Trauma is a response to an intensely stressful event(s) or situations. The effects can be long-lasting, but healing is possible.
Traumatic events can happen at any age and have lasting effects on your physical and mental well-being. Each person’s experience is unique, but there are common causes, and many people share some symptoms of post-traumatic stress, like anxiety, flashbacks, and sleep disruption.
Some in the medical community dispute what constitutes trauma. As researchers and therapists learn more, conversations about trauma’s definition are ever-evolving based on new evidence.
With proper treatment and social support — especially through trauma focused therapy — many people can overcome these negative effects, experience an improved quality of life, and move toward healing.
Trauma refers to your response following an event that psychologically overwhelms you, often resulting in shock, denial, and changes in the body, mind, and behavior.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma is an event you experience as harmful or life threatening. It has lasting adverse effects on your mental, physical, emotional, social, or spiritual well-being.
Trauma is typically associated with significant events such as physical or sexual assault, violence, or accidents. But it can also involve responses to repeated events, like ongoing emotional abuse or childhood neglect.
Not everyone who has experienced a traumatic event will have long lasting effects. Around 20% of people who experience a traumatic event will develop post-traumatic stress disorder (PTSD), and many others might still have subthreshold symptoms of post-traumatic stress.
Trauma that repeatedly occurs over time can have a cumulative impact. This is known as complex trauma.
Complex trauma is often associated with childhood trauma. Early experiences of trauma can leave a deep imprint on your worldview, sense of self, and relationships later in life.
Trauma can affect many areas of your life, including your emotional, social, and physical well-being.
During extreme stress, the body and mind become overwhelmed, engaging the nervous system’s fight, flight, or freeze response.
Symptoms of post-traumatic stress are aftereffects of your overwhelmed nervous system — your body and mind can’t fully process the traumatic events as they are happening.
Common symptoms after trauma include:
- intrusive thoughts, including flashbacks or nightmares
- avoiding things that remind you of the trauma, including people, places, or objects
- hypervigilance, or being very aware of danger
- being easily startled or “jumpy”
- being activated by triggers that remind you of the trauma, whether consciously or subconsciously
- changes in how you see yourself, such as believing you are “bad,” or feeling excess guilt or shame
- a small window of tolerance, meaning you feel overwhelmed easily or have difficulty controlling your emotions
Traumatic stress can show up in your physical health, too. Body-based effects are known as somatic symptoms and can include:
- chronic pain
- sleep problems
- chest pain
- chronic pain
How common is trauma?
According to the Sidran Institute, trauma is pervasive in the United States:
- About 70% of U.S. adults have experienced a traumatic event at least once. Not everyone who experiences trauma will develop PTSD.
- Up to 20% of these people meet the criteria for PTSD.
- Women are twice as likely to develop PTSD than men.
- The risk of developing PTSD varies based on the trauma. The risk is especially high after rape (49%), physical assault (around 32%), and other sexual assault (around 24%).
According to the
- About 61% of adults surveyed across 25 states reported experiencing at least one ACE, such as violence, abuse, neglect, or substance use issues in the home.
- Nearly 1 in 6 reported experiencing 4 or more ACEs.
- Women and some ethnic minority groups had a greater risk of experiencing four or more ACEs.
Trauma is less about the event and more about how you responded. But some events are more likely to lead to trauma than others.
The National Child Traumatic Stress Network reports that the following events can lead to trauma:
- medical trauma
- sexual trauma
- family trauma
- refugee trauma
- traumatic grief
- terrorism and violence
- intimate partner violence
- disaster trauma
- childhood neglect
The Jed Foundation, a nonprofit that protects emotional health and prevents suicide for teens and young adults, breaks trauma into three types:
- Emotional trauma: The feelings traumatic events leave us with. Characterized by feeling unsafe in one’s body, emotional trauma can alter our brain function and lead to an overarching sense of hopelessness.
- Complex trauma: A series of traumatic events that can have a lasting impact.
- Secondary trauma. Also known as vicarious trauma, secondary trauma refers to being a witness to trauma. Witnessing a traumatic event can impact your emotional health and is deserving of support, empathy, and compassion.
‘Big T’ and ‘little t’ trauma
Some clinicians break down traumas into “big T” and “little t” events. “Big T” traumas are usually associated with PTSD, including combat and sexual assault. “Little t” traumas may involve big life changes, emotional abuse, or bullying.
But breaking down traumatic experiences into these categories is controversial. Over time, repeated exposure to “little t” traumas may cause as much emotional harm as exposure to “big T” traumas, especially when experienced during childhood and in the case of complex trauma.
All emotional wounds deserve empathy and support, and all events that result in harm warrant the need for validation and support.
Trauma is associated with various health conditions, including:
Not everyone who experiences trauma will develop PTSD, but around 20% will meet the diagnostic criteria.
Dissociation is a common response to trauma. According to the American Psychiatric Association, 90% of dissociative disorders may be linked to trauma. Dissociative disorders include:
- dissociative identity disorder
- dissociative amnesia or dissociative fugue
- depersonalization/derealization disorder
Borderline personality disorder
Characterized by a lack of energy and feelings of worthlessness, among other symptoms, depression is a common response to trauma.
Symptoms of anxiety, such as feelings of dread and panic, often overlap with PTSD symptoms. Anxiety might arise when you’re faced with something that reminds you of a trauma. Some people may develop anxiety disorders related to trauma.
Though recovery from trauma isn’t easy, it’s possible. Trauma-focused psychotherapy is one of the most effective things you can do for recovery.
The American Psychological Association strongly recommends the following therapies for trauma:
- cognitive behavioral therapy (CBT)
- cognitive processing therapy (CPT)
- prolonged exposure (PE) therapy
They also conditionally recommend Eye Movement Desensitization and Reprocessing Therapy (EMDR) and narrative exposure therapy (NET).
If you’re looking for mental health support, Psych Central’s How to Find Mental Health Support resource may help.
In addition to traditional psychotherapy, expressive arts, such as creative writing or theater, can help heal trauma. According to a 2019 study, expressive writing can improve resilience to trauma.
Many people who have experienced trauma find it difficult to practice self-care and self-compassion. Trauma therapists can work with you to boost your skills in these areas, which can have lasting effects on many areas of life.
Psychoeducation can also help you understand your symptoms, which can be a major step toward healing. Reading healing stories about trauma from leading experts can be empowering and inspiring.
Books about trauma
Some book recommendations for understanding and healing trauma include:
- “The Body Keeps the Score” by Bessel van der Kolk, MD
- “It Didn’t Start With You” by Mark Wolynn
- “Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation” by Janina Fisher, PhD
- “Trauma and Recovery” by Judith Lewis Herman, MD
- “The Complex PTSD Workbook” by Arielle Schwartz, PhD
- “Trauma and the Body” by Pat Ogden, PhD
- “What Happened to You? Conversations on Trauma, Resilience, and Healing” by Bruce D. Perry, MD, PhD, and Oprah Winfrey
As you seek to identify, define, and explore what trauma means, remember to have self-compassion because learning about trauma can be a challenging process.
Through learning about trauma, you raise awareness about a widespread issue and empower yourself with tools to help heal yourself and others.
People recover from trauma every day and lead happy, productive lives.