By Laura Vismara
The words trauma and traumatized have been consistently in the spotlight for the last two decades, rapidly surging to become commonplace and reaching new peaks of popularity in recent years, according to internet search trends. Propelled by major world events that rightfully fall under the label of traumatic—pandemics, wars, and episodes of violence to name a few—trauma has become epidemic.
As we gain more confidence in sharing our mental health struggles openly and oftentimes publicly, we are witnessing a massive spread of “therapy speak” and “trauma talk,” or the language of harm. Terms once reserved for the therapist’s couch, such as trigger, denial, toxic, and abusive, are seeing a stark rise in usage outside the healthcare arena, infiltrating casual conversation, and fast becoming part of our collective vocabulary.
This might do more harm than good, some experts say. Improperly and incorrectly labeling ourselves or others as “disordered” can worsen things, and turn a fleeting problem into something bigger. Aside from that, it might unintentionally undermine the realities that those who live with a mental health condition face daily.
Also, the casual use of trauma and its related concepts can dilute terms that once had impact. And while how we use those words doesn’t necessarily change their meaning, it can strip them of their complexity and rob them of their value.
Nuances get lost and everything becomes trauma. And yet, not all harm is trauma, and not all stressful events are traumatic.
So, what exactly is trauma?
What is trauma, exactly?
Trauma is elusive to define. Truth is, there is still much debate over its definition and no clear-cut answer, as yet.
Trauma is considered a form of severe and lasting emotional stress, caused by an extremely unsettling experience that far exceeds one’s ability to cope. Trauma throws its victims into a state of shock and denial immediately after the event and often keeps haunting them long after, with recurrent nightmares, sudden flashbacks, symptoms of panic, and long-term neurosis grouped under the category of posttraumatic stress disorder (PTSD), commonly overlapping and co-occurring with other psychiatric disorders.
As defined by the American Psychological Association (APA), trauma is an “emotional response to a terrible event like an accident, sexual or physical abuse, or natural disaster.” PTSD is the mental health disorder that can develop from it; while not all trauma leads to PTSD, the majority of cases do.
The DSM-V (the latest edition of The Diagnostic and Statistical Manual of Mental Disorders) states that trauma requires “actual or threatened death, serious injury, or sexual violence” [10] (p. 271), either as a victim or a witness. This means that events that do not involve an immediate threat to life or physical injury should not be considered trauma, according to this definition. This also means that if you haven’t directly experienced an event deemed as traumatic, but you have directly witnessed it, you might still meet the criteria and legitimately be traumatized by it. For example, directly witnessing a horrific accident can meet this criteria for trauma.
Many, within the medical community and among mental health professionals, criticize and challenge the DSM-V’s definition for being still too limiting. It restricts trauma to singular events of catastrophic proportion and doesn’t acknowledge that trauma may also occur from being exposed to a series of distressing events happening over a long period of time, like those experienced in cases of abuse. Besides, it doesn’t acknowledge that people respond to trauma differently, depending on a variety of factors, and that any situation that leaves one feeling alone and completely overwhelmed can still be traumatic—even without physical harm.
However, experts all agree that trauma is a deep emotional wound requiring ongoing support, extensive counseling, and therapy, more often than not.
And yet, trauma hasn’t always been a “wound of the soul.” Trauma has had a remarkably long life, full of twists and turns, gaps and cycles of fame and neglect, fascination and indifference.
Learn how to talk about mental health.
From physical injury to wound of the mind
As a term, trauma is broad and slippery, and ever-evolving. It can define a physical injury, an emotional wound, and the incident that caused them.
Borrowed from the Greek τραύμα, meaning “wound, hurt,” the word and its siblings traumatic and traumatized, share the same linguistic root (*terə) as terms for twisting, piercing, breaking apart, and wearing away. In its early days and for quite some time, trauma was used in clinical settings to refer to physical injuries and harm only.
First recorded in medical literature in 1685, trauma has been stunning its victims and leaving deep scars behind for millennia, long before it was named. Tales of trauma and behavioral disorders, which often went by the name of hysteria, date back to ancient times. In those days, a wide range of symptoms, deemed as incoherent and incomprehensible, was often seen as evidence of demonic possession, blamed on spirits, magic, or supernatural forces. As such, they were often treated by priests rather than physicians.
