Trauma: Definition, Response, & Symptoms
Trauma is your body’s response to an experience that overwhelms it and may even put your life at risk. How do we respond to, and heal from, trauma?
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Many therapists—including me—like to talk with clients about their “window of tolerance.” This is the idea that there is a range of experiences and sensations we can have and still feel regulated and safe. When we have more intense or extreme experiences, they may take us outside of our window of tolerance. What happens then? Some of us might have a meltdown, lash out physically or verbally, binge a television show, or turn to drugs or alcohol to cope. |
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What Is Trauma? (A Trauma Definition)
To illustrate why this distinction matters, here’s a story of a traumatic event. Fair warning: It is somewhat gruesome. Perhaps five or six years ago, someone I know from growing up—let’s call him Francis—witnessed a murder. He was in the library of the quiet suburban town I grew up in, working on a project near some other patrons. A young man (who was later found to be experiencing a psychotic break and deep in delusional thinking) came into the room where Francis was studying and repeatedly stabbed a young woman who had rejected his romantic advances. Having attacked her, the young man wandered out into the rest of the library, where Francis and another library patron, in an absurd display of courage, cornered the young man until the police arrived and subdued him, the knife still in his hand.
Aside from scheduling a few extra sessions with his long-standing therapist—and being somewhat shaken up for the next couple days—Francis did not experience a great deal of distress after the event. He certainly never developed the full-blown symptoms of posttraumatic stress disorder (PTSD), which we will discuss more in just a bit. Why not? Although Francis was definitely afraid in the moment, he responded to the assault with decisive action. As we shall see, whether or not a person develops a traumatic response to an upsetting event depends in part on how much agency they were able to exercise in the moment (Keane et al., 2006).
Causes of Trauma
There cannot be trauma without one or more events that generate a response in us, but it may be the intensity of our response that ultimately determines whether the event registers in our bodies and minds as trauma (van der Kolk, 1996). Considering again Francis’s situation, suppose he had frozen in the moment and done nothing, had tried in vain to help the woman who was stabbed, or had been attacked and injured by the murderer. In each of those circumstances, he would probably have felt much more threatened or helpless, and therefore he might have been more likely to develop a trauma response.
Experiences of overwhelming fear and helplessness, as well as extreme pain or injury, are very, very hard for our brains and bodies to integrate into our sense of the world (van der Kolk, 1996). They typically upend our preexisting notions about how the world works, and the natural response of our bodies is to repress these incredibly painful memories. It is simply too disorienting and disruptive to fully face what happened, so we do our best to forget that it did in the first place.
How does this play out in real life? Nearly everybody experiences intrusive thoughts after a traumatic event (van der Kolk, 1996). Many people—and Francis is fortunate to be among them—can integrate those thoughts and feelings; they are able to gradually accept what transpired and adjust to the new reality they live in. When people have a traumatic response, it is because this integration does not happen. Instead, they try to resist the traumatic memories while simultaneously experiencing those memories as increasingly more intrusive and distressing. As so many therapists like to say, “That which you resist, persists.”
This tendency to want to repress and forget traumatic events has been documented throughout much of human history (Keane et al., 2006). It seems to be a very natural response, and it is effective in the short term because the traumatized person experiences less distress when they repress the memories. But it is ineffective in the long term because over time it becomes harder and harder to repress the memories. Only recently has this been fully recognized by psychologists and historians, with men’s traumatic responses to war and women’s traumatic responses to sexual assault being some of the first traumas to be scientifically studied.
As researchers learn more about trauma, they realize that it often starts at a very young age. Unfortunately, this sensitizes the developing brains of children to experience more distress in subsequent potentially traumatizing events. To learn more about how trauma develops in childhood, I recommend watching this video:
Video: Childhood Trauma and the Brain
Trauma & Family Systems Therapy
When anybody experiences trauma, the effects almost inevitably ripple out to touch the people around them. Thus trauma is often at the heart of difficulties in families. This is because traumatic events and patterns are often kept secret in families (Abrams, 1999), and the effects are passed down or grow over generations.
Let’s take as an example when there is sexual abuse between family members. To most anybody, this would be a fairly intolerable truth to face: It rearranges their understanding of the family system and maybe of the world at large. Rather than deal with that reality, many families deny or repress what has happened (Abrams, 1999). Resolving trauma on a family level means bringing the whole family into contact with what happened and leveraging the relationships to heal and achieve closure (MacKay, 2012). Often this means changing the level of closeness between family members, as managing family-related trauma has often required people to be closer or more distant than is healthy for them.
What Is a Trauma Response?
