Trauma Defined: How Do I Know If I Have Trauma?
When defining trauma, psychologists get more specific by separating experiences into three categories:
Trauma exposure
Trauma response
Ongoing trauma symptoms
When people think about trauma, a variety of explanations come to mind. Part of the reason there are so many different definitions of trauma - and part of the reason I do this podcast - is because society has generalized this word to the point where it is now unclear and all-encompassing.
I wanted to dedicate this blog to going back to the basics and orienting ourselves on trauma, the definition of trauma, what it means when someone says they have trauma, and how it presents for most survivors.
When people think about trauma, a variety of explanations come to mind. Part of the reason there are so many different definitions of trauma - and part of the reason I do this podcast - is because society has generalized this word to the point where it is now unclear and all-encompassing.
I’ll dive deeper into how and why that has happened and why that can be problematic, but for now, I want to start by defining trauma, and I’m going to do so from a psychological/science-based discipline perspective.
In psychology, we don’t use the word trauma the way the general public does as a way to describe any and everything uncomfortable or distressing. When people say something along the lines of “I have trauma,” they can mean several things.
3 Stages of Trauma Reaction
When defining trauma, psychologists get more specific by separating experiences into three categories:
Trauma exposure
Trauma response
Ongoing trauma symptoms
How our diagnostic manual defines traumatic exposure - according to our collective body of research - is exposure to an actual or threatened death, serious injury, or sexual violence, and this exposure occurred in a number of ways.
Typically, people refer to trauma symptoms when they say they have trauma or use it as an umbrella statement for all three of those categories.
Another common phrase people may use is “That was traumatizing” for things that may not actually fit the definition of trauma.
Let’s get down to the nitty-gritty!
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Trauma Exposure
Trauma Exposure is, simply put, exposure to a traumatic event.
Many people disagree on what constitutes traumatic exposure. They jump in and make claims about what incidents meet the criteria for being traumatizing.
Essentially, this sets up this conversation of what is “bad enough” to be considered traumatizing. The first thing I want to do when defining trauma is take this concept out of the conversation.
Trauma does not always happen because an experience is really bad, and less bad things are not trauma. Trauma is a psychological injury that occurs, and many experiences can be awful or distressing due to other response systems in the body that are not trauma.
When we argue about what trauma is, many professionals worry that we’re invalidating people’s pain. Something important to keep in mind is that all pain is valid, and all experiences are important to look at, honor, and respect.
Just because pain may not equal trauma does not necessarily mean that pain is not legitimate, valid, or worthy of getting help and support.
Pain does not have to be trauma to warrant getting support.
“Exposure” just means the experience has happened to you. “In a number of ways” means directly experiencing it, witnessing the events in person as they happened to somebody else, or learning that the traumatic event happened to a close family member or friend. The last exposure is common with parents, caregivers, siblings, and partners.
When talking about “traumatic death” or “near death,” this isn't your typical end-of-life death. It’s a death that happened in an accident or due to some kind of violence.
End-of-life death or death at the end of a terminal or chronic illness is considered to be very normative and doesn’t actually activate a trauma response.
Even though they can be highly distressing, these deaths launch us into grief patterns where we can then have complicated grief patterns, delayed grief, etc.
Another type of exposure to trauma is experiencing repeated or extreme exposure to aversive details of a traumatic event, for example, first responders who arrive on the scene of something traumatic, EMTs who treat the victims, ER doctors, social workers working with abuse cases, therapists and psychologists working with their clients, etc.
Repeated exposure to trauma that happened to somebody else, particularly in moments where it’s high intensity/high crisis where there’s a certain amount of psychological vulnerability, like in therapy sessions, can activate a trauma response as well.
It’s important to note that exposure to a traumatic event does not apply to watching an event happen on TV, movies, or seeing pictures unless it is work-related - i.e., viewing these things as part of an investigation.
This rule of thumb, however, comes under fire when discussing the events of 9/11.
There were a lot of people across the U.S. who reported having a trauma response to this attack and who only viewed the footage via the news. Likely, what we’re seeing in this situation is that, in addition to the terrorist attack and the emotions evoked by such an event, there was severe and repeated exposure of the footage.
These different terms constantly evolve and continue to be revised as we grow and understand trauma more through research.
