“Trauma” is one of those buzz words these days. I remember about ten years ago, some of the only times I heard the word was on the television show ER. You remember, too?
Does trauma only happen in a hospital emergency room?
What we think it is. Doctors and nurses rush around, in and out of triage rooms separated by swinging sheets, beeping noises fill the background, and someone is usually crying. ER trauma, especially in real life, is just that – traumatic.
What is NOT trauma is me saying to my kids, “Get off that tree branch! You’re going to give me PTSD!” Or, “My hair is such a disaster, it’s traumatizing.”
Similar to my last post about panic attacks, these mental health buzzwords are complicated. They rarely mean what we think they mean and they are rarely used as intended. Most of the time, we use “trauma” and “PTSD” interchangeably, when in fact, they are different from each other. Sure, there are crossover components, and yes, someone who has the diagnosed condition of Post-Traumatic Stress Disorder has experienced a trauma (or multiple). But for our purposes of learning in order to understand, validate, and accept each other more fully, “trauma” does not just mean “scared” and some people suffer from debilitating PTSD on a daily basis.
Mr. Webster’s definition. According to Mr. Webster, trauma is: 1. a deeply distressing or disturbing experience; emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis. 2. A physical injury.
The DSM-V’s definition. Remember, the DSM-V contains the diagnostic criteria for mental illnesses. This manual defines trauma as “actual or threatened death, serious injury, or sexual violence.” There is even a specifier that explains that a stressful life event, such as losing a job or getting divorced, is not considered a “trauma” by the authors of the DSM-V unless such event threatens harm to life.
Hmmm. It appears we have a dilemma.
Before we continue, I need to introduce us to the diagnostic definition of PTSD, because, as I stated earlier, we tend to use trauma and PTSD without much regard for their differences.
Yikes! Sounds pretty horrible, right? It is. PTSD is a debilitating condition that can make living life very challenging.
So, it is correct to say that not everyone who has experienced trauma has PTSD. It is also correct to say that trauma, in and of itself, can be incredibly difficult to live with and often leads to depression, anxiety, and other unwanted challenges that bring people into my office.
Little “t” traumas and Big “T” traumas. If you identify with all I have said so far in this post, you’re probably wondering how to make sense of it all in a practical way. You’re not alone! We could spend days trying to figure out if that one experience you witnessed or that one terrible nightmare you had is actually a trauma. The only reason it really matters in significance is the degree to which those situations impair your daily life. Outside of that, there’s really no sense in arguing what is and is not someone’s particular trauma.
Many times, I connect with clients by using the words “little t” and “big T” traumas. Maybe you’ve experienced something really horrific in your life, but are convinced it’s not that big of a deal because you didn’t witness a murder and you haven’t been raped. When we diminish our experiences out of guilt or comparison, we’re often left feeling confused and ashamed and still very sad. The truth is, maybe you didn’t witness a murder… AND life can be very difficult and cruel. It is appropriate to call that cruelty traumatic if it helps you make sense of it and moves you toward healing.
My take. I actually identify with and appreciate using the word “trauma” with my clients, and in my own life, when trying to put into words an experience that is life-altering; perhaps the label only lasts as long as the experience did, or perhaps it is part of my vocabulary for 10 years. I do not see the benefit in saying, “You did not experience trauma” to a person who is very much struggling to integrate the said trauma into his or her life.
As a counselor, not a diagnostician or a psychiatrist, I do not diagnose Post-Traumatic Stress Disorder. When appropriate, I may point out PTSD symptoms that can be managed and improved in counseling, with medication (under the care of a physician), and/or with lifestyle changes. In my own life, I try to not use the term “PTSD” in a sarcastic or slang way; I will be honest, in our society today, this goal takes more effort and intentionality than I’d like to admit.
The bottom line. Stress can change our brain’s wiring. Long-term or severe stress – trauma – changes our brain’s wiring and even it’s structure. More and more research in recent years points to the brain’s amazing power to adapt to life stressors, a scientific term called neuroplasticity. But before we can ask our brain to revisit it’s internal wiring system, we have to be willing to be aware of what is going on. When we understand and accept how our past experiences meet our present-day life, we can really start to make some strides in healing both little “t” and big “T” traumas.
If you’re a brain nerd like me, I recommend you check out Dr. Bessel Van der Kolk’s amazing book, The Body Keeps the Score. You can find it here.
Tune in next time to find out all the secrets you never knew about Obsessive Compulsive Disorder (OCD).
Written by Lauren Eisleben