We are talking about trauma all wrong
If I were to tell you I’m going to talk about “my trauma(s),” what would you imagine? I bet it’d be something like- a narcissistic mother, an alcoholic father, or a history of sexual abuse. Some concepts or images from your own life would come to your mind, and I would probably catch your attention.
But what If I were to tell you I’m going to talk about “trauma.” What do you imagine? Take a few seconds and allow your mind to figure out what you think I am referring to. I couldn’t possibly guess where your mind went.
I’m asking because I want to make a point of how many different meanings we can assign to that word: trauma.
I was not born in the US and English is not my first language, therefore, I try to be as clear as possible about the meaning of the words I use in order to communicate my thoughts well when I’m talking and writing. Trauma is exactly the same word in my language and in several others — maybe because it comes from the exact same word in Greek that means “injury” or “wound.”
As a therapist, it’s really important to confirm that my clients understand what I’m saying and that I understand what they are telling me. When there is confusion with any term, I immediately look at the dictionary. It blows my mind to see so many different concepts and definitions of psychological trauma — but not an ‘official’ one we could all agree on.
Not a week goes by where I don’t have to explain to someone that being upset is not the same as trauma. I’m asked all the time:
“How do I overcome the trauma of a breakup?” or
“How can I get past the trauma of having failed a test?”
I was motivated to write this article and clear up this distinction so that maybe it will alleviate some individuals to know that they are not exactly “traumatized.” Once we draw this line in the sand, the hurt individual can concentrate on healing with the interventions that go according to the level of damage.
If you look for the term applied in medicine, you will find a pretty clear definition of what psychical trauma is: an injury (such as a wound) to living tissue caused by an extrinsic agent. It’s easy to understand that psychical trauma is the damage caused to the person’s body when an object or force strikes, often resulting in concussions, deep cuts, or broken bones, or when an object pierces the skin or body, usually creating an open wound. Physical trauma is not the object that injures, but the injury, It’s as clear as crystal.
But when we are talking about psychological trauma, there is a lot of confusion because we call both the object and the subject “trauma.” To make the confusion worse, we also refer to what happens in between “trauma.” We call “trauma” to the event, to the experience, to the response, and to the symptoms. Baffling, right?
If I suffer a car crash and my leg breaks, trauma is only what happened to my leg — not the car, not the bleeding, only the broken bone, damaged tissue, and their sequela. But if my mother was rageful, we use the term trauma to refer to either her rage, growing up with her, the stress caused by her rage, the memories of her rage attacks, and/or the victimization of having had her as a mother. We would hardly talk, using the term “trauma,” about emotional dysregulation, learning problems, digestive issues, or the way the brain makes you relive her rage again and again.
There are many definitions of trauma, and these definitions cover a wide range of possibilities. There are those who refer to the physiological response (fight/flight) as “trauma,” as the American Psychological Association (APA) does — “[trauma is] an emotional response to a terrible event.” Some dictionary definitions include “an emotional upset,” or “trauma: an agent, force, or mechanism that causes trauma.” Here’s why we have to re-think these official definitions as we’ve done in the past with terms that were outdated: If you look at these definitions, they are basically saying that trauma is… the thing that causes trauma! How could a phenomenon be defined by itself? It sounds like a joke! A joke courtesy of Merriam Webster!
You may be thinking that I’m exaggerating, that it may be only a matter of semantics, and that there are no real consequences to using the same term for different things. Why should we care? Unfortunately, it’s not a semantics issue. We should care because there are huge repercussions. In terms of mental health, psychological trauma is a severe emotional disorder that is debilitating and could create severe dysfunction, especially if it gets ignored. Psychological trauma is a mental disorder and an injury to your nervous system.
If we confuse an emotional upset with a severe disorder, we are in trouble; using the word as lightly as we use it could give us the impression that the whole population suffers from trauma, and therefore, its relevance could become insignificant. Ignoring its importance is demonstrably harmful to our mental health; all sorts of symptoms and mental disorders (including personality disorders) are trauma-based but are not treated as such. We have been blaming individuals’ behavior/thoughts instead of understanding the roots of the reactions/perception of those that suffer from severe psychological wounds.
Psychological trauma has been ignored for centuries because it implies taking responsibility; from accepting the psychological damage of war and poverty to the way bullying, sex abuse, criticism, punishment, or neglect damage children; from the psychological wound of racism and oppression to the way that sexism impacts women and society for generations.
Post Traumatic Stress Disorder (PTSD) was not a diagnosis until the 1980s when addressing what veterans were experiencing, and the damage that domestic abuse was causing, was impossible to ignore any longer.
Just think about the fact that there are laws that make a person who hits someone driving accountable for damage either financially or with incarceration, but there are basically no laws to apply to someone that causes psychological trauma to another human being. Nobody pays for the damage caused, even when the person may become incapacitated for life. Think about how drinking and driving are strictly punished, but alcoholism behind closed doors goes completely under the radar.
I’m not necessarily advocating for penalizing traumatization with laws; I’m advocating that we give psychological trauma the importance it deserves — to either help in the healing, or better yet, invest in preventing it. And to facilitate the communication of the right message when we do use the term “trauma.”
The whole point of this article is to invite you to think about how if we don’t have a clear understanding of the serious injury that psychological trauma is, we will continue not having enough ways to address its consequences. For example, there is no mandatory training for people who treat trauma. Some clinicians claim to be trauma therapists because they work with traumatic memories, which is not the same as psychological trauma. Working with traumatic memories and calling yourself a trauma therapist is like calling yourself a doctor because you know how to fix broken bones. We all have traumatic memories without unnecessarily suffering from the disorder; traumatic memories are only one symptom. Traumatic memories are like the broken bone of someone who is in a coma after an accident. Psychological trauma is the coma, and very few clinicians that claim to be trauma specialists know how to deal with ‘comatose’ clients.
So what’s “psychological trauma” then?
Psychological trauma is the set of alterations in the functioning of the system that the body/brain suffers from after experiencing the hazard of losing something essential for survival (the mother, housing, community, etc) or from the possibility of dying (surgery, illness, accidents, natural disasters, etc.) that keeps the person in survival mode — and with a frame of mind of fear, terror, defeat, and hopelessness.
The symptoms and consequences are endless, including alteration in perception, mood, self-concept, physiology, and the way the brain functions in general; their severity depends on the length of time during which the person experienced the stress of living under threat, and the level of hopelessness they fell into. It also depends on the type of strategies that the individual developed to survive and the level of resilience they had before the traumatization.
If we don’t take psychological trauma as seriously as it deserves, and keep talking about trauma as a synonym of “upset,” we will never reach the point where preventive measures could be imposed.
I see a future in which preventative measures could be imposed on parents and schools, laws that require abuse of all types to be regulated could be enacted, we could establish accreditation for trauma treatment, make diagnoses that are based on trauma, and ensure reparative measures from institutions, families, and civilians.
If we hurt someone psychologically — as in traumatizing them — there should be consequences, as well as well-established ways to identify and repair the damage. Perhaps punitive measures are unnecessary as long as we have more educational measures in place.
When we acknowledge the hurt, we could heal. An enormous change from re-thinking just one little word.
You can read the different uses of the word trauma and their explanations in this article: What’s called trauma in therapy