Defining Trauma
What is trauma? We hear that word frequently these days in conversation, in the media, or on platforms like TikTok with phrases like “That’s so traumatic”, or “I’m traumatized”. So what is it clinically? Trauma is defined as a psychological, emotional response to experiencing through a distressing event. That statement seems pretty vague, so let’s break that down.
Let’s start with the phrase, “psychological, emotional response”. This refers to the resulting symptoms one experiences following the trauma. Some such symptoms may include:
Feelings of anger
Persistent feelings of sadness and despair
Flashbacks
Unpredictable or mismatching emotions to situations
Physical symptoms (e.g., nausea, headaches, etc.)
Intense feelings of guilt or shame
Feelings of isolation and hopelessness
Helplessness or powerlessness
Children may experience all of these symptoms, and they have a few developmentally specific signs as well:
Fear of separation from parents/ caregivers
Crying and screaming frequently
Eating poorly and/ or losing weight
Increased nightmares
Having a hard time concentrating in school
For teens: Developing eating disorders and self-harming behaviors, beginning to abuse alcohol or drugs, or becoming sexually active
Every person’s reaction to a trauma will look different. They may exhibit all of these symptoms or just a few. Regardless of the number they endure, their experience is very real. Moreover, they may display these symptoms not just in response to the traumatic event itself, but also to reminders of the incident as well. These situations can be called “triggers”. This is another word we hear quite often these days. In relation to trauma, though, triggers are reminders that are usually accompanied by a physical, emotional, or psychological response. Trauma alters the way that people react to what may be seen as everyday stimuli or events. It can negatively impact a person’s sense of self, safety, spirituality, view of the world, and ability to regulate emotions and navigate social relationships.
Now that we’ve defined “psychological, emotional response”, let’s move on to the word “experiencing”. In this context, experiencing does not need to occur first hand. It absolutely can be a situation in which the person feeling the resulting trauma was the person who went through the event. It also can be that the person exhibiting symptoms of trauma witnessed it occurring to someone else, learned of an event that happened to a close family member or friend, or repeated exposure to details of traumatic events. A good example of this is 9/11. This was an event that affected the nation and resulted in widespread fear and trauma not just for those individuals present but people across the country and world. Other examples include a person whose family member experienced a death threat or a first responder who has had to collect deceased individuals. Each of these situations are traumatic and can, therefore, result in symptoms of trauma.
Lastly, we will discuss what a “distressing event” refers to in this context. Now, this is difficult to define because distressing events are entirely subjective, so really, this is an occurrence that someone experienced as particularly painful. Some examples include:
Natural disasters
Bullying
Physical, emotional, psychological, sexual, or financial abuse
Neglect or abandonment
Living with a family member with mental health or substance use disorders
Poverty
Racism, discrimination, and oppression
Violence in the community, war, or terrorism
Personal, close friend, or family member death or illness
Divorce or separation
While these are all situations that can cause trauma to individuals and families, not everyone will experience them as traumatic. What makes the difference between people’s reactions are what we refer to as protective factors. Protective factors are aspects, experiences, or qualities of a person’s life that enable them to be resilient as they face challenges. Examples of protective factors include:
Secure attachment to parents/ caregivers
Safe adults outside of the family unit
Positive self-esteem
Good physical health
Adequate sleep
Having a sense of purpose
Healthy coping skills
Positive social supports/ friends
Emotional awareness and communicativeness
These are just a few of the many protective factors out there. A really good example that highlights the strength and importance of protective factors comes from my own experience as a clinician. I was working with a family doing family counseling, and we were meeting for the first time. I ask questions about each person’s life to get to know everyone better and to establish patterns of behavior and thinking. One of the questions I ask is if the person had experienced anything traumatic in their life. When asking the father this question, he said no, that he hadn’t. Now, one thing to know about this man was that he had a prosthetic leg. I looked at him a bit confused, and gently said that losing a limb can be traumatic for many people. He just laughed. He said that he had this leg amputated due to an issue with this diabetes and had no problem with it at all. I will never forget that he said “Good riddance,” with a laugh. I was absolutely stunned because, for most people, myself included, that would be a terribly traumatic experience. There are even therapy groups dedicated to individuals in his position. To him, though, there was nothing traumatic about it. Whatever his protective factors were, they made him so resilient that losing a limb did not profoundly affect him. We are all different, we react to situations differently, and we experience trauma differently.
Treatment
While trauma can appear to be this huge, insurmountable obstacle, there are ways to address it in counseling. As trauma can result in differing degrees of severity, there are various treatment options to start that journey towards healing. Here are a few modalities that can help those who have experienced trauma and would like assistance in learning how to lessen and manage the symptoms:
Cognitive behavioral therapy (CBT): helps individuals increase their awareness of their thoughts and beliefs regarding their trauma and supplies them with skills to manage their triggers in a healthier way.
Exposure therapy or In Vivo Exposure Therapy: helps individuals reduce the fear they experience with their triggers by introducing them to the person in a slow and safe manner.
Eye Movement and Desensitization Reprocessing (EMDR): helps individuals access their distressing memories to process them in a way that decreases and resolves associated stress.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Used with children aged 3-18 years old to help them identify, modify, and challenge unhelpful thinking or distorted cognitions related to trauma. It incorporates family members into the sessions as well.
Play Therapy: Used with children aged 2-12 can help them address unresolved trauma and communicate and explore repressed emotions in a developmentally appropriate way to foster personal growth.
Resources
by Madison Gabriel, MS, LCMHCA, NCC