Time To Retire The Word Trauma
Time To Retire The Word Trauma
The word trauma has come to be thrown around casually – in online posts, in everyday conversation. Seemingly, every person now has the credentials to diagnose trauma.
The word trauma is being diluted and rendered meaningless. People who would benefit from psychological support are being washed away by the flood of “trauma” diagnoses on the internet.
Trauma was once reserved as a term used by the medical community. Now it has been reduced to “anything that feels bad”. However, simply experiencing a painful event does not constitute trauma.
Trauma refers to a physical or psychological “wound”.
When a stressful event occurs, the body has built-in mechanisms to process the wave of emotion and healthily discharge. For instance, we may notice that animals spontaneously shake after an accident. This natural body movement allows the nervous system to regulate itself.
We can have a painful experience that may not be traumatizing. If we allow our body to process our emotions, then we can move beyond painful experiences.
When this process is disrupted or suppressed, the body feels overwhelmed by the stressful situation. This “overwhelm” is what we may colloquially refer to as trauma. Trauma is therefore energy that gets locked in a fight / flight / freeze response in the body.
Acute Stress Disorder (ASD) is a short-term psychological condition that typically lasts for a month after a stressful event. Characteristically, a person has difficulty regulating their nervous system, which may result in anxiety, flashbacks, and heightened emotionality.
ASD can contextually be a beneficial response to a difficult situation. If our life is in danger, remaining hypervigilant, ready to fight, and in a state of energy conservation can be tremendously helpful.
Post-Traumatic Stress Disorder (PTSD) involves similar behaviors over a chronic period of time. PTSD is in most cases maladaptive and causes the individual more difficulty than good.
Both are medical diagnoses that help to guide proper treatment towards people who would benefit from psychological support.
Simply experiencing a negative event does not lead to trauma. Rather, ASD and PTSD involve large amounts of dysregulation and overwhelm in the nervous system.
Amongst the general population 6% experience PTSD in their lives. The prevalence of PTSD amongst the military is only slightly higher than the general population at 7%.
We be surprised to find out that only 10% of United States military personnel are in active combat. Additionally, the majority of veterans who experience PTSD are actually nowhere near combat. Something other than combat experience is causing this adverse reaction to stress.
Studies show that the veterans who do experience PTSD are likely affected more by factors outside of military service than their actual service itself. Experiences such as preexisting psychological issues, childhood physical or emotional abuse, and educational deficit are greater predictors of PTSD in the military than any other factor.
Even among the people in the general population who we would classify as experiencing trauma, only 20% end up experiencing any long-term effects of overwhelm.
Our co-founder, Dr. Mazen R. Harb is a neuroscientist who worked at the prestigious Max Planck Institute and is published in Nature Family. At Charité – University Hospital, Berlin - Department of Psychiatry and Neurosciences, he conducted fascinating research in support of Syrian Refugees during the 2015 war.
Amongst the population sampled 53% were diagnosed with PTSD and 47% did not exhibit PTSD. Yet almost all participants across both groups experienced stress and trauma.
This means that almost half the participants who experienced extreme stress did not develop long-term ramifications.
Interestingly, the group that experienced PTSD had common factors:
In contrast, the group that did not experience PTSD had:
Somewhat paradoxical (to our current understanding), those who had more to lose experienced more stress, which was difficult to process and led to higher incidents of PTSD. Yet having a traumatic story alone was not indicative of a long-term stress response.
All told, humans are remarkably resilient to stressful and traumatic experiences. We have evolved to employ many biological and social tools to navigate difficulty.
When we exaggerate and over-inflate day-to-day stressors, we cause individuals much more harm.
If the danger of trauma is unregulated stress, amplifying one’s perception of trauma will increase their levels of stress. When we label someone, they can unconsciously create an identity around the label and become stuck.
Moreover, dramatizing events to be more stressful can further feelings of helplessness and hopelessness. In essence, that the individual is out of control and at the mercy of events around them. This significantly increases psychological distress.
We must emphasize, we are not suggesting that we “down play” events either. The healthiest thing we can do is to stick to real facts, remove subjective interpretation (whether positive or negative) and decouple the facts from emotions.