Plagued by the same fate as many other mental health disorders, trauma—as we know it today—went unrecognized and untreated until the late 1880s when things took a turn for the better.
Pierre Janet, Charcot, Freud and the wound of the mind
It was only towards the late 1800s that the term took on a new identity and became a wound of the mind, making its way into the terrain of modern psychology.
Along with the work of French neurologist Jean-Martin Charcot (1825–1893) and Austrian neurologist Sigmund Freud (1856–1939), early research is credited to pioneering French physician and philosopher Pierre Janet (1859-1947), whose 1889 scientific account of traumatic stress, De l’Automatisme Psychologique (On Psychological Automatism), is considered part of the foundation of our understanding of trauma. In an attempt to shed light on war neurosis and hysteria, these practitioners developed the notion of trauma as a wound inflicted not just upon the body but upon the mind and the memory, reshaping our understanding of it and setting the foundation stone of psychotherapy and psychoanalysis.
While trauma as a physical injury kept lingering, undisturbed, in clinical settings, public awareness of the new concept of trauma as emotional injury increased throughout the 20th century, experiencing sudden bursts of popularity in times of war.
WWI, WWII, Vietnam veterans, the Women’s Movement, and PTSD
Wartime trauma and its train of symptoms were once better known as war neurosis, battle fatigue, and shell shock until PTSD, or posttraumatic stress disorder, became the primary term for such diagnoses.
Survivors, traumatized by the horrors of war and experiencing mutism, amnesia, tics, paralysis, and recurrent nightmares, were often labeled as “undisciplined and unwilling soldiers,” diagnosed with battle or combat fatigue, and barely treated. Things started to shift during World War I when the term shell shock was coined by British psychologist Charles Samuel Myers, acknowledging and validating soldiers’ mental health struggles, thought to be caused by being exposed to exploding shells.
It was the Vietnam War, in the 1960s and 1970s, that prompted a renewed interest in war neurosis and the burgeoning of new studies. Shell shock became a recognized medical disorder with a formal diagnosis and specific treatments and was admitted into the DSM-III as posttraumatic stress disorder (PTSD) in 1980.
Contemporarily, the Women’s Movement in the 1960s and 1970s played a key role in expanding the definition of trauma and broadening our view of traumatic events to include violence and sexual abuse against women and children.
From the shadows to the spotlight, from wound of the body to wound of the mind, surviving through the war and the great cultural and social shifts of the ’70s, trauma is now creeping into our daily conversations, flooding mass and digital media, and seeping into our lives with unforeseen side effects and potential collateral damage.
Is it trauma or hurt feelings?
Are we turning normal events into catastrophes? While losing a job or failing an exam can certainly be distressing experiences, mental health professionals encourage patients to distinguish such events from those that can leave deep scars on a person’s psyche. Unflattering words and unpleasant conversations might make you uncomfortable and leave you unsettled for hours or even days but shouldn’t haunt you with petrifying flashbacks or heart-pounding nightmares. Recounting a painful heartbreak will stir up bad memories but shouldn’t trigger PTSD. There are many forms of anguish that shouldn’t be mistaken for trauma.
While it is important to acknowledge trauma when it is trauma and seek proper help, feeling distressed is different than being disordered. And invoking trauma where harm might suffice, or calling traumatic something that really isn’t, might leave us in fact traumatized, helpless, hopeless, and unable to move on.
As we figure out how to talk about our emotions, thoughts, behaviors, and feelings in a way that serves us better, we might find out that things are not as hard to overcome and we’re not as damaged or traumatized as we think.
Laura Vismara is an integrative health and science writer based in the UK. She works closely with health organizations at a national and local level to promote more inclusive and person-centered care approaches. She’s also ghostwritten her share of books and ghostwrites for health & wellness magazines and online publications. You can find her at lauravismara.com. For more by Laura, read: How To Talk About Mental Health: Do’s, Don’ts, And Words To Know | “Dementia” vs. “Alzheimer’s”: What’s The Difference?| “Panic Attack” vs. “Anxiety Attack”: Which One Have You Had? | “Depression” vs. “Anxiety”: Which Do I Have (Or Is It Both)? | “Placebo” vs. “Nocebo”: The Good And The Bad