A lot of people argue that trauma is in the eye of the beholder - if it was traumatic to you, then it was traumatic. This begs the question, “What does traumatic really mean?”
Typically, we mean it elicited a trauma response.
What Are the 4 Types of Trauma Responses?
A trauma response is our instinctual fight, flight, or freeze response and is a very normative and crucial system we were born with.
Let’s use a car accident as an example. This is a reasonably standard exposure to a traumatizing event, as almost everyone experiences a car accident in their lifetime. Not many people will suffer trauma symptoms as a result of a car accident.
We will likely experience the event, and our bodies will respond with either fight, flight, or freeze in some capacity. Then, it will resolve over time. This process is how our bodies are built to respond to traumatic events.
We are animals meant to survive in the wild, which means surviving multiple life-threatening events daily. Our response system is set up with a natural resolution that enables us to move on.
The trauma response (fight, flight, or freeze) is the symptom that our body experiences emotionally, physiologically, and sensory-motor-wise to prepare us to neutralize the threat.
Let’s discuss each response!
The fight response is exactly as it sounds - our body prepares to fight off whatever the threat is.
This response is reserved primarily for when we consider the threat too close in physical proximity to successfully run away, AND we are physically capable of fighting off that threat.
Our body and mind make this judgment very quickly.
When the threat is too close in physical proximity, where fleeing or fighting is not possible, or we’re not skilled enough to fight the threat off, or fighting the threat is potentially more damaging, our body will activate the instinctual freeze response.
This response is common in instances of sexual assault, as the threat is very physically close to the survivor, and the threat itself is often something or someone that could be damaging to fight off.
What’s hard is that survivors (and the public who don’t understand the complexities of trauma or sexual violence) will frequently shame and blame themselves for not having fought their assailant off or attempting to run away.
It’s important to remember that this part of our brain is focused on one thing only: survival. Our brain will try to keep us alive no matter what it takes to get there, even if that means freezing until the incident is over.
Our brain prioritizes survival, not cultural pressure.
Freeze response can often feel like dissociation.
Dissociation is when we are not entirely in touch with what our body is experiencing in the present moment. Sometimes, we can dissociate completely, which is when we’re entirely out of our body. Some individuals dissociate partially, which leaves them somewhat aware.
Our bodies and minds are shutting down any effort to fight or flee because that will not help us in that moment.
There’s something that feels very graceful about that. The brain is set up to try to spare you some of the pain of facing the horror of what’s happening until later so you can preserve energy to fight back.
There is a lot of wisdom in the freeze response because it prevents further physical harm, enabling you to escape the predator or threat afterward. Once the assault ends, we typically move into either fight or flight.
This can also be the point where the lesser-known fawn or befriend response occurs. The brain instinctively understands that you must make nice to escape the threat. Unfortunately, this response can also confuse survivors and those around them.
The third response is flight or flee. The body and mind may prioritize this response if they feel the likelihood of getting away is high.
You may suddenly feel the need to run and get help as soon as possible, and this response comes on quickly.
For example, when driving and a car swerves into our lane, we instinctually swerve to escape it very quickly. This is that flee response at work. Our body is making the choice to get out of the way.
The thing to keep in mind when these responses get activated is they are instinctual.
Our brain stem region activates, where the fight, flight, or freeze responses house. The brain stem region is a more primitive part of our brain, so it remains unchangeable and will activate quickly and automatically.
It also happens without us consciously thinking about it. This is because our bodies know they can’t pause and problem-solve the best solution when a threat is approaching. It understands that you just need to act, so we go through those animal instincts without thinking about them, and we don’t always get to choose what that response will be.
When trauma is happening, and our responses kick in, we’ll notice our conscious thought is not clear, we’re acting from almost complete instinct, and our senses constrict.
During this process, we’re not in a place where we can gather information to learn about what’s happening or who’s doing it. This can be difficult when attempting to report what happened, and we can’t recall any details.
Ultimately, a trauma response is the activation of our survival skills.
Once we have resolved the situation, neutralized the threat, and the experience is over, in most cases, we’ll feel a resolution. We’ll feel the symptoms come down and calm down.
The adrenaline will begin flowing away, and some shaking may occur. Your body may go into what some describe as “shock,” where you’ll feel your senses more, and you may feel pain from any injuries you endured.
