What is Trauma?
Everyone is talking about trauma. What is it really?
It’s difficult to feel clear about what trauma is these days. Trauma has become a buzzword in popular culture and there is lots of conflicting information. Maybe you have read an article, listened to a podcast, or talked to a mental health professional about it, and you still don’t feel any clearer. You might have gotten conflicting or slightly different information from each source. Thats because there has been a huge surge of research and progress in the field of trauma and the medical system hasnt totally caught up yet. This seems to have some health professionals in a tizzy because what the general population calls trauma doesn’t necessarily match how we diagnose trauma as post-traumatic stress disorder.
I can see how popular use of the word can make it feel like it is losing its meaning, and we are over-diagnosing ourselves. This could be true to some extent. However, I also think many of us are becoming more aware of how our difficult experiences have shaped us and how we behave in the world. Our gut feeling is not wrong. The most current research supports a spectrum of trauma and the diverse ways it shows up in our lives.
In this post, I will discuss trauma as a concept rather than a diagnosis. If you're curious about the criteria that health practitioners use to diagnose post traumatic stress disorder (PTSD), this link from the National Library of Medicine is a great resource.
It’s helpful to know that your doctors and therapists are held to strict standards when diagnosing trauma-related disorders. A P-TSD diagnosis usually requires a major horrific life-threatening event, injury, or sexual assault. Things like chronic childhood stress, emotional abuse, and neglect don’t make the cut but still result in trauma. Let me be clear; you can still be dealing with trauma and not meet the requirements for PTSD.
Trauma, The Big Picture
Trauma is not what happened to you. It is what happens inside you as a result of an experience. World-renowned trauma expert, Gabor Mate, defines this beautifully in his most recent book, The Myth of Normal (2022):
“…trauma is an inner injury, a lasting rupture or split within the self due to difficult or hurtful events… Likewise trauma is a psychic injury, lodged in our nervous system, mind, and body, lasting long past the originating incident(s), triggerable at any moment. It is a constellation of hardships, composed of the wound itself and the residual burdens that our woundedness imposes on our bodies and souls: the unresolved emotions they visit upon us; the coping dynamics they dictate; the tragic or melodramatic, or neurotic scripts we unwittingly but inexorably live out; and, not least, the toll these take on our bodies.” (p.20)
An “inner injury” seems like a vague explanation, but there truly are so many ways we become injured and wounded. Our earliest wounds are often the most powerful and mysterious. Looking at trauma this way, we widen our view of how it happens. It is not limited to one horrific event like a car crash or rape. Research shows that long-term or repeated exposure to stressful events (e.g., difficult childhoods or abusive relationships) can result in symptoms similar to PTSD and other traits that wreak havoc on our lives.
In modern society and culture, there are threats to our well-being everywhere. As social animals, we rely on our families and social circles for support and safety. Threats to social safety often go overlooked but are critical to our health. A lot of trauma is connected to how we interact with other humans. We can become wounded in relation to parents with the best intentions following the parenting advice of their time. We live in cultures that deprive us of the opportunity to fulfill our most basic needs. We receive messages from media that cultivate self-hatred. We strive to fit into boxes and be things we are not. We abandon our authentic selves in search of our need to be loved, and exchange it for conditional approval. And when we are so deeply hurt, guided by our frantic desire to avoid further pain, we tend to hurt each other.
How Trauma Changes Us
Trauma changes us. Our nervous systems sense stress as a possible threat to safety. It responds by using biological and mental processes to try and prevent harm. Trauma is a deep and powerful learning process. We learn how we are not safe and develop strategies for protection. These strategies can be very good at protecting us from mental harm while still in a traumatic environment. However, the strategies stay with us as we age and enter new settings. They become very unhelpful, especially in relationships with other people. These strategies manifest as a diverse collection of symptoms. Over time, we manage our symptoms by creating behavior patterns that merge with our personalities.
Below is a list of common symptoms. Keep in mind, there is a range of experiences when it comes to these symptoms. Therapists often see lots of gray areas in how these symptoms show up in clients.
Distressing memories
Recurrent distressing dreams
Dissociation
Distress with triggers
Avoidance
Inability to remember an important aspect of the traumatic event(s)
Negative beliefs or expectations about ourselves, others, or the world.
Blaming ourselves or others
Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame)
Loss of interest in activities
Feelings of detachment or estrangement from others
Interpersonal challenges
Inability to experience positive emotions
Irritable behavior and angry outbursts
Reckless or self-destructive behavior
Hypervigilance
Exaggerated startle response
Problems with concentration
Sleep disturbance
Impairment in daily functioning
You’re probably quite familiar with some of these symptoms in yourself or others. These ring true on some level for most folks with trauma. Humans are also delightfully complex. When we are in pain, we do many things to avoid suffering and feel valued. These symptoms can transform into behaviors that our culture supports and even celebrates. Who doesn’t love a workaholic employee, a cutthroat business person, a perfectionist, an overachiever, a people pleaser, a “tough guy,” or a woman who perfectly adheres to beauty standards? They can also manifest in ways that our culture shames: being a “needy” partner, being highly sensitive, having a learning disability, addiction, playing the victim, having chronic health concerns, folks who struggle to function that we often call lazy, or a woman who obsessively adheres to beauty standards. These are not the only ways trauma influences how we are in the world. Trauma is especially good at showing up in interpersonal relationships in all kinds of tricky ways.
What do we do now?
If you are in the market for trauma treatment, find a trauma-focused/trauma-informed practitioner. A good health practitioner recognizes the limits of PTSD diagnosis. If you're not looking for help from a proffesional, you can still raise awareness about how your experience has changed you. You can look at your behaviors with curiosity and wonder whether the ways you have adapted to the world are actually helpful in the long term. What do you do to protect yourself from pain? Perfectionists and overachievers may be trying to protect themselves from failure or disapproval. Workaholics and people with other addictive behaviors are often attempting to avoid inner pain. A people pleaser is constantly hustling to avoid feeling unlovable.
It would be a wonder if someone navigated our society without experiencing some form of trauma. We can get stuck in the wounded dance, taking turns harming ourselves and each other. The last thing we can all do is look at ourselves and each other through eyes of compassion and understanding. It’s not our fault how we came to be the way we are. However, after the first glimpse of awareness and opportunity, it is our responsibility to help ourselves and help others. I say this from a place of privilege and offer a closing disclaimer: Yes, we should heal ourselves, but this is often a matter of privilege and access to resources. Our society itself is traumatized and harms many of its citizens. Being denied access to help and basic needs is a traumatic experience that many people face daily.