnosis is to insurance companies), you could still use some help in healing and getting rid of your trauma symptoms.

Noting the symptoms above, you can have a pretty good idea if you are having a trauma reaction. Have you been through either a “big T” or “little t” event? Do you have several of the difficulties noted above? If yes, then you are most likely having a trauma reaction. However, in order to get a diagnosis of PTSD, you should meet with a mental health professional who is trained in mental health diagnosis and trauma assessment. They will know what questions to ask in order to better understand what is going on with you.

How does trauma affect kids differently?

Children can show the same symptoms as adults, but some things might look different. Increases in tantrums, irritability, and moodiness are common. Kids might have more trouble separating from their parents or other caregivers. They might not want to be alone and want to sleep in the same bed as a parent or sibling. They might stop doing things they used to like. They might even start doing things they had stopped doing, such as sucking their thumb or wetting the bed. You also might see changes in the child’s play, such as playing out what happened to them. This can actually be a good thing – it is a way for the child to make sense of and work through what happened. Kids might also start to struggle in school when before they hadn’t. They might not perform as well, or lose interest in, things such as sports, playing instruments, or other hobbies. It is important to intervene and get treatment while they are young, so the symptoms and negative effects of the trauma don’t further impact them into their adolescence and adult years.

What causes PTSD – why do some people get it, and some don’t?

There are a lot of different theories on this, but the bottom line is that it has nothing to do with a person’s “strength.” Anyone can develop PTSD after a trauma. There are some very normal reactions after going through a trauma, and for many, these will resolve naturally in about a month. However, if these reactions last, they can develop into PTSD. For some, PTSD won’t develop right away, and it can take months, or even years, before symptoms fully kick in. Sometimes, PTSD only develops after someone goes through a second traumatic event. The more traumas a person experiences, the more likely that person is to develop PTSD. It develops when the brain doesn’t reset its fight-flight-freeze response. The person who went through the traumatic event then avoids dealing with it. While this can help initially, over time it creates more problems and increases the likelihood that PTSD develops.

What do I do if I think I have PTSD?

Before anything else, remember that you went through something terrible. Of course it’s going to affect you. And it’s okay if you aren’t okay. Self-compassion is important. Stop comparing what you went through to things that have happened to other people that you might view as “worse” than what you experienced.

It’s important to take care of yourself. Eat well. Get exercise or other physical activity. Reach out to people you trust for support. Talk about what happened with someone you trust. Learn and use healthy coping skills. Be aware of and reduce unhealthy coping skills. Do your best to get at least 7 hours of sleep every night.

Seek professional help. In other words, find a therapist who specializes in trauma. Therapy can help, no matter what the trauma was, or whether it’s been three months, three years, or thirty years. Ask your primary care doctor (or even your gynecologist or other specialist) for recommendations. Ask a friend or someone else you trust if they have any recommendations. Do an internet search. Ask to do a consultation phone call to see if it might be a good fit. Wherever you find a therapist, make sure they specialize in trauma and PTSD. Don’t wait until you feel “ready” – there will never be a magical moment when you feel perfectly ready to do this. Just trust that now is the time because healing is better than struggling.

What you do with this information is totally up to you. I hope that you will reach out to get help – if not from me, then from someone else. What happened to you will never be okay—not ever. But therapy can help you feel like you’re okay despite this terrible thing that happened. Therapy can help you escape the hold it has on you and ease the burden it has forced you to carry. I am a witness – I see it happen all the time.