When this happens, the rest of our brain also returns online. Our consciousness, cognitive thinking, and emotional processing activate once again. This is often when we feel the fear, terror, sadness, and anger around what happened. Many people get very tired during this time.
It is also common for some symptoms to linger.
Example of Trauma Response
For example, if you were in a car accident, you might still find it difficult to drive by the spot where the accident happened. If somebody attacked you at school, your anxiety might still spike every time you walk by that area or when you see people who witnessed what happened, etc.
This is very normal. Usually, over the course of a couple of weeks, these symptoms come down.
What happens in the case of someone having ongoing trauma symptoms or “being traumatized” by an event is when those symptoms linger and we get stuck in that response.
Being stuck in these responses changes how the brain operates in our environment. This is why we call it a psychological injury.
When feeling activated by a perceived threat persists longer than a month, that’s when we would consider someone having ongoing trauma.
When we come back to trying to define trauma, there are a few definitions that float around that I believe are unspecific and problematic.
One common definition, especially amongst mental health professionals, is referring to something as a Big-T-Trauma or a Little-T-Trauma.
What is Big T Trauma?
Big-T-Traumas are the experiences like sexual assault, physical attacks, abuse, near-death experiences, violence, etc.
Little-T-Trauma is used to describe upsetting or distressing experiences, like attachment ruptures that contribute to shifts in the way we perceive ourselves in relationships down the road.
What I think is problematic is that people who have a cluster of those “Little-T-Traumas” or experienced multiple occurrences of invalidation, attachment ruptures, betrayal, upsetting breakups, etc., start to believe they’ve suffered trauma, when they’re actually unable to recover from distress.
These individuals tend to seek out inappropriate treatment for what they need.
The expansion of the definition of trauma has gained traction, mainly due to social media, but mental health professionals have unfortunately laid the groundwork for that to happen.
We’ve seen studies come out and demonstrate that people who define trauma in this expanded way (anything negative that happens to you is traumatic or anything that overwhelms your nervous system) are harmful.
It’s expected that when trauma happens, there is distress, but there are also a lot of other things that cause distress that are not traumatic, and traumatization doesn’t happen as a result of it.
We see that people who believe that anything upsetting or overwhelming is trauma show signs of launching into crisis much quicker. They do not resolve after crises, are less able to manage instances of distress, have more frequent instances of distress, and are more likely to have increased episodes of distress in response to environmental issues.
Ultimately, what we see with people who have this expanded definition of trauma are less resilient and are more likely to enter into psychological crises in response to events.
This is a problem.
Our efforts to help people have led to them having more and more mental health issues simply by us attempting to generalize what trauma is.
People who have this more specific definition of trauma, which is in alignment with our diagnostic manual and the research and science that guides psychology, are actually much more resilient.
They can respond to crises and stressful events much more effectively, recover quickly, develop skills, and symptoms of distressing events do not linger for them. These individuals have more psychological resources as well.
The other thing that I’ve seen floating around is this idea that trauma is in the eye of the beholder. More specifically, I see videos on the internet about specific characteristics being “trauma responses.”
The problem with this is that we end up pathologizing normal behaviors. This means we call normal behaviors symptomatic or indicators of sickness.
When we pathologize ordinary experiences and behaviors, we communicate that things that are not indicators of problems are actually issues.
People believe they have a problem and seek help they don’t need, which increases their distress.
This over-pathologization also communicates that unless something is trauma, it doesn’t warrant intervention, and that is absolutely not true.
Part of the argument I hear from my fellow mental health professionals and people online is that they generalize the definition of trauma to whatever the client says is trauma out of an effort to validate somebody’s experiences.
This is doing more harm than good and is precisely why the definition of trauma is something we need to be very specific about.
Validation is crucial, but validating something invalid is hugely unhelpful. This increases chronic dysregulation and difficulty with accurate emotional expression.
When we validate the invalid, we also communicate that the valid is invalid.
We’re denying the truth that somebody’s non-traumatic pain is worth hearing, intervening in, paying attention to, and making changes for. We’re saying it’s not valid because it’s not trauma.
We must step away from validating somebody’s perception of what they think is trauma and move more toward supporting and validating what they’re going through while also giving them an accurate sense of what’s happening.
A powerful and similar example a friend and colleague gave me is how we often take diagnoses and turn them into casual colloquialisms.
