What is Trauma? Types and Impact.

Defining Trauma: Beyond Popular Understanding

Trauma is one of the most misunderstood concepts in mental health. Many people think of trauma as only referring to major catastrophic events like war, natural disasters, or severe accidents. However, the clinical understanding of trauma is much broader and more nuanced (van der Kolk, 2014).

The American Psychological Association defines trauma as an emotional response to a terrible event, but this definition doesn’t capture the full complexity of how trauma affects the human experience. More comprehensive definitions recognize that trauma occurs when a person experiences events that are outside their ability to cope, leaving them feeling helpless, overwhelmed, and fundamentally changed (Herman, 2015).

Dr. Gabor Maté, a renowned trauma expert, offers a more expansive understanding: “Trauma is not what happens to you, it is what happens inside you as a result of what happened to you.” This perspective shifts the focus from the external event to the internal experience and its lasting effects (Maté, 2022).

What makes an experience traumatic isn’t necessarily the objective severity of the event, but rather how the individual experiences and processes it. Factors like age, previous experiences, support systems, and personal resilience all influence whether an event becomes traumatic for a particular person.

Understanding trauma in this broader context helps us recognize that many more people have experienced trauma than we might initially realize, and it validates experiences that might not seem “traumatic enough” by conventional standards.

“Trauma is not what happens to you, it is what happens inside you as a result of what happened to you.”

Dr. Gabor Maté

Types of Trauma: A Comprehensive Overview

Acute Trauma

Acute trauma results from a single, isolated incident that overwhelms a person’s ability to cope. These events are typically sudden, unexpected, and intense (Friedman et al., 2021):

Examples of Acute Trauma:

• Motor vehicle accidents
• Natural disasters (earthquakes, floods, hurricanes)
• Violent crimes (assault, robbery, rape)
• Sudden death of a loved one
• Medical emergencies or life-threatening illnesses
• Terrorist attacks or mass violence
• Single incidents of physical or sexual abuse

Characteristics:

• Clear beginning and end to the traumatic event
• Symptoms often develop shortly after the incident
• May resolve more quickly with appropriate support
• Can still have long-lasting effects, especially without treatment

Complex Trauma (C-PTSD)

Complex trauma, also known as Complex Post-Traumatic Stress Disorder, results from repeated, prolonged exposure to traumatic events, especially those that occur in relationships of care or dependency (Herman, 2015):

Examples of Complex Trauma:

• Childhood abuse (physical, sexual, emotional, or neglect)
• Domestic violence in intimate relationships
• Human trafficking or captivity
• Concentration camps or prisoner of war experiences
• Cult involvement or extreme religious abuse
• Ongoing workplace harassment or bullying
• Chronic medical trauma or repeated medical procedures

Key Characteristics:

• Repeated exposure over months or years
• Often occurs in relationships with power imbalances
• Victim may be unable to escape or seek help
• Profound impact on identity, relationships, and worldview
• More complex symptoms than single-incident trauma

Additional Symptoms Beyond PTSD:

• Emotional dysregulation (difficulty managing emotions)
• Negative self-concept and chronic shame
• Interpersonal difficulties and attachment issues
• Consciousness disturbances (dissociation, memory problems)
• Distorted perceptions of the perpetrator
• Loss of meaning and hope

Developmental Trauma

Developmental trauma occurs during critical periods of childhood development, affecting how the brain and nervous system develop. This type of trauma is particularly significant because it happens while foundational neural pathways are still forming (Perry & Szalavitz, 2017):

Common Sources:

• Neglect or abandonment in early childhood
• Inconsistent or frightening caregiving
• Witnessing domestic violence as a child
• Parent with untreated mental illness or addiction
• Frequent moves or placement changes in foster care
• Medical trauma in infancy or early childhood
• War or community violence affecting children

Impact on Development:

• Affects attachment formation and trust
• Disrupts emotional regulation development
• Impacts cognitive development and learning
• Influences stress response system development
• Affects social and relationship skills

Intergenerational Trauma

Also called historical or transgenerational trauma, this refers to trauma that is passed down through families and communities across generations (Brave Heart & DeBruyn, 2019):

Examples:

• Holocaust survivors and their descendants
• Slavery and its ongoing effects on African American communities
• Indigenous peoples’ experiences of colonization and genocide
• Refugee families fleeing war or persecution
• Families affected by systematic oppression

Transmission Methods:

• Epigenetic changes that affect gene expression
• Parenting practices shaped by trauma
• Family stories and cultural narratives
• Social and economic disadvantages
• Ongoing discrimination and marginalization

Medical Trauma

Medical trauma results from frightening, painful, or life-threatening medical experiences, procedures, or diagnoses (Hall et al., 2021):

