What is Trauma?
The word trauma stems the Greek word “traûma,” which translates to mean “wound.” Today the word trauma still closely resonates with its wound origins, describing the nature an infliction has an individual’s state of being. According to the American Psychological Association (APA) (2019), “Trauma is an emotional response to a terrible event…,” (Trauma, p. 1). A pervasive quality of trauma is that it overwhelms a person’s capacity to manage it, causing an intense emotional reaction.
The National Child Traumatic Stress Network (NCTSN) (2019) defined childhood trauma as “a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic as well,” (About Child Trauma, p. 1, para. 1). The powerful stress of the situation may cause the individual to feel like their safety or well-being are threatened of harm. Complex trauma designates “both children’s exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long term effects of this exposure,” (NCTSN, 2019, Complex Trauma, p. 1). This type of trauma involves a consistency of various experiences and their accumulation leading to harmful adaptions over time. Simply, trauma is a dramatic change in the environment or conditions which a person’s views as a danger to their welfare.
“Through Our Eyes: Children, Violence, and Trauma—Introduction” is the first astonishing video in a trauma-informed care series, produced by the Office for Victims of Violent Crimes. This video explains how trauma can carry pervasive impacts to the experience and the development of children. Various renowned trauma experts (such as Dr. James Henry) explain the destructive nature and longitudinal consequences of trauma in terms that are easily understood. In addition, survivors give personal accountings of what trauma looked like for them and how it changed their lives.
The Substance Abuse and Mental Health Services Administration (SAMHSA) developed a method of understanding the concept of trauma called the “Three E’s Approach.” The three E’s include: event, experience, and effect. SAMHSA (2014) described, “Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being,” (p. 7).
Event refers to the potential or real occurrence of mental or physical danger in the person’s present reality. Some instances that could classify as a traumatic event include: domestic violence, sexual abuse or assault, emotional abuse or psychological maltreatment, neglect, natural disasters, warfare, witnessing violence, and grief or loss.
Experiences is centered upon the person’s perception or way of viewing the situation, and their physical and emotional reaction to it. Thus, the present set of circumstances have been interpreted by the individual as extreme and overwhelming based on their perspective.
Effects are the long-term physical or mental consequences of trauma which could impact the person’s health and well-being. Possible traumatic effects could impact multiple dimensions of functioning including: psychological, emotional, spiritual, social, developmental, biological, and physiological.
“InBrief: The Science of Neglect”
This video discusses how multiple forms of neglect (both emotional/psychological and physical) can affect the development of children and cause harmful consequences to health and well-being. Neglect, the most commonly reported form of child maltreatment, can often times go covertly undetected and in some cases seem even invisible to the public eye. However, its multilayered scope of influence can create widespread destruction for vulnerable children, especially concerning the formation of brain networks, attachment, and social relationships.
Types of Trauma
There is a wide-range of trauma types, but classifying something as traumatic tends to be based on the individual and the context (i.e. the Three E’s). However, there are specific distressful instances that frequently produce negative outcomes to one’s well-being. Listed below are some of the typical sources of trauma.
- Sexual Assault – Sexual assault can be considered any unwanted or involuntary sexual behavior in which a person doesn’t provide unencumbered consent. Examples of sexual assault may include: rape, molestation, sexual exploitation, or sexual harassment.
- Neglect – Neglect occurs when a parent or caregiver fails to care for a child and provide them with their basic needs. Instances are considered neglectful when the caregiver has the resources (income) or opportunity (assistance) to fulfill a child’s needs but avoids doing so. Examples of neglect could include: failure to make available food/shelter/clothing, not coordinating proper medical or mental healthcare, or exposing a child to dangerous/toxic environments.
- Sexual Abuse – Sexual abuse can involve various different sexual behaviors that are committed against a child by an adult (or another child/adolescent). These abusive behaviors can be physical, involving bodily contact, or can be avoidant of direct contact but for sexual purposes. Examples of sexual abuse could include: touching, fondling, kissing, intercourse, or any type of sexual contact. Sexual abuse that doesn’t involve bodily contact could include: exposure of genitals (“flashing”) or pornographic material, verbal sexual exchanges, or sexual exploitation or trafficking.
