What is Trauma?

Over the last few years, the word ‘trauma’ has become more and more mainstream. We hear and read it mentioned in the media, by public figures discussing their mental health, in movies, music and politics. And this is undoubtedly a good thing. As with all aspects of mental health, it’s excellent to hear people discussing trauma more openly, raising awareness and admitting to the painful experiences they may have had.

But what actually is trauma? What does it mean? And why is it such an important concept to understand, if you want to grapple with and address the root causes of human suffering?

Trauma is both an experience and its effect

One of the reasons the concept of trauma can be a bit confusing is because it describes both an event and the impact of that event. For example, we would say that a bad car crash, in which you or other passengers were injured, would be a traumatic incident. So we would describe the car crash itself as a trauma.

Somewhat confusingly, mental-health professionals such as myself would also describe the effect of that car crash as trauma – this means all of the ways that the crash effected you, mentally and physically. So that could be your injuries, which in themselves might be serious or life-altering, which is of course traumatic for anyone.

And the impact on your nervous system, which might also be serious and life-altering – leading to chronic stress and anxiety, or numbing and emotional shutdown. And on your mind, in terms of the unhelpful ways of thinking about yourself, the crash or your injuries, which can cause all sorts of problems.

The clinical definition of trauma

If you asked a psychologist what they meant by trauma, they would probably say that there are two main types: single-incident trauma and complex trauma. A typical single-incident trauma would be the car crash, above. It could also be a mugging or assault, witnessing or being involved in any type of violence, a terror attack or natural disaster like an earthquake or tsunami. These events are clearly highly stressful and can overwhelm your ability to cope – you might feel so frightened that you freeze to the spot, unable to run. Or you might experience dissociation, detaching from the situation, or your body, or feeling like time has slowed right down.

This feeling of overwhelm is crucial to understanding trauma – it’s what turns a purely unpleasant experience into a traumatic one. It is also helpful to understand the difference between traumatic stress and post-traumatic stress disorder (PTSD). If we go back to the fictional car crash, it is perfectly natural to experience traumatic stress when your vehicle ploughs into another one. So during the incident (and immediately afterwards) you might feel shaken up, anxious, upset or extremely confused.

Natural healing processes

But, as with bereavement, your body and mind have all sorts of natural, hard-wired healing processes to help you cope with this kind of stress. After all, our ancestors lived in a world where they experienced scary, threatening or even life-and-death incidents on a regular basis. Their daily life involved hunting and being hunted; attacking enemy tribes and being attacked. So their mind-body system was adapted to dealing with traumatic incidents, processing them and then getting on with their lives.

We know that only around 30 percent of people in that car crash would go on to develop PTSD. There are all sorts of reasons for that, but it seems likely that most of those people will have experienced complex trauma earlier in their lives. So their systems are already highly sensitive to stress and unable to engage in the natural healing processes that most people benefit from.

In PTSD, essentially you don’t calm down once the incident is over – it’s as if you are still living through it. So if a red car hit you in your crash, seeing a red car now might trigger intense anxiety. You may have flashbacks, where fragmentary memories of the crash hit you seemingly at random. You may also be hypervigilant, jumpy, irritable, panicky (high-energy states known as hyperarousal) or feeling numb, empty, spacey, shut down and depressed (low-energy states called hypoarousal).

Complex & developmental trauma

The other main type of trauma is known as complex trauma. Unlike the one-off incidents described above, this is when you experience traumatic events on a regular basis, usually in childhood. And when this happens at key developmental stages in your childhood, it’s known as developmental trauma (sorry, no more jargon, I promise!). Complex trauma is often harder to overcome than one-off incidents, because it might have happened over and over again.

If you were a child, your coping mechanisms, stress tolerance and emotional regulation would not have fully developed yet, so you would probably have felt much more overwhelmed, powerless or threatened than an adult or even an older teenager going through the same experiences. This kind of trauma is often perpetrated by a caregiver, like your parent, sibling, uncle or grandparent, making it even more confusing and painful for your highly sensitive, developing body and mind.

Trauma on a spectrum

I believe that we should think about trauma as being on a spectrum – from milder at one end to more extreme at the other. And, as trauma expert Dr Pat Ogden states in the quote below, trauma to me means any experience that is so stressful we feel completely overwhelmed. For example, I think being bullied in school can be extremely traumatic. It may not be a single-incident trauma, like the car crash. It might not even be complex trauma, like experiencing severe neglect or abuse. But being attacked, physically or just verbally, day after day, can be highly traumatic.

“Any experience that is stressful enough to leave us feeling helpless, frightened, overwhelmed or profoundly unsafe is considered a trauma.

— Dr Pat Ogden

Other common experiences that can be traumatic include having a parent or parents who are alcoholic, drug-addicted or suffering with severe mental health problems. Bereavement, especially of a highly loved family member, friend or partner, can be traumatic. And various medical procedures can be traumatic (even if they are needed and performed with skill and care). Your body experiences being cut open as highly threatening, even if you’re sedated and unconscious.

This is not to say that every negative experience is a trauma. Some experiences are just scary or unpleasant. But the key word here is overwhelmed – any experience that overwhelms your ability to cope is traumatic, in my view.

I hope that explains this highly complex, often confusing word. If you are the survivor of any kind of trauma, I very much hope you get the help you so deserve.

Warm wishes,

Dan