What is Trauma?

Warning: This article contains details about sexual trauma that may not be appropriate for some readers. Caution recommended.

Shelia's* Story

“Trauma? Like PTSD? But I haven’t been to war. I haven’t even seen someone die. How can I have PTSD?” Shelia sat on my couch, hands clenched on her thighs. Her right foot tapped her left foot in unrhythmic jolts. 

“Yes, your symptoms are trauma symptoms.”

“Like what?”

“All of the things you just mentioned. You experienced a sexual assault, after which you started feeling intense guilt, jumpiness whenever someone touches you–even gently, flashbacks, anxiety, fear, avoidance of returning to that location, fears of seeing the person who did this to you, not to mention you broke up with your boyfriend and dropped out of school—things that you said were out of character for you.”

Shelia stared at the floor. “I just froze.”

“When he assaulted you?”

“Yes. I couldn’t move. I could have stopped it but I couldn’t move.” Her eyes darted back and forth and the foot tapping increased in speed.

“That’s called a freeze response. It’s when your body moves so far into a trauma response that it bypasses fight or flight and goes into the most protective mode called freeze. And it does that when your brain senses danger so intense that it feels it cannot handle it."

“But what if I wanted it? Maybe I did and I don’t remember. Maybe I wanted it and it’s all my fault.”

“Did he have sex with you?” Shelia paused, looking away.

“Yes.”

“Did you give him permission?”

“No.” Her eyes looked into mine. “He threw me on the bed. I couldn’t speak. I was so scared.” Tears fell from both cheeks.

“You’re here, and you’re safe now.” I paused, giving her a moment to process. She finally nodded.

“What do I do now?”

“That’s a great question, and you’ve actually already taken the first step. Let’s talk about some ways to process this and give you coping skills for the day-to-day emotions…”

Trauma is a complex topic, and although we can’t cover all of it in one article, we can begin the conversation. While many people associate posttraumatic stress disorder (PTSD) with war combat, it has many variations. 

The Trauma Response

On a neurobiological level, a trauma response is the activation of the nervous system into fight or flight (or freeze, as we read above), in order to protect the brain and body. This activation has significant effects on the autonomic nervous system. If the body is activated into fight or flight, the sympathetic nervous system triggers physiological responses that cause dry mouth, reduced activity in the digestive system, and increased heart rate—among many other reactions. It also suppresses the immune system because it needs that energy to protect, rather than heal. In addition, blood vessels in the extremities are constricted to keep blood in the body’s core: If the human body is threatened, it can live without a limb, but it can’t live without a brain or torso! So, the blood supply is focused on these more important places for survival.

If the body goes into freeze mode, these responses include shutting down the mental responses (among other physiological responses) because the information is simply too much.

In other words, think of a trauma response as a highly-activated distress response. You can respond with distress while driving on fast freeways, but a normal commute shouldn’t send you into distress. A car cutting you off on the highway should activate your nervous system with moderate distress, but it shouldn’t send you into long-term fight or flight. But if the car that cut you off ends up slamming the brakes and causes a serious accident with your vehicle, you will likely have so much distress that it becomes a fight, flight or freeze trauma response–before you even know what is happening.

Big “T” Trauma

Big “T” Trauma is one way of referencing a PTSD-level event. These events, as per DSM-5 definition, require exposure to actual or threatened death, serious injury, or sexual violence in any of the following ways:

• Direct experience

• Witnessing it occur to others

• Learning a violent or accidental death has occurred to a loved one.

• Learning that serious injury or sexual violence has occurred to a loved one.

• Repeated or extreme exposure to aversive traumatic details (e.g. first responders, etc.)

Note that none of these criteria mention war combat (although it certainly falls under a few of them). Also, a PTSD diagnosis requires many additional criteria, such as intrusive memories (flashbacks, dreams), avoidance of reminders of the event, mood changes, and hypervigilance. There are other trauma-related diagnoses that are often used when a person does not meet full criteria for PTSD.  

But the concept of trauma is much bigger than diagnostic criteria.

Little “t” traumas

Trauma can stem from years of a chronically activated nervous system, even if none of the triggering events meet criteria for PTSD. Therapists call such events little “t” traumas.  They can include years of living with a parent with anger issues that frequently became verbally aggressive, growing up as a parentified child, or moving and switching caregivers frequently. These types of repeated experiences create unhealthy attachment issues and a chronically activated nervous system that continues into adulthood.

Sexual Trauma

Sexual trauma comes with its own set of unique experiences that make it especially difficult to overcome. The level of violation that a person feels after sexual coercion or trauma extends beyond their flesh, causing wounds and dysfunction deep into their sense of self and safety. This part of them is forever changed, and recovery can be a difficult process due to the intimate nature of their wounds and memories.

Healing Trauma

No trauma is beyond the reach of God’s healing hands. Shelia and I used a combination of EMDR and attachment-based, insight-oriented therapy to process her trauma. At first, she had to use a lot of coping skills outside of our time in therapy. Eventually, her nervous system returned to normal levels of functioning, and she was able to return to school and make healthier choices about her relationships.

We've barely scratched the surface of this Big "T" Topic. If you’ve never worked through your little "t" traumas” or your Big "T" Trauma(s), I encourage you to take the bold step of reaching out to a trained trauma therapist. You’ll not only improve your emotional health, but you’ll see benefits in your relationships and overall sense of safety and self-worth.

*fictional client, plausible story