What is trauma? There are many ways to define trauma, and some disagreement as to what trauma really is. Trauma literally means shock, injury, or wound. Historically, trauma referred to harm to a physical person. But as society became more attuned to psychology, it became widely understood that trauma could impact someone’s mental health as well. 

After the World Wars, soldiers who were not physically hurt came back broken and damaged. Something as simple as seeing a hat from an army uniform could cause a solider to scream, cry, and curl into a fetal position. 

As understanding of trauma developed, symptoms of traumatic stress in the general community were explored in further depth.

Trauma and Its Impact

Researchers discovered most people with traumatic stress symptoms were women. Often, they were women who experienced sexual violence–often in their own homes. 

In the 1980’s, clinicians at a weight loss clinic in San Diego uncovered something interesting. The people who lost the most weight were the ones who were at the highest risk of dropping out and regaining the weight. How could that be? Wasn’t losing weight what they wanted? Why would they sabotage their own goals?

Researchers began interviewing the patients. They asked routine background questions:

• when did they start gaining significant weight 

• how old they were when they became sexually active

• What was their physical activity levels like

They found nothing. Feeling defeated, one researcher asked a subject one critical question: 

“How much did you weigh when you became sexually active?” Flat and expressionless, she said, “40 pounds.” 

“Excuse me? You’re only 37. That doesn’t make sense.” 

“You asked me how much I weighed when I became sexually active. I was 40 pounds…. I was in the 4th grade.”

Making the connection, researchers started asking about sexual abuse. Almost everyone who dropped out after successful weight loss had a significant history of childhood trauma. 

Researchers then began asking about more traumatic events in childhood. Compiling their results took months because they were so devastated by what they uncovered. 

The researchers found 10 adverse childhood events (ACE) were linked with many problems including increased rates of chronic illness, mental illness, divorce, legal problems, low achievement, and early death. 

The 10 ACEs are:

1. Physical Abuse

2. Emotional Abuse

3. Sexual Abuse

4. Physical Neglect

5. Emotional Neglect

6. Relative has a mental illness

7. Domestic Violence

8. Divorce

9. Relative has been incarcerated

10. Relative has substance abuse issue

‘Big T’ and ‘Little t’ Trauma

Trauma can come in various forms. You may have heard of “Big T” and “Little t” trauma. 

Big T trauma occurs when something shocking and incredibly painful happens. 

Big T trauma could be:

• combat exposure

• car accidents

• natural disasters

Little t traumas are often slightly harmful experiences. 

Little t trauma could be:

• bullying

• a relationship breakup

• getting fired from your job

Little t trauma is shocking, but depending on the person’s history, they can turn out to be relatively fine. However, if the little t’s happen consistently with little to no repair, they can turn out to be just as problematic as big T Traumas. It’s the proverbial “death by a thousand papercuts.”

Trauma also depends on context. If someone’s life is going pretty well and they get dumped by a long-term partner, they might have difficulties for a while, but bounce back after some time. However, if events are compacted to include getting divorced, a dog's death, and getting passed up for a promotion to a younger colleague, that may be considered traumatic.

What sort of problems do people with unresolved trauma experience?

There are several types of challenges people with unresolved trauma may experience. 

Flashbacks

Flashbacks can be physical in the sense that you physically feel like you are in the place where the trauma happened. They can be emotional. Times where you feel overwhelmed, numb, afraid, full of rage, or defeated when the intensity of the situation and your emotional reaction are out of proportion with one another. 

The reactions can go both ways. Many people think of the loud reactions to trauma, but it can be difficult to recognize someone chronically under-responding to emotional moments. 

Low Self-Esteem

Painful events can cause a strong reaction that creates a need to do something quickly. When something stressful happens, we automatically want to tell someone we trust about it. In dysfunctional families and communities, people will bring up these events and either get blamed, ignored, or dismissed. They generally gain minimal support. But the anger at being hurt needs to go somewhere, and if it’s not safe to express the anger about the person or thing causing the injustice. So, we direct it at ourselves. This is where low self-esteem and toxic shame is created. This is the point the question changes from “what happened to you?” to “what’s wrong with you?” 

Self-Neglect

While some self-sacrifice and compromise is a part of a healthy relationship, it leans into self-neglect when the scales are constantly tipped to where you focus on the other person. This could show up by making the other person happy or by focusing on how they are making your life miserable. Either way, they feel out of control about their relationship and powerless to do anything about it. 

Relationships should be mutually supportive where each person takes responsibility for their thoughts, feelings, and behaviors and acknowledges their impact on the other person. 

Self-Critical Perfectionism

Perfectionism can mean the need to be flawless or it can show up as unrelenting pressure or demand to constantly do better. Criticism is where you judge yourself as good or bad. Most people think of criticism as bad, but fail to see that good is its mirror opposite. If one is true, then its opposite is true as well. 

Additionally, if we cannot accept this perfectionism in ourselves, it can be projected onto others. This could show up as a child and parent locked in a three hour top-of-the-lungs argument over math homework ending with the child sobbing in a pile of tears at their kitchen table. The parent has decided the child has done something wrong and wants to teach them a lesson. However, this lesson has gone well beyond the realm of math and became about shame, self-hatred, and perfectionism. 

Interpersonal Anxiety

One of the most robust factors for healing is social connection. But what if you think something is fundamentally wrong with you? What if the people who are supposed to be your greatest source of safety (your parents) are also your greatest source of danger? 

We fear what we do not know. If we do not know how someone is going to respond to our pain, then anxiety and depression will naturally occur instead of support and safety.

So, where do we go from here?

The 3 R’s: Regulate, Relate, Reason

As a therapist, I go by the three R’s: Regulate, Relate, and Reason as they follow with the development of the brain. 

Regulate involves the brainstem, relate uses the social and emotional parts of the brain, and reason involves the part of the brain used for working memory, planning, and action. 

Regulate 

Our brains and bodies like to be in coordination with one another. As babies, we were soothed with rhythmic, coordinated movement like rocking and bouncing. This soothing does not change as we become adults, it just looks different. 

Think about how easy it is to remember the words to a song. Can you say the alphabet without using your sing-song voice? 

Ways to regulate include:

• Going for walks

• Massage

• Singing

• Dancing

• Exercising

Relate - Social Connection

Relating is all about social connection. Do you know the worst punishment, besides death? Solitary Confinement. We are created to be in relationship. In order to not feel lonely, people will literally hallucinate and create people in their mind to talk to.

Ways to relate include:

• Talking to a friend

• Listening to music or watching a movie that connects with how you feel

• Creating something important to you and share it

Reason - Make sense of life

Why do bad things happen to good people? What is the meaning of life? These are not just hypothetical questions, but questions that need to be answered in a way that makes sense to you. 

Many people have “cherished beliefs” about the world that get fundamentally challenged by their trauma. Therapy can help people figure out what those beliefs are and how to adapt them to be more realistic. 

Some of those beliefs are:

• People get what they deserve. 

• Parents have their child’s best interest in mind. 

• I will die when I’m old. 

• If other people are happy, then I will be happy, too.

• If I’m in control, then I can’t be hurt.

Conclusion

Now that you better understand trauma and it’s impact, it may be time to seek help to resolve the effects trauma has had on your life. Consider scheduling an initial consultation to see if working together would help you move forward.