- Emotional Abuse/Psychological Maltreatment – Emotional abuse can be considered instances where a caregiver commits acts that can be deemed mentally damaging and disruptive to a child’s development and well-being (cognitive, emotional, behavioral). These occurrences can cause a child to have a negative perception of themselves and a distorted sense of worth. Examples of emotional abuse may include: verbal abuse, emotional abuse, or domineering demands on a child’s performance. Psychological maltreatment can be evaluated as acts that cause a child mental anguish or disturbances. These behaviors can also be neglectful, such as withholding attachment or mental health needs or socially isolating a child.
- Physical Abuse – Physical abuse is when a caregiver attempts or succeeds in causing physical harm or injury to a child’s body. This could take of the form of intentional injury, excessive or brutal punishments or discipline that is harmful and not age-appropriate. Examples of physical abuse could include: beating, kicking, punching, slapping, burning, or any other behavior that compromises a child’s bodily integrity.
- Domestic Violence – Domestic violence can be defined as threatened or executed acts of violence (physical/sexual violence, emotional abuse) committed between partners in an intimate relationship. It’s important to note, domestic violence can be significantly harmful for children who are not hurt but who witness the acts as well.
- Community Violence – Community violence can be categorized as witnessing or being directly involved in physically destructive behaviors among people outside of the private sphere. Examples of community violence can include: sexual assaults, shootings, gang conflicts, and robberies.
- Natural Disasters – Natural disasters can be any weather or climate related natural catastrophe which alters a person’s typical interaction with their environment. Examples of natural disasters could include: hurricanes, tornadoes, or earthquakes.
- War or Combat Violence – War or combat violence can be classified as active participation in warfare conflicts (shooting, bombing, looting), witnessing horrific acts (injuries or death), and excessive exposure to fear or mental disturbances.
- Traumatic Loss – Traumatic loss can be considered the grief associated with the removal of a significant person, purpose, or function within one’s life. These occurrences are typically unexpected or sudden and can elicit a substantial amount of distress. Examples of traumatic loss can include: the death of a loved one, physical or mental alterations in functioning, or significant material loss.
Impact on Physical & Psychological Well-being
Trauma, especially when experienced during childhood, can cause an individual to have a predisposition to developing health problems or medical conditions later in life. Some of these physiological health issues can include: Heart disease, Certain types of cancer, Stroke, COPD, Headaches or migraines & Immune system suppression (chronic infections).
The distressful and overwhelming nature of trauma can lead to the development of risky or harmful behaviors, often times used to cope or avoid unwanted psychological traumatic symptoms. Some of these maladaptive coping strategies or behaviors can include:
- Substance abuse (alcohol, prescription medications, illegal drugs)
- Smoking or other tobacco product use
- Overeating or “binge eating”
- Avoidance or a lack of exercise
- Unsafe or risky sexual practices
- Self-harm or “cutting”
Additionally, trauma can cause a wide-range of mental health symptoms that can impact psychological functioning and well-being. Many of these symptoms can cause severe disruptions to one’s relationships and quality of life. In fact, trauma can even fuel the formation of certain mental illnesses.
“7 Ways Childhood Trauma Can Follow You into Adulthood”
Traumatic events, especially those during childhood, have the power to change the way people interact in social relationships, interpret their environment, and understand themselves. Psych2Go’s “7 Ways Childhood Trauma Can Follow You into Adulthood” displays some of the significant ways that trauma can alter experience in the long-term. The video portrays some of the typical sources of trauma and explains how these instances invoke destruction in crucial components of life.
- Emotional dysregulation (trouble regulating one’s feelings)
- Harmful or dysfunctional social relationships
- Intrusive thoughts or memories
- Maladaptive coping behaviors (avoidance/impulsivity)
- Difficulties with reasoning/problem-solving, learning, or attention
- Distorted sense of self and surrounding world
Mental illnesses commonly associated with trauma
- Post-traumatic stress disorder (PTSD)
- Borderline Personality Disorder (BPD)
Can trauma be passed down to a person’s children?
In the words of Dr. Bruce Perry, “One is the trans-generational cycle. If you grow up and you have lots of adversity, you’re going to think, have a world view, and behave in ways, that increase that probability that some of that will impact the way you parent.” Trauma has the potential to impact one’s biology, specifically the brain’s stress response system, and can effectively alter one’s genetic coding. Epigenetics is an emerging area of study involving the interaction between the biologic science of genetics and the impact environmental conditions have on gene activation. This concept is commonly referred to as the “intergenerational transmission of trauma,” which describes how trauma’s biological alterations can be passed down through heredity. Trauma changes the way one’s brain functions leaving an imprint upon their biological processes and genetic makeup.
