TRAUMA: A Brief Overview
The word “trauma” is often used in our culture, yet it can be difficult to know exactly what it means. Generally speaking, a past adverse experience is considered traumatic if it causes one to act as if the experience is happening or is about to happen in the present. Such a believe can create irrational disproportionate, or unrealistic reactions to present day events. This post will explore some aspects of trauma and how it can affect our lives.
Two people facing the same painful event may experience it very differently. One person may be relatively unaffected while the other may continue to have physical, emotional, and psychological affects, even years later. Multiple factors contribute to how one responds to traumatic events: personality, age, resiliency, one’s support system, genetics, how one makes sense of the event, one’s ability to protect him or herself during the event, vulnerability factors at the time of the event, and one’s history of previous adverse experiences, to list a few. Almost any painful or stressful event can be experienced as traumatic depending on the person, the context, and the event itself.“Big T” and “small t” are terms commonly used to categorize traumatic events.
"BIG T" AND "small t" TRAUMAS
“Big T” traumas are sudden, “single-blow” events (i.e., a natural disaster, sudden serious illness, or serious car accident) and/or events which are (or perceived as) threatening to one’s own or someone else’s life or physical safety (i.e, physical and sexual abuse, rape, violence, threats of violence, witnessing violence or abuse). These events can overwhelm the person’s ability to respond, often leaving him feeling helpless and powerless. Approximately 25% of adult “Big T” trauma survivors go on to develop symptoms consistent with post-traumatic stress disorder (PTSD; Courtois, 2014). Others may manifest reactions and symptoms that are problematic, but do not meet criteria for a PTSD diagnosis.
Less known and less easily identified are “small t” traumas. The "small t" isn't to indicate its less important or painful. Rather, "small t" indicates its probably not life threatening, but is usually insidious and harder to talk about. Some examples of "small t" traumas are:
neglect or abandonment of a child or dependent adult,
constant criticism or shaming,
loss of important people, animals, or objects,
being unprotected by authority figures (i.e., parents, law enforcement),
betrayal of a trusted other (i.e., discovering a partner's infidelity)
lack of attention, acceptance, or comfort--especially of a child,
exploitation of a child or less powerful adult,
unpredictability in the environment (i.e., walking on egg shells).
MORE ABOUT "small t" TRAUMAS
Most “small t” traumas are not one-time events. Instead, these typically occur in regular interactions with parents, teachers, peers, partners, supervisors, and other constant figures in our lives. Sometimes the survivor may believe this type of treatment is normal (or even healthy or Godly). It is not recognized as traumatic by her nor by those around her (including some mental health professionals). Traumatic experiences can be cumulative. The addition of new adverse experiences triggers old traumatic memories, compounding the negative consequences of past and current events. The cumulative effect is especially true for “small t” traumas, given that they are often experienced many times.
While “small t” traumas will not likely lead to a PTSD diagnosis and do not carry the threat of death or bodily harm, their consequences can be just as painful. Dr. Elizabeth Barbash noted that “small t” traumas are “better described as ego-threatening” because “small t” traumas overwhelm the person’s ability to hold on to a sense of authentic self. This disconnection from authentic self can create increasing anxiety and depression, addiction, codependency, relationship problems, decreased self-esteem, increasing conflict with others, a decreasing ability to manage everyday life stressors, and decreased life satisfaction. For these reasons, "small t" traumas are just as damaging as "Big T", but are harder to recognize and talk about.
TRAUMA AND ADDICTION
Trauma and its consequences can be identified in addicted family systems. For some, the addiction itself has become the source of trauma. When the addict, partner, and family members are given appropriate support, they are able to heal and the trauma can resolve. For others, the trauma of addiction has hooked into older wounds, bringing it all crashing down. Here, in addition to addressing the addiction and related traumas, healing old traumatic memories and dysfunctional coping strategies will be necessary for a sustainable and healthy recovery.