PTSD

The other day I received a request from a potential guest for the How to Deal With Grief and Trauma podcast. The first 3 lines from his email sufficed to create a shock response as the content traumatized me just by reading it. It started with ‘Imagine…’ followed by a short description of the horrific, ritualistic, and sadistic childhood trauma the person had experienced.

Yes, simple words in a couple of lines are enough to traumatize the reader. Why is that?

Trauma happens on different levels

Trauma does not just happen to the person experiencing it. It also happens to the person seeing it happen (witnessing by sight), or the person hearing it happen (witnessing by sound).

It does not even require the words ‘imagine this…’ – the brain automatically makes an internal image of what has been shared.

Take for example the events taking place on 9/11 – a historical event etched in the memory of every human being on the planet who was old enough to hear it and connected in some form or other to the world news. Even just referring to an event with a number (9/11) will bring up memories of where you were that day, who you were with, and what you did.

Who was affected by this traumatic event?

• People directly at the different scenes of events (Twin Towers, Pentagon, etc)
• Friends and family members of those people
• Rescue teams, news reporters, medical care teams, etc
• People watching the news
• People hearing from those who were at the scene
• People hearing from those who watched the news

Not all people who COULD be affected by a traumatic event
are necessarily affected,
and not likely in the same way.

What happens to people affected by trauma?

Depending on the level of involvement and closeness to the trauma, people either go into a full trauma response or a milder version. Immediate reactions after a traumatic event include shock and denial, while more long-term reactions may include mood swings, relationship challenges, flashbacks, and physical symptoms. These responses may be concerning to the person experiencing them and those around them, but they are normal responses to traumatic events.

People have different reactions to traumatic events. For example, those who live through the same natural disaster can respond very differently despite experiencing the same event.

Type of trauma (traumatic events)

Traumatic events include (but are not limited to):

• Child abuse
• Child neglect
• Bullying
• Being attacked
• Being kidnapped
• Harassment
• Physical abuse
• Domestic violence
• Violence in the community
• Natural disasters
• Medical trauma
• Sexual abuse
• Sex trafficking
• Substance use
• Intimate partner violence
• Verbal abuse
• Accidents
• War
• Refugee trauma
• Terrorism
• Traumatic grief
• Intergenerational trauma
• Childbirth

Even a seemingly positive event such as childbirth can be traumatic, depending on the circumstances!

Duration of trauma: Acute versus chronic emotional trauma

Traumatic events can be isolated or repeated, ongoing events. A person can also experience trauma after witnessing something (by sight or sound) traumatic happening to someone else.

Trauma can either be physical or emotional. Physical trauma is a serious bodily injury. Emotional trauma is the emotional response to a disturbing event or situation.

 More specifically, emotional trauma can be either acute or chronic, as follows:

• Acute emotional trauma is the emotional response that happens during and shortly after a single distressing event.
• Chronic emotional trauma is a long-term emotional response a person experiences from prolonged or repeated distressing events that span months or years. Additionally, complex emotional trauma is the emotional response associated with multiple different distressing events that may or may not be intertwined.

Small ‘t’ versus Large ‘T’

Small ‘t’ traumas are events that exceed our capacity to cope and cause a disruption in emotional functioning. These distressing events are not inherently life or bodily-integrity-threatening, but perhaps better described as ego-threatening due to the individual left feeling notable helplessness. Some examples include:

• Interpersonal conflict
• Infidelity
• Divorce
• Abrupt or extended relocation
• Legal trouble
• Financial worries or difficulty
• etc.

A large-T trauma is distinguished as an extraordinary and significant event that leaves the individual feeling powerless and possessing little control over their environment. Such events could take the form of, for example:

• Natural disaster
• Terrorist attack
• Sexual assault
• Combat
• Car accident
• Plane accident
• Childhood ritualist abuse
• etc.

Helplessness is also a key factor of large ‘T’ traumas, and the extent of experienced helplessness is far beyond that of a small ‘t’ trauma. Large ‘T’ traumas are more readily identified by the experiencer, as well as those who have any familiarity with their plight.

These might be 38 types of trauma but the list is not complete.

More articles to come on:

• trauma symptoms
• trauma-informed care
• trauma in childhood
• healing from trauma
• complex trauma

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