TRAUMA – as you read this word, what feeling does it evoke in you? Perhaps stress, fear, irritation, or curiosity? Many of you reading this term have encountered trauma or traumatic experiences and might react in a variety of ways. Trauma can leave an indelible impression and can cause effects that last for generations. Our culture has, over the last 50 years, increased awareness of trauma and traumatic experiences. Some think this awareness has gone too far, causing hackneyed use of the term over recent years. The Google Books Ngram Viewer indicates a significant increase in the use of the word across the last several decades, as shown in the picture below:

Whether or not the term is overused, we live in a culture that is more open than ever to discussing mental health and possible traumatic experiences. Family gatherings in the months of November and December can remind us of some of these experiences and cause additional stress. What is trauma? How does it differ from regular distress? When does a person’s reaction to trauma rise to the level of Post Traumatic Stress Disorder (PTSD)?

The National Institute of Mental Health defines a traumatic experience as a “shocking, scary, or dangerous experience that can affect someone emotionally and physically.” These can include a variety of situations, including natural disasters, witnessing the loss of life, and more. The World Mental Health Survey Consortium estimates that lifetime prevalence rates of trauma exposure are possibly as high as 70% world-wide. Multiple trauma exposures are also possible. Many, many people encounter traumatic situations across their lifetime.

The American Psychological Association (APA) defines trauma as “any event that exceeds an individual’s capacity to cope… and is severe enough to interrupt daily functioning.” This definition not only includes “life-threatening or physically injurious events described in the DSM-5-TR, but also psychosocial adversity that may be experienced throughout the lifespan.” These may even include experiences such as acute sexual harassment or racial discrimination .

It becomes somewhat tricky to quantify what experience may be traumatic or merely distressing for a particular individual. Not everyone acknowledges true trauma as such, downplaying or minimizing experiences. Others may claim trauma when instead they have experienced distress and an unpleasant situation. Ultimately, an important marker is the response a person has to a particular experience.

The APA highlights four types of traumatic response: acute, chronic, complex, and secondary. An acute response is the immediate aftereffects from a one-time short-term traumatic experience. These effects can typically resolve on their own with proper support and time. A chronic response is the result of long-term, repeated exposure to traumatic experiences. As one might assume, recovery from chronic exposure takes more support to overcome. Further, a complex response includes not only long-term and repeated exposure to these events but also includes no possibility of escape. Complex traumatic reactions are even more challenging to address. And finally, secondary traumatic responses are typically experienced by responders who aide those in crisis. 

The vast majority of people recover from the effects of trauma over time. However, 3-10% of people who experience trauma go on to develop Post-Traumatic Stress Disorder (PTSD). PTSD is a response to a traumatic experience and is recognized in the DSM-5-TR. Several supports are available for those diagnosed with PTSD. Complex PTSD, however, is a distinct disorder, currently only recognized in the 11th edition of the International Classification of Diseases (ICD-11). It is considered a response to several, prolonged traumatic experiences over one’s lifetime and is a more severe diagnosis than PTSD. Professional support is invaluable in addressing the challenges of Complex PTSD.

It is important to note that humans can be incredibly resilient in the face of trauma. Six factors increase resilience– optimism, cognitive flexibility, active coping skills, a positive social network, attending to one’s physical well-being, and embracing a sense of purpose. Sometimes, however, these factors are not enough in the face of adversity. Four response mechanisms are outlined in the book Complex PTSD: From Surviving to Thriving by Pete Walker: Fight, Flight, Freeze, and Fawn if you are interested in reading to learn more. Otherwise, these will be discussed in detail in Part 2 of this collection. Stay tuned!

The providers at PACT offer trauma-informed individual therapy, please contact us if you are interested in setting up services. Otherwise, if you or someone that you know is experiencing trauma and needs support during this holiday season, please reach out to the national Suicide & Crisis Hotline by dialing 988 or by visiting their website.