A trauma response is when people have mental and physical symptoms related to past traumas because something in their current environment is reminiscent of the traumatic event(s). This is a behavioral pattern that is thought to be an adaptive response taken to a maladaptive extreme (Baldwin, 2013). We need our bodies and brains to recognize and respond to threats, but some events are so threatening that we become overly sensitized to those threats and things that remind us of them. Therefore, an event that seems to contain very little actual threat can evoke an outsized response from somebody who has been traumatized.
What Is Trauma Dumping?
What Is Posttraumatic Growth?
Healing From Trauma
Cognitive behavioral therapy incorporating exposure therapy is the most well-validated form of therapy for PTSD (Kar, 2011). The point of exposure therapy is not to torture the person who has been traumatized but to give them experiences of successfully surviving their traumatic response symptoms and not being as overcome as they might have feared, as well as using coping skills to manage those symptoms. At the same time, other aspects of healing from trauma include learning how to regulate one’s breathing, the practice of similar relaxation techniques, and cognitive-behavioral techniques such as cognitive restructuring.
Psychology of Trauma
What influences our likelihood of developing PTSD? Some people might be more susceptible to this kind of response to an extreme event in the first place (Keane et al., 2006) thanks to different biological and psychological factors, and much hinges on the nature of the traumatic event as well. One’s lived experience during the event itself—the thoughts one has, the degree of dissociation and attempts to take action—also powerfully inform how the event affects one after it has passed. All of these factors influence the meaning-making that takes place in the weeks and months after an event (McNally, 2003).
What Are Trauma Symptoms?
Trauma symptoms and PTSD often co-occur with other mental health diagnoses such as anxiety and depression, personality disorders, and substance use (Baldwin, 2013). People with trauma often have physical symptoms as well, such as chronic pain. Thus people who have been through trauma may experience any number of symptoms.
What Is Trauma-Informed Therapy?
Trauma-informed therapy is any therapy that takes into account how frequently occurring and personally affecting trauma experiences are (Berliner & Kolko, 2016). The term “trauma-informed” is broadly used to describe any kind of intervention or practice that operates from this awareness that trauma is ubiquitous and likely impacting many or most people around you.
Quotes on Trauma
- “Trauma fractures comprehension as a pebble shatters a windshield. The wound at the site of impact spreads across the field of vision, obscuring reality and challenging belief.” — Jane Leavy
- “If you get an infection, you get a fever; the fever is your body dealing with the infection. If you get traumatized, your mind and your brain have a reaction to that trauma. If you’re not dreaming about it, something’s probably wrong.” — Sebastian Junger
- “Trauma is a fact of life. It does not, however, have to be a life sentence.” — Peter Levine
- “Trauma happens in relationships, so it can only be healed in relationships. Art can’t provide healing. It can be cathartic and therapeutic but a relationship is a three-part journey.” — Alanis Morissette
- “I am often asked how I can work with a subject as morbid as trauma without becoming burned out or depressed. My answer to this question is that witnessing the transformation that takes place in people when they master their traumas has proven to be a deeply sustaining and uplifting experience in my life.” — Peter Levine
Articles Related to Trauma
Books Related to Trauma
Final Thoughts on Trauma
Trauma is a common human experience, and it is eminently treatable. If you or someone you know is struggling with reactions to traumatic events, I hope this article has both normalized the experience and indicated that effective treatment is available.
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References
- Abrams, M. S. (1999). Intergenerational transmission of trauma: Recent contributions from the literature of family systems approaches to treatment. American Journal of Psychotherapy, 53(2), 225–231.
- Baldwin, D. V. (2013). Primitive mechanisms of trauma response: An evolutionary perspective on trauma-related disorders. Neuroscience & Biobehavioral Reviews, 37(8), 1549–1566.
- Berliner, L., & Kolko, D. J. (2016). Trauma informed care: A commentary and critique. Child Maltreatment, 21(2), 168–172.
- Henson, C., Truchot, D., & Canevello, A. (2021). What promotes post traumatic growth? A systematic review. European Journal of Trauma & Dissociation, 5(4), 100195.
- Kar, N. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric Disease and Treatment, 7, 167–181.
- Keane, T. M., Marshall, A. D., & Taft, C. T. (2006). Posttraumatic stress disorder: etiology, epidemiology, and treatment outcome. Annual Review of Clinical Psychology, 2, 161–197.
- MacKay, L. (2012). Trauma and Bowen family systems theory: Working with adults who were abused as children. Australian and New Zealand Journal of Family Therapy, 33(3), 232–241.
- McNally, R. J. (2003). Psychological mechanisms in acute response to trauma. Biological Psychiatry, 53(9), 779–788.
- van der Kolk, B. A. (1996). The complexity of adaptation to trauma: Self-regulation, stimulus discrimination, and characterological development. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society (pp. 182–213). Guilford Press.
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