The Many Faces of Trauma

We’ve talked on this blog before about the various signs and symptoms of trauma you might experience.  In that article, I referenced the difference between what I called “big T” traumas and “small t” traumas.  But how do we categorize those different events?  Maybe you’ve had the experience where something you thought was “normal” ended up having a greater negative impact on you.  What types of events can be defined as traumatic? How do different stressful life events affect how we process and deal with trauma?

“Big T” traumas

A “big T” trauma is a uniquely identifiable and significant distressing event.   You might immediately associate these type of events with post-traumatic stress disorder (PTSD).  PTSD involves a cluster of symptoms that interfere with daily life, including: exposure to a traumatic event, re-experiencing through flashbacks or intrusive thoughts, avoidance of reminders of the traumatic event, negative thoughts about self or others, and heightened reactivity.  Significant traumas such as these can lead to feelings of isolation, due to the distinctive nature of these events.  The individual who experienced this trauma may also feel a greater pull to avoid reminders of the trauma and experience a sense of helplessness over circumstances.

Recently, we’ve been faced with horrendous scenes of destruction in the wake of two major hurricanes that ripped through the southern states of our country.  It is easy to see the effects of these major events as trauma that affects the individuals whose homes were damaged or destroyed and who are now displaced.

Examples of “big T” traumas include:

• Physical or sexual abuse in childhood or adulthood

• Sexual assault

• Natural disasters

• Sudden and unexpected death of a loved one

• Witnessing the death or injury of someone else, particularly a loved one

• Domestic violence

• Robbery

• War

• Military service/combat

• Acts of terrorism

• Car or airplane accidents

“Small t” traumas

“Small t” traumas are distressing events that are smaller in scale than “big T” traumas, but often occur over a more prolonged period of time. These traumas are more persistent and subtle than the “big T” traumas, and can be just as painful as a result.  They are especially impactful for those who experience them in childhood. While typically those who have faced these types of trauma do not have enough criteria to be diagnosed with PTSD, they may experience symptoms of trauma that mimic the characteristics of this disorder.

I imagine this type of trauma like a series of waves in the ocean.  The first time the waves sweep your feet out from under you, it’s relatively easy to recover.  Once you’ve regained your footing and tried to stand, however, you find you've been knocked off your feet again as the current pushes another wave toward you.  Before long, you become exhausted by the process of trying to stand up to the current.  "Small t" traumas are often minimized by the individuals who are facing them because they do not carry the label of a significant trauma, but this persistent nature is just as impactful as the “big T” traumas.

examples of “small t” traumas include:

• Betrayal/infidelity by a spouse

• Emotional abuse in childhood or adulthood

• Non life-threatening injuries

• Family or work conflict

• Bullying or harassment

• Divorce

• Loss of a significant relationship

• Sudden relocation/moving

• Legal issues

• Loss of a job

• Financial distress/poverty

• Being the child/spouse of an addict or individual with mental illness

• Ongoing parental criticism

• Parental disconnection and disengagement

Life Stressors

Sometimes even positive life experiences can create increased stress levels that lead to distress or anxiety and compound the symptoms associated with a more major trauma.  The Holmes and Rahe stress inventory is a measurement used to identify how some stressors (which can be either “small t” traumas or positive events that created a pattern of stress) may be affecting you today.  The interactive survey here helps you to identify how stressful life events have impacted you this past year.

Examples of significant life stressors include:

• Planning a wedding/getting married

• Starting a new job

• Moving across the country

• Having/adopting a child

• Holidays

Each of these traumatic or stressful situations is handled uniquely by different people.  How you respond to trauma is related to your predisposition and personality.  However, one factor that has been shown to affect the experience of traumatic symptoms is avoidance.  The more a person avoids the traumatic experience, the more likely they are to integrate that trauma into their psyche and have a harder time recovering.  Instead of choosing to avoid the pain , allow yourself to feel impacted by it and seek the help you need.  These traumatic events can be painful, and they deserve care and compassion.

What are some of the experiences listed above that have caused trauma in your own life?  How are you coping with that trauma?

Am I Going Crazy? Seven Signs of Trauma and Post Traumatic Stress

Here you are again.  It’s 2am, and you’ve woken up in the middle of the night after disturbing nightmares.  You don't really remember what happened, but you're still feeling deep and intense fear.  You can’t fall asleep again, and your mind is racing with anxious thoughts.  Why am I up in the middle of the night again?  What happened to me wasn’t even that bad, people have had much worse things happen to them.  I mean, it probably was partially my fault anyway.  There must be something wrong with me.