For example, people will say, “I’m so OCD” when they’re talking about liking things clean and neat, or they’ll say, “I’m so bipolar” when talking about mood swings. Using these terms interchangeably has become so common, but the problem is that others actually experience those conditions on much more complex levels. It communicates their symptoms of OCD and Bipolar Disorder are far out of the norm.
We also don’t want the pendulum to swing too far in the other direction where we over-pathologize these conditions and say that what people are experiencing is so severe that they’re incompetent, unfit, or unstable. Many of these conditions are treatable or manageable when given the right services.
I liken it to going to the doctor. Lacking specificity around trauma is as if we went to the doctor, and they beat around the bush in regards to a cancer diagnosis. We want them to be straightforward when giving us a medical diagnosis!
Doctors are specific with their diagnoses because each diagnosis requires different treatment. The same goes for trauma and psychiatry.
If we were much more effective at validating people’s pain, then we’d see how this generalization of trauma creates more harm.
What Is Little T Trauma?
Little-T-Traumas are things like attachment ruptures, which is where something happens in the relationship with our primary caregivers growing up where we feel like the caregiver violated their role in some way. Maybe they didn’t keep us safe, care for us effectively, weren’t emotionally in tune with us the way we needed them to be, etc.
Attachment ruptures won’t activate the trauma response system because it is not a survival issue. It’s not going to cause a psychological injury that we see happen with trauma.
However, these things can - especially when they occur in a chronic sense - shape the way we think about ourselves, perceive ourselves, and perceive and engage in other relationships. Repairing attachment styles doesn’t require trauma intervention.
If trauma occurs in that caregiving relationship - life-threatening experiences, sexual violence, or physical harm - that is trauma, and you would probably engage in trauma intervention to resolve that.
When it’s isolated to those misattunements, invalidation, emotional invalidation, emotional intrusion, boundary crossings, etc, these require a completely different intervention.
This is not to say that these issues are less important. For some people, these may be more important to resolve. They just don’t require a trauma intervention.
We must identify when something is distress rather than trauma because when distress is chronic, it doesn’t typically lead to trauma symptoms necessarily, but it leads to chronic dysregulation of emotions.
This chronic dysregulation of emotions is similar to something we see with borderline personality disorder, where people have this feeling that their emotions are controlling their lives no matter what they do. They get overwhelmed by their feelings easily.
People with trauma symptoms will experience things like intense dissociative episodes, survival instincts coming online when it’s not appropriate, avoidance, etc. With trauma, we’ll typically see a lot of emotional shutdown and a restriction of emotional range, but with chronic distress, there’s an expansion of emotional range.
We want people to get the support they need and to validate everybody’s experiences. The community as a whole must broaden access to mental healthcare by allowing space for everybody’s pain and experiences to be treatable, not just trauma.
For other mental health professionals who are expanding the definition of trauma, it’s important to preserve our clinical work to be as effective as possible and to truly show up as allies and advocates for our clients and the population as a whole. We must be specific with what we see.
Many mental health professionals are drifting into ideology-based practice based on beliefs and opinions rather than research. We’re healthcare professionals. We must practice science rather than ideology.
When we expand the definition of trauma, it diminishes the integrity of an important clinical word. In our efforts to validate everybody’s suffering, not only have we begun invalidating many people’s suffering and leading them down the wrong path, but we have diminished the meaning of the word, and people no longer respond to it the way we need them to.
We want people to pay attention to mental health issues and mental health care, but when we overuse diagnoses to mean normative experiences, that can cause the general population to diminish their response to trauma.
Validating means being accurate. Sometimes, that means challenging others when we hear them misuse these terms and doing so compassionately.
As a final point for communities wanting to show up as allies for survivors, be specific with the terms we use because many survivors feel grossly invalidated and overlooked by the way trauma is expanding and losing its meaning.
Survivors are getting shuffled out because, somehow, everyone is experiencing trauma.
If you want to support survivors, begin challenging the expansion of this word, get more specific on what trauma is, and challenge others to be specific.
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You can listen to this episode on my podcast, “Initiated Survivor.” The episode is titled “Trauma Defined Part 1” and is available on Apple Podcasts and Spotify! In my next post I’ll define Trauma Symptoms and how trauma symptoms show up in our lives.
Thank you for reading. Until next time!
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