What is Trauma and How Does it Impact Us?

The word “trauma” has become a lot more common in the average person’s vernacular today, used in terms like “trauma dump” and “trauma bond”. Unfortunately, the term is sometimes being used colloquially and inaccurately, like when people say “I have OCD” because they are neat, or “she is bipolar” because someone experiences oscillation in mood. Thus, it’s helpful to understand what trauma is, and how it impacts us physically, emotionally, cognitively, and interpersonally.

What is trauma?

Trauma is addressed in the in the DSM, the Diagnostic and Statistical Manual of Mental Disorders, referring to “exposure to actual or threatened death, serious injury, or sexual violence” via direct exposure, witnessing an event, learning about an event that happened to someone close, or repeated exposure to traumatic material, also referred to as vicarious trauma (American Psychiatric Association, 2013). However, the term can encapsulate so much more.

In the field of psychology, there is sometimes a differentiation between “Big T” and “little t” trauma. Oftentimes, when people think of the word trauma, they think of a one-time incident, like a car crash, assault, or a natural disaster. However, a lot of trauma is interpersonal in nature, like domestic violence, emotional abuse, and the like. “Big T” trauma refers more-so to acute, major events, like these one-time events mentioned above. “Little t” trauma generally refers to chronic, repeated negative experiences, like bullying or emotional/physical neglect. Notably, both types of trauma can be registered in the body in the same way.

What is complex trauma?

Complex trauma, also referred to as chronic trauma, refers to repeated, often interpersonal trauma, which may result in complex PTSD. Examples of complex trauma might be long-term emotional abuse or neglect by caregivers, domestic violence in a relationship, or experiencing repeated racism and microaggressions.

Survivors of complex trauma often minimize and dismiss what they went through, and do not consider their experience to be “traumatic” at all. In the case of emotional abuse or neglect, survivors may have had their reality and emotions invalidated, making it difficult to understand how they feel and manage their emotions. Thus, these individuals might experience their emotions as overwhelming, painful, or paralyzing.

How can trauma impact us?

Experiencing trauma, no matter in what form, has been shown to impact us on a multitude of levels, including physically (how our body responds to a perceived threat), emotionally (how we experience, identify, and cope with our emotions), cognitively (our beliefs about ourselves, others, the world, our future, and more), and interpersonally (Dye, 2018). 

Physically           

Experiencing trauma and fear puts our body into a heightened state of fight or flight. However, in recent years, research has shown that our bodies also might respond with freeze or fawn (Owca, 2020). When we feel safe, our parasympathetic nervous system is active and our body feels at ease, allowing for digestion, slowed heart rate, and relaxed muscles. Conversely, in response to a threat, our sympathetic nervous system is activated, preparing our bodies to survive via whatever means necessary: fighting, running away, playing dead (freezing), or appeasing a potential assailant.

While fight, flight, and freeze are fairly self-explanatory responses in the face of threat, one that may warrant more explanation is the “fawn” response. When individuals are exposed to repeated interpersonal trauma and abuse, or even a figure in their household who takes up a lot of emotional space, they may have learned that the safest way to manage interactions this person was to “fawn”, ingratiating themselves or offering excessive flattery in order to placate and soothe this figure. Thus, these individuals learn that in the face of conflict, the best way to survive and create peace is to pacify others; these people might be characterized as “people pleasers”.

When we have experienced trauma, either chronic or a single event, it becomes easier for our trauma responses to become activated. For example, for people who have experienced a car crash, their bodies might freeze up or their heartrate might dramatically increase at the prospect of getting into a car. Adults who grew up in a chaotic household with an alcoholic, narcissistic, or emotionally abusive figure may react with the “fawn” response in the face of their partners becoming upset, a coping mechanism they learned to try to keep peace at home.

An important aspect to note is that our physical responses are automatic and not of our volition; our body is simply reacting in the best way it knows how in order to try to create safety.

Emotionally

Trauma often negatively impacts our ability to understand, regulate, and communicate our emotions to others. In the context of an acute trauma, survivors may experience negative affect (e.g. depression, anxiety, guilt, irritability), heightened emotional intensity, and difficulty managing these feelings, leading to feeling “out of control”.

Interpersonal trauma, such as sexual assault, emotional abuse from caregivers, or domestic violence dynamics, have been found to have a stronger association with emotion regulation difficulty than non-interpersonal traumas; furthermore, as both the frequency and severity of trauma exposure increases, so does the difficulty with managing emotion (Ford et al., 2006). When people have their experience questioned, like with invalidation or “gaslighting”, it often causes confusion. For example, if a young child says to her mother, “Mom, I’m feeling sad”, and the mother responds with, “Oh, you’re not sad – you’re just tired – you need some sleep”, the child will then question whether that “sad feeling” is actually sadness or being tired. Furthermore, the child is receiving the message that their sadness is unacceptable and must be fixed by sleep or another solution, which can lead to emotional avoidance and repression. Unfortunately, resistance to uncomfortable feelings is quite common and is associated with negative outcomes, like poorer relationships and, paradoxically, and increase in intensity and length of experiencing these emotions (Chervonsky & Hunt, 2017; Dalgleish, 2009). Thus, survivors of trauma often have difficulty trusting their own experience, as well as handling emotions when they arise.    

Cognitively

Our experiences throughout life teach us about the world and what to expect. When we experience trauma, our beliefs are impacted; the world can appear to be a dangerous place, leading to isolation or difficulty trusting. Furthermore, experiences of trauma, especially when unprocessed, may arise in various forms, like in nightmares, intrusive thoughts, or flashbacks.