Basically, when a person with a traumatic history has children, they could be passing down genes linked to a dysregulated stress response system. These genes are present when the child is born but their activation is dependent upon the child’s interactions during development. The child has a predisposition to harmful brain connectivity along with a higher potential for maladaptive gene activation. This could be due in part to their parent’s behavior over their childhood. If the parent acts negatively toward the child or exposes them to trauma, then the likelihood of activation increases. If the parent provides a safe and nurturing base, gene activation is less likely to occur and the chances of transmission to future generations decreases. Thus, trauma can be passed down to future generations but there is hope in avoiding this occurrence if mindful steps are taken toward resolution.
Treatments for Trauma
Over the last decade, there have been huge improvements in understanding the impact of trauma, research on intervention strategies, and the development of effective treatments. Some treatments methods involve elevating basic aspects of everyday life while other require the guidance of a medical or mental health professional.
- Regular exercise and a nutritional diet
- Healthy sleeping patterns
- Nurturing and stable relationships
- Mindfulness or meditation exercises
- Professional treatment assistance
- Psychotherapy or counseling
- Medical physician evaluation and intervention
- Psychotropic medication
- “The paradox of trauma is that it has both the power to destroy and the power to transform and resurrect.”—Peter Levine (Potential Use in Rotating Slide Show)
- “When people are behaving in apparently self-destructive ways, it’s time to stop asking what’s wrong with them, and time to start asking what happened to them.”—Dr. Robert Anda
- “Although the world is full of suffering, it is also full of the overcoming it.”—Helen Keller
- “Understanding is the first step to acceptance and only with acceptance can there be recovery.”—J.K. Rowling (Harry Potter and the Goblet of Fire)
- “Even in its darkest passages, the heart is unconquerable. It is important that the body survives, but it is more meaningful that the human spirit prevails.”—Dave Pelzer (A Child Called It)
- “We do not believe in ourselves until someone reveals that deep inside us is valuable, worth listing to, worthy of our trust, sacred to out touch. Once we believe in ourselves, we can risk curiosity, wonder, spontaneous delight or any experience that reveals the human spirit.”—E.E. Cummings
- “Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.”—Dr. Bessel van der Kolk (The Body Keeps the Score)
- “As long as you keep secrets and suppress information, you are fundamentally at war with yourself…The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage.”—Dr. Bessel van der Kolk (The Body Keeps the Score)
- “Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control their processes, they often become expert at ignoring their gut feelings and in numbing awareness of what has played out inside. They learn to hide from their selves.”—Dr. Bessel van der Kolk (The Body Keeps the Score)
General Childhood Trauma Resources
The National Child Traumatic Stress Network (NCTSN)
The National Child Traumatic Stress Network (NCTSN) provides an online platform for evidence-based information and resources associated with childhood trauma and trauma-informed care. The NCTSN’s mission “is to raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States,” (NCTSN, 2019, Home).
The ChildTrauma Academy is known as one of the leading national organizations exclusively focused on treating and helping traumatized children recover. This organization was founded by Dr. Bruce Perry, a child psychiatrist and author, who pioneered some of the most influential conceptualizations of childhood trauma to date. Dr. Perry and the ChildTrauma staff offer users insight into how trauma can impact child development with a special focus on neurodevelopment and the implications of social interactions.
Substance Abuse and Mental Health Services Administration (SAMHSA) “Understanding Child Trauma”
The Substance Abuse and Mental Health Services Administration (SAMHSA) presents an informative platform for growing one’s knowledge on trauma with a special emphasis on the self-destructive coping behaviors associated with a traumatic history. This site offers users a basic way to interpret what constitutes trauma, information on how trauma can evolve into other problems, and insight into how healing can be fostered. In addition to trauma resources, SAMHSA provides more narrow and concise data on certain issues that can be rooted in trauma or exasperated by it, such as behavioral manifestations (like substance abuse) or mental health conditions (like post-traumatic stress disorder).
Mainstream Books on Trauma
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma – By Dr. Bessel van der Kolk
- The Deepest Well: Healing the Long-Tern Effects of Childhood Adversity – By Dr. Nadine Burke Harris
- Trauma and Memory: Brain and Body in a Search for the Living Past – By Dr. Peter Levine
- Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror – By Dr. Judith Herman
The Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others – By Laura van Dernoot Lipsky and Connie Burk
Waking the Tiger: Healing Trauma – By Dr. Peter Levine