You hear the sound of a siren or a car alarm on the street outside your house and you jump back, startled.  Suddenly, an image flashes into your head of discovering your husband’s betrayal.  Your emotions do a complete 180, and you’re furious.  Adrenaline is coursing through your veins, your heart starts to pound, and you feel wide awake, like you could jump out of bed and run a marathon.  Seriously?  I am sick of everyone trying to blame me for the things he’s done.  You would yell and scream and throw things too if you found out your husband was cheating on you with multiple women. You feel sick to your stomach.

Finally, exhausted by this burst of adrenaline, you curl under the covers of your bed and the tears begin to fall.  What is happening to me?  Eventually your sobs slow down and lull you back into fitful sleep.

Experiencing the effects of trauma can be disorienting, distressing, and lonely.  You might look at your reactions and feel as though you are crazy.  In the dictionary, trauma is defined as a deeply distressing or disturbing experience.  As psychologists, we define trauma as “an emotional response to a terrible event like an accident, rape, or natural disaster,” which is accompanied by several short and long term effects.

But this definition limits our understanding of trauma.  Yes, events such as abuse, violence (sexual or otherwise), tragic accidents, and serious injuries are major traumas that cause lasting effects, and are what would be explained by counselors as “big T” traumas.  Yet oftentimes people experience smaller-scale traumas that accumulate over time, or what we would call “small t” traumas.  These include such events as effects of divorce, emotional abuse, complicated grief, betrayal in the form of an affair or sexual addiction, or various other events.  These events can have similar traumatic effects and symptoms of a major trauma. 

What are some indicators that you might be having a response to trauma?

You witnessed and were impacted by one or more distressing events.

It may be clear to you that you have experienced a traumatic event.  "Big T" traumas are often easy to discern and connect to your symptoms.  However, you may have a tendency to minimize the impacts of "small t" traumas as you compare them to the pain of more major traumas.  I’ve often heard minimization of emotional abuse in families or the impact of divorce simply because it was considered to be “normal” in your family.  If you experience symptoms of trauma but aren’t sure why, spend some time with a counselor or trusted friend talking through your past experiences to get a reality check on how normal they actually were.

Vivid imagery of the traumatic event pops into your mind at the least convenient moments.

When you’re out driving in your car, spending time with friends or family, or even in the middle of the night in the form of a nightmare, you can be tormented by vivid memories of the traumatic event.  Not only do the images arise, but they often leave an emotional mark on you as you experience intensity of emotion similar to when you were experiencing the trauma.  Often trying to push away the images or stop thinking about it doesn’t work: attempts to ignore the thoughts only serve to intensify them.

Your emotions are intense and shift rapidly between anger, fear, sadness, numb, and everything in-between.

Mood swings are incredibly common in trauma, as the traumatic re-experiencing can trigger a storm of negative emotions.  One second everything is fine, and the next, you're a puddle of tears on the floor.  You could become easily irritated or annoyed, being harsh with your loved ones.  At times, it can feel like you’re completely disconnected and cannot access emotion at all.  This intense fluctuation of emotions can be bewildering and seem to prove the mistaken belief that you're crazy.

You’re more suspicious and startle easily.

Prior to the traumatic experience, you may have never thought twice about walking down the street alone in the dark, sleeping in your house by yourself, or your husband’s late nights at work.  Now that the trauma has happened, however, these events take on a new component of fear and worry.  You might notice yourself becoming jumpy or on edge, reacting strongly to unexpected loud noises or events. 

You’re isolated and withdrawn from your friends and activities you used to enjoy.

Often the painful emotions that accompany traumatic events lead you to withdraw from relationships.  You might avoid friends or loved ones because you worry they won’t be able to understand what you went through.  They might ask about how you’re doing, but you don’t want to talk about it anymore.  Your energy levels are likely much lower, so you may lack motivation or energy to do the things you used to love to do.

While you were once confident, now your self-esteem is crushed.

Shame is often a major component of trauma, either in the form of blaming yourself for the event or experience, or receiving messages about yourself from the event that have left you questioning who you are.  According to Bréne Brown, shame is the intensely painful experience of believing that we are flawed and therefore unworthy of love and belonging.  Experiencing shame in connection to a traumatic event can be confusing, especially if you’ve had a strong sense of self prior to the experience.

All you want to do is stop thinking about what happened, so you avoid reminders.

You might stop going to a certain restaurant or area of town where you experienced the traumatic event.  You may have discovered your husband’s betrayal by viewing his browsing history, so even opening your computer may trigger that twinge of fear.  Being in your childhood home can bring to mind memories of emotional abuse, so you avoid even visiting your hometown.  If you notice yourself going out of your way to avoid certain situations or people, you might still be reeling from a trauma you experienced.

Do any of the above statements describe you?  If so, be kind and caring toward yourself and get the help you need.  Seek out a counselor who works with trauma to help you on your path toward healing.