It is important to acknowledge that experiencing trauma often impacts memory. Many survivors of trauma report difficult remembering details of trauma, including timeline of events, and often question whether these events occurred at all (Barry et al., 2018). Doubting whether the trauma occurred, its cause, and the details impedes the process for healing, as it is difficult to unpack and process something when we do not understand it.

Similarly, survivors often report difficulty with attention in later years, which may result from a common trauma coping mechanism: dissociation. In this case, individuals often had to “leave” their experience while not being physically able to do so (like a child who is dependent upon an emotionally abusive caregiver and cannot survive on their own), so disconnect from reality via dissociation, which may look like being “spaced out”. When we are disconnected from reality and our body, we are not able to properly attend to our environments and to encode memories – so we often do not remember what happened properly (Kaplow et al., 2008).

Furthermore, experiencing trauma may lower the threshold for what feels like a threat, as well as alter our perception and sense of danger. For example, individuals who experience childhood sexual abuse commonly experience sexual abuse again in later life, a phenomenon known as revictimization; one study demonstrated that almost half of survivors of childhood sexual abuse experienced revictimization (Walker et al., 2019).

Interpersonally 

Trauma may have far-reaching effects on relationships, especially when the trauma itself was interpersonal in nature. Experiencing trauma can be an overwhelming experience, sometimes leading to feelings of shame, secrecy, and isolation. In fact, research shows that having trusted people in our life with whom we can share and process traumatic material can often make the difference between developing negative symptoms or not (Fredette, 2016). 

Trust itself is one of the areas most impacted by experiencing interpersonal trauma, especially when it occurred during childhood. For children who ought to have been able to rely on caregivers for emotional and physical safety but were not able to, it becomes difficult to discern who is trustworthy at all. Furthermore, trauma survivors often turn on themselves, questioning how they “let” something like this happen, or are critical of how they end up in similar situations, subsequently wondering how they are able to trust themselves. Much of therapy for trauma survivors involves understanding how to trust themselves, how to figure out who is worthy of trust, and how to feel safe with others.

Post-Traumatic Growth and Resilience

Notably, experiencing a traumatic incident does not guarantee adverse impact nor posttraumatic stress disorder; in fact, some individuals have been shown to experience what is referred to as “posttraumatic growth”, which refers to the experience of a positive life change after struggling with a stressful challenge (Tedeschi & Calhoun, 2004).

Many individuals who experience traumatic incidents find that they are able to make meaning and grow emotionally after experiencing trauma, especially with proper support. For example, a survivor of a domestic violence may seek refuge with friends and family after leaving the relationship, talking as much or little about what it was like to be in that dynamic and what they have learned about themselves and their ability to persevere.

Treatment

Luckily, trauma treatment is constantly evolving. Working with a trauma-informed therapist can help survivors better understand what they have experienced and how it has impacted them, which can include processing traumatic incidents that may have not been thoroughly integrated yet.

There are multiple types of specific trauma therapy, including Prolonged Exposure, EMDR, Cognitive Processing Therapy, Narrative Therapy, as well as different types of therapy, like interpersonal or acceptance-based therapies, that might help alleviate specific symptoms, like shame or difficulty trusting. It can be hard to know where to start!

Above all, finding a trusted provider whom you feel you can count on to guide you through the various stages of healing is of pivotal importance. Feeling safe with someone, especially after experiencing trauma, as well as working with a therapist who will take it at a reasonable pace and make sure that you are integrating and okay along the way, is crucial. Once you feel safe with a therapist, you can begin to explore (with their support) your experiences in a way that helps you to better understand, accept, and move towards the life that you want to build. 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Barry, T. J., Lenaert, B., Hermans, D., Raes, F., & Griffith, J. W. (2018). Meta‐analysis of the association between autobiographical memory specificity and exposure to trauma. Journal of Traumatic Stress, 31(1), 35-46.

Chervonsky, E., & Hunt, C. (2017). Suppression and expression of emotion in social and interpersonal outcomes: A meta-analysis. Emotion, 17(4), 669–683.

Dalgleish, T., Yiend, J., Schweizer, S., & Dunn, B. D. (2009). Ironic effects of emotion suppression when recounting distressing memories. Emotion, 9(5), 744.

Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392.

Ford, J. D., Stockton, P., Kaltman, S., & Green, B. L. (2006). Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women. Journal of interpersonal violence, 21(11), 1399-1416.

Fredette, C., El-Baalbaki, G., Palardy, V., Rizkallah, E., & Guay, S. (2016). Social support and cognitive–behavioral therapy for posttraumatic stress disorder: A systematic review. Traumatology, 22(2), 131.

Kaplow, J. B., Hall, E., Koenen, K. C., Dodge, K. A., & Amaya-Jackson, L. (2008). Dissociation predicts later attention problems in sexually abused children. Child abuse & neglect, 32(2), 261-275.

Owca, J. (2020). The Association between a Psychotherapist’s Theoretical Orientation and Perception of Complex Trauma and Repressed Anger in the Fawn Response (Doctoral dissertation, The Chicago School of Professional Psychology).

Tedeschi, R. G., & Calhoun, L. G. (2004). " Posttraumatic growth: conceptual foundations and empirical evidence". Psychological inquiry, 15(1), 1-18.

Walker, H. E., Freud, J. S., Ellis, R. A., Fraine, S. M., & Wilson, L. C. (2019). The prevalence of sexual revictimization: A meta-analytic review. Trauma, Violence, & Abuse, 20(1), 67-80.