Trauma

Trauma is an emotional response to an event or series of events that is deeply distressing, threatening, or harmful. According to Psychology Today, trauma literally means "wound, shock, or injury" and refers to psychological distress resulting from an event that overwhelms a person's capacity to emotionally process it [1]. These experiences can involve actual or perceived threats to life, safety, or well-being and can have lasting effects on how a person thinks, feels, and interacts with the world.

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes trauma as "an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning" [2]. What makes trauma unique is that it's defined not just by what happened, but by how the person experienced the event and its aftermath.

Types of Trauma

Trauma comes in various forms and can be categorized in several ways. Understanding these different types can help in recognizing trauma responses and finding appropriate support.

Based on Duration and Frequency

Acute Trauma: Develops in response to a single, overwhelming event, such as a car accident, natural disaster, or assault [3]. With proper support, many people recover without long-lasting effects.

Chronic Trauma: Results from repeated exposure to distressing events over an extended period, such as ongoing domestic violence or recurring abuse [4]. The cumulative effect of these experiences can be particularly damaging to mental health.

Complex Trauma: Refers to situations where a person experiences multiple, chronic, or severe traumatic events, often within interpersonal relationships [4]. This type of trauma typically begins in childhood and can profoundly affect development, identity formation, and relationship patterns.

Based on the Source of Trauma

Developmental Trauma: Occurs during critical stages of childhood development and can significantly impact emotional, cognitive, and social development [5]. Because it occurs during formative years, developmental trauma can fundamentally alter how a person's brain and nervous system function.

Relational Trauma: Stems from dysfunctional family systems, domestic violence, abandonment, or other harmful relationship dynamics [5]. This type of trauma shapes how a person forms attachments and engages in relationships throughout life.

Collective/Community Trauma: Affects entire groups of people who experience or witness a traumatic event together, such as a community affected by a natural disaster or mass shooting [6].

Intergenerational Trauma: Occurs when the effects of trauma experienced by one generation impact subsequent generations through changes in parenting patterns, family dynamics, or even epigenetic changes [7].

"Big T" vs. "Little t" Trauma

Mental health professionals sometimes distinguish between:

"Big T" Trauma: Events that threaten someone's life or physical safety, such as serious injury, sexual violence, or natural disasters [5]. These are experiences most people would immediately recognize as potentially traumatic.

"Little t" Trauma: Events that exceed a person's ability to cope and cause disruption in emotional functioning, such as interpersonal conflict, loss of significant relationships, or prolonged stress [5]. While these might not seem as obviously traumatic to observers, they can still profoundly affect a person's mental health.

However, categorizing trauma as "big" or "little" can be problematic, as it might minimize experiences that have had a significant impact [8]. The effect of trauma is highly individual, and what matters most is how the experience affected the person.

Common Responses to Trauma

Trauma affects each person differently, but there are some common patterns in how people respond to traumatic experiences.

Immediate Responses

In the immediate aftermath of a traumatic event, a person might experience shock, denial, confusion, overwhelming fear, emotional numbness, heightened alertness, or physical symptoms like nausea and trembling [3].

Short-term Responses

In the days and weeks following trauma, someone might experience intrusive thoughts about the event, disturbing dreams, flashbacks, intense reactions to trauma reminders, difficulty sleeping, changes in appetite, mood swings, or withdrawal from others [4].

Long-term Effects

If trauma symptoms persist or worsen over time, they may develop into Post-Traumatic Stress Disorder (PTSD), depression or anxiety disorders, substance use disorders, changes in self-perception, relationship difficulties, or chronic health problems [1].

How Trauma Affects the Brain and Body

Understanding the neurobiological impact of trauma helps explain why trauma responses can be so intense and persistent.

The Stress Response System

When a person encounters a threatening situation, the body's stress response system activates: the amygdala detects danger, stress hormones flood the body, heart rate increases, breathing quickens, and muscles tense [6]. This "fight, flight, or freeze" response is adaptive in dangerous situations but can become dysregulated after trauma, remaining activated even when danger has passed.

Memory Processing

Trauma can disrupt normal memory processing. During overwhelming events, the brain may not encode memories normally, resulting in fragmented sensory impressions rather than coherent narratives [7]. These fragmented memories can intrude into consciousness as flashbacks, and the brain's fear network becomes sensitized to trauma reminders.

Long-term Neurobiological Effects

Chronic or severe trauma can lead to lasting changes in brain regions involved in stress response, how stress hormones are regulated, autonomic nervous system function, and inflammation throughout the body [7]. These neurobiological changes help explain trauma's wide-ranging effects on physical and mental health.

Risk and Resilience Factors

Not everyone who experiences a potentially traumatic event will develop lasting symptoms. Various factors influence vulnerability and resilience.