Supporting an individual after a moment of shock necessitates creating a feeling of safety, a sense of control, and an internalized feeling of dignity.
The best thing for someone experiencing a loss of power is to healthily claim their power.
Diagnosing everyone on the internet with trauma is not helping those people. Instead, it may be:
Just as having some behavioral tendencies similar to narcissism does not clinically equate Narcissistic Personality Disorder, experiencing a difficult or stressful event does not mean traumatization.
The beauty of the internet allows people without access to resources, education and medical care the chance to understand more about themselves and find tools that may benefit their health. And normalizing mental health care can allow us to move from stigma to receiving proper care.
But if we dilute the word trauma to the point that it is meaningless, we rob those same people of the care that they actually need.
Even practitioners and clinicians dilute the meaning of trauma.
Therapists who strongly react to the stories recounted by their patients amplify the emotion of the event. They are in essence communicating, “I cannot safely hold this space. There is something wrong. Let’s add fuel to the fire.” This negative feedback loop exacerbates the problem.
Life coaches and consultants are now jumping on the bandwagon offering services that are “trauma-informed”.
Except… “Trauma-informed“ is vague and unsupported by evidence. It’s a term invented so that coaches and organizations can peddle their services without experience or credentials. We’ve reached a point where even trauma is being commoditized and exploited for commercial value.
What exactly is “trauma-informed care”?
The term has come about in the last few years and due to its unregulated use has taken off. There are 6 components:
These are wonderful pillars and should be part of any service/intervention. We would all benefit from practicing these virtues. But they do not actually correspond to caring for trauma, post-traumatic stress disorder, or acute stress disorder.
Let’s leave that to the professionals.
Humans have built-in mechanisms to cope with stress.
As mentioned above, spontaneous shaking after an overwhelming event can help us healthily discharge. Social support – having a space to healthily discharge one’s emotions – is a crucial factor in avoiding a maladaptive stress response.
It is true that some people have a greater range of resilience to regulate their nervous system. But this is a skill that can be learned. Additionally, we are increasingly treating stress related events with great efficacy.
Up to 70% of veterans who seek medical care have clinically improved symptoms. There is even some research suggesting that the symptoms of “long COVID” are actually a stress response that can be treated by regulating the nervous system.
Developing our capacity to manage stress is a skill that everyone can learn and master.
Learning to healthily process emotions is a skill that everyone can learn and master.
Creating a vibrant and supportive social network is a skill that everyone can learn and master.
Decoupling emotions from past events is a skill that everyone can learn and master.
We do not need to be beholden to the past or carry around our wounds like permanent scars. In actuality, we have many resources that help us to healthily put the past to rest so that we can live a full life in the present.
As a society we must both reduce unnecessary chronic stressors AND we must strengthen individual resilience to cope with unexpected events. Both of these go hand-in-hand.
We can both eliminate child abuse, educational deficits, discrimination AND equip individuals to have higher levels of stress management, emotional processing, social support. If a “solution” only focused on one side of the equation at the expense of the other, then it is not a solution at all.
The word trauma is now overused and has lost its meaning. Simply experiencing something negative does not equate with trauma. We are over-pathologizing people (without having qualifications) and actually increasing their levels of stress and identification with stress. When stress is not healthily processed and discharged, it can lead to more maladaptive and harmful behavior.
Humans are remarkably resilient to stressful events and innately can cope with stress. Incidents of Acute Stress Disorder and Post-Traumatic Stress Disorder are much lower than commonly thought. ASD and PTSD are more often than not caused by factors outside of the stressful event itself (abusive childhood, discrimination, educational deficits, low social support).
Professionals are increasingly treating stress related disorders with high levels of efficacy. Treatment of stress related behaviors is best left to professionals who are qualified to work with people.
If we truly care about helping people instead of virtue signaling, bonding over, or glamorizing chronic stress, then the choice is clear. Let us listen and support each other without labeling or amplifying. Let us feel a sense of safety and empowerment. And let us leave the word trauma to the professionals.