Common Triggers:

• Life-threatening diagnosis (cancer, heart disease)
• Invasive medical procedures
• ICU stays or mechanical ventilation
• Medical errors or complications
• Feeling helpless or not informed during treatment
• Pain that isn’t adequately managed
• Childhood medical procedures

Unique Aspects:

• May be necessary for survival despite being traumatic
• Can create conflict between fear and need for medical care
• Often involves loss of bodily autonomy
• May be minimized because it’s “for your own good”

Vicarious or Secondary Trauma

This occurs when individuals are exposed to trauma through their relationships with trauma survivors or through their work (Figley, 2019):

Common in:

• Therapists and counselors
• First responders (police, firefighters, paramedics)
• Healthcare workers
• Social workers and child protective services
• Journalists covering traumatic events
• Family members of trauma survivors

Symptoms:

• Similar to direct trauma exposure
• Intrusive thoughts about clients’ or loved ones’ experiences
• Avoidance of trauma-related triggers
• Emotional numbing or hyperarousal
• Changes in worldview and beliefs about safety

The Neurobiology of Trauma

How Trauma Affects the Brain

Trauma fundamentally changes how the brain functions, particularly in three key areas (van der Kolk, 2014):

The Brainstem (Survival Brain):

• Controls basic survival functions like breathing and heart rate
• Trauma can cause hypervigilance and exaggerated startle responses
• May lead to chronic activation of fight-or-flight responses

The Limbic System (Emotional Brain):

• Includes the amygdala (fear center) and hippocampus (memory center)
• Trauma can cause the amygdala to become hyperactive
• The hippocampus may shrink, affecting memory formation and retrieval
• Emotions may become dysregulated and overwhelming

The Neocortex (Thinking Brain):

• Responsible for rational thinking, planning, and language
• Trauma can impair prefrontal cortex function
• May result in difficulty with executive functioning and decision-making
• Can affect the ability to put experiences into words

Nervous System Responses

Trauma affects the autonomic nervous system, which controls involuntary functions. Dr. Stephen Porges’ Polyvagal Theory describes three main states (Porges, 2011):

Social Engagement (Ventral Vagal):

• The optimal state for connection and learning
• Feeling safe, calm, and able to connect with others
• Facial expressions and voice tone are warm and engaging

Fight or Flight (Sympathetic):

• Activated when feeling threatened
• Increased heart rate, breathing, and muscle tension
• May feel anxious, angry, or panicked

Freeze/Shutdown (Dorsal Vagal):

• Activated when fight/flight isn’t possible
• Body and mind may shut down or disconnect
• May feel numb, spacey, or dissociated

Trauma’s Impact on Memory

Trauma affects how memories are stored and retrieved:

Implicit Memory: Bodily sensations, emotions, and behavioral responses stored without conscious awareness

Explicit Memory: Conscious, verbal memories that can be intentionally recalled

Fragmented Storage: Traumatic memories may be stored in fragments rather than as coherent narratives

State-Dependent Recall: Memories may only be accessible when in similar emotional or physical states

Common Trauma Responses and Symptoms

Immediate Responses (Acute Stress)

In the immediate aftermath of trauma, people may experience:

Physical Responses:

• Shock and disbelief
• Nausea or digestive upset
• Fatigue or inability to sleep
• Headaches or body aches
• Changes in appetite
• Increased susceptibility to illness

Emotional Responses:

• Intense fear or anxiety
• Feeling overwhelmed or helpless
• Emotional numbing
• Mood swings
• Guilt or shame
• Anger or irritability

Cognitive Responses:

• Difficulty concentrating
• Memory problems
• Confusion or disorientation
• Intrusive thoughts about the event
• Difficulty making decisions

Behavioral Responses:

• Avoidance of reminders
• Social withdrawal
• Changes in sleep or eating patterns
• Increased use of alcohol or substances
• Restlessness or agitation

Long-Term Trauma Responses

When trauma isn’t processed and integrated, long-term symptoms may develop:

Re-experiencing:

• Flashbacks (feeling like the trauma is happening again)
• Nightmares or disturbing dreams
• Intrusive memories or images
• Physical reactions to reminders

Avoidance:

• Avoiding thoughts, feelings, or conversations about the trauma
• Avoiding people, places, or activities that serve as reminders
• Inability to remember important aspects of the trauma
• Emotional numbing or detachment

Hyperarousal:

• Difficulty sleeping
• Irritability or angry outbursts
• Difficulty concentrating
• Hypervigilance (constantly scanning for danger)
• Exaggerated startle response

Negative Changes in Thinking and Mood:

• Negative beliefs about self, others, or the world
• Persistent negative emotions
• Diminished interest in activities
• Feelings of detachment from others
• Inability to experience positive emotions

Dissociative Responses

Dissociation is a common response to trauma, involving disconnection from thoughts, feelings, memories, or sense of identity:

Depersonalization: Feeling detached from yourself or like you’re observing yourself from outside

Derealization: Feeling like the world around you is unreal, dreamlike, or distorted

Amnesia: Inability to remember important aspects of the traumatic event

Identity Confusion: Uncertainty about who you are or feeling like different parts of yourself

Emotional Numbing: Feeling disconnected from emotions or unable to feel

Risk and Protective Factors

Factors That Increase Trauma Risk

Certain factors can make individuals more vulnerable to developing trauma responses:

Pre-existing Vulnerabilities:

• Previous trauma exposure
• Mental health conditions
• Chronic medical conditions
• Substance use disorders
• Developmental disabilities

Social and Environmental Factors:

• Lack of social support
• Poverty or financial stress
• Community violence or instability
• Discrimination or marginalization
• Family dysfunction or conflict

Event-Specific Factors:

• Severity and duration of the event
• Perceived life threat
• Physical injury
• Loss of loved ones
• Human-caused vs. natural disasters

Protective Factors That Promote Resilience

Other factors can help protect against trauma or promote recovery:

Individual Factors:

• Good physical health
• Strong sense of self-efficacy
• Problem-solving skills
• Emotional regulation abilities
• Spiritual or religious beliefs
• Previous successful coping experiences

Social Factors:

• Strong social support network
• Stable family relationships
• Community connections
• Access to mental health services
• Cultural identity and pride

Environmental Factors:

• Safe and stable housing
• Economic security
• Access to education and healthcare
• Community resources and programs

Cultural and Social Dimensions of Trauma

Cultural Trauma

Some traumas affect entire cultural groups and can persist across generations:

Historical Trauma: Large-scale events that affect cultural groups (genocide, slavery, colonization)

Cultural Expression: How different cultures understand and express trauma varies significantly

Healing Practices: Traditional healing methods may differ from Western therapeutic approaches

Collective Memory: How communities remember and process shared traumatic experiences

Social Trauma and Oppression

Ongoing social conditions can create traumatic stress:

Systemic Racism: The ongoing stress of discrimination and marginalization

Poverty: Chronic stress from economic insecurity and lack of resources

Oppression: Effects of systematic disadvantage based on identity

Collective Violence: Community-wide exposure to violence or threat

Intersectionality and Trauma

Multiple identities can compound trauma experiences:

• How race, gender, sexuality, class, and other identities intersect
• Unique vulnerabilities faced by marginalized communities
• Barriers to accessing culturally competent treatment
• Need for trauma-informed approaches that understand social context

Trauma Across the Lifespan

Childhood Trauma

Trauma during childhood has unique characteristics and impacts:

Developmental Considerations:

• Limited cognitive ability to understand events
• Dependence on caregivers for safety and interpretation
• Critical periods for brain and emotional development
• Impact on attachment formation

Common Childhood Traumas:

• Physical, sexual, or emotional abuse
• Neglect or abandonment
• Witnessing domestic violence
• Medical trauma
• Natural disasters or accidents
• Bullying or peer victimization

Long-term Effects:

• Increased risk for mental health problems
• Difficulty with relationships and trust
• Impact on academic and career success
• Higher rates of physical health problems
• Increased risk for revictimization

Adolescent Trauma

Teenagers face unique trauma risks and responses:

Common Teen Traumas:

• Dating violence
• Sexual assault
• Bullying or cyberbullying
• Accidents or sports injuries
• Witnessing community violence
• Family conflict or divorce

Developmental Factors:

• Identity formation challenges
• Peer influence and social pressures
• Risk-taking behaviors
• Brain development still occurring

Adult Trauma

Adults may experience various types of trauma throughout their lives:

Relationship Trauma: Intimate partner violence, divorce, betrayal

Work-Related Trauma: Workplace violence, harassment, job loss

Loss and Grief: Death of loved ones, miscarriage, divorce

Life Transitions: Major illness, disability, retirement

Random Violence: Crime, accidents, natural disasters

Older Adult Trauma

Seniors may face unique trauma experiences:

Age-Related Traumas:

• Medical trauma and hospitalizations
• Loss of independence
• Death of spouse or peers
• Elder abuse or neglect
• Financial exploitation

Historical Context: May carry unprocessed trauma from earlier in life

Resilience Factors: Often have developed coping strategies over time

The Impact of Trauma on Daily Life

Physical