Risk Factors

Factors that may increase the likelihood of developing trauma symptoms include prior traumatic experiences, pre-existing mental health conditions, lack of social support, high stress levels at the time of the event, direct exposure, and genetic factors affecting stress response [8].

Resilience Factors

Protective factors include strong social support networks, access to resources and services, effective coping strategies, a sense of self-efficacy, finding meaning in the experience, and mental and emotional flexibility [3].

Trauma-Informed Treatment Approaches

Recovery from trauma is possible with appropriate support and treatment. Several evidence-based approaches have shown effectiveness in addressing trauma symptoms.

Trauma-Focused Psychotherapies

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Designed specifically to address the effects of trauma, helping people process and reframe traumatic memories, reduce symptoms, and develop coping strategies [6].

Eye Movement Desensitization and Reprocessing (EMDR): Incorporates elements of cognitive-behavioral therapy with eye movements or other rhythmic, left-right stimulation to help "unfreeze" traumatic memories so they become less intrusive [6].

Somatic (Body-Centered) Therapies: Focus on bodily sensations rather than thoughts about the traumatic event. Examples include Somatic Experiencing, Sensorimotor Psychotherapy, and the Hakomi Method [4].

Dialectical Behavior Therapy (DBT): Effective for many people with complex trauma, as it focuses on emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness [6].

Other Therapeutic Approaches

Effective approaches may also include psychodynamic therapy, narrative therapy, Internal Family Systems (IFS), mindfulness-based therapies, group therapy, and expressive therapies like art or music [7].

Medication

In some cases, medication may help manage trauma symptoms. Options include antidepressants for depression, anxiety, and some PTSD symptoms; anti-anxiety medications for severe anxiety; and sleep medications for trauma-related sleep disturbances [4]. Medication is typically most effective when combined with psychotherapy.

Self-Care Strategies for Trauma Recovery

While professional treatment is often necessary, self-care practices can support healing:

Building Safety and Stability

Establish routines and predictability, create a safe physical environment, practice setting healthy boundaries, and develop strategies for managing intense emotions [2].

Regulating the Nervous System

Learn grounding techniques, engage in regular physical activity, practice relaxation techniques like deep breathing or gentle yoga, and spend time in nature [4].

Processing and Integration

Journal about experiences and feelings, engage in creative expression, connect with supportive communities, and practice self-compassion [1].

Supporting Someone Who Has Experienced Trauma

If someone you care about has experienced trauma, you can provide support by listening without judgment, validating their feelings, respecting their boundaries, avoiding pressure to talk about the trauma, encouraging professional help when appropriate, and taking care of your own well-being [3].

Finding Professional Help

Recovery from trauma often requires professional support. When seeking help, look for providers who specialize in trauma treatment, ask about their training in specific trauma therapies, consider what type of therapy would be most helpful, and ensure their approach feels comfortable and safe [6].

The SoCal Mental Health Directory: Your Resource for Trauma Recovery

The SoCal Mental Health Directory can help you find specialized treatment providers who understand trauma and offer evidence-based approaches to recovery. Our directory includes professionals with expertise in various trauma types and treatment modalities, making it easier to find the right match for your needs.

Whether you're dealing with the effects of a recent traumatic event or working through childhood trauma, our directory can connect you with compassionate, skilled providers who can help you on your healing journey.

Use our location search tool to find trauma treatment providers near you.

Sources

1. Psychology Today. (2009). "Trauma." https://www.psychologytoday.com/us/basics/trauma

2. Substance Abuse and Mental Health Services Administration. (n.d.). "Trauma and Violence." https://www.samhsa.gov/mental-health/trauma-violence

3. American Psychological Society. "Trauma." https://psychology.org.au/for-the-public/psychology-topics/trauma

4. HelpGuide.org. (2024). "Emotional and Psychological Trauma." https://www.helpguide.org/mental-health/ptsd-trauma/coping-with-emotional-and-psychological-trauma

5. Newport Institute. (2024). "Big T vs. Little t Trauma in Young Adults: Is There a Difference?" https://www.newportinstitute.com/resources/mental-health/big-t-little-t-trauma/

6. National Center for Biotechnology Information. (n.d.). "Trauma-Informed Therapy." https://www.ncbi.nlm.nih.gov/books/NBK604200/

7. Charlie Health. (2023). "Types of Trauma." https://www.charliehealth.com/post/types-of-trauma-the-7-most-common-types-and-their-impacts

8. Brickel and Associates LLC. (2019). "Using 'Big T' and 'Little T' for Trauma Can Be a Big Mistake." https://brickelandassociates.com/big-t-little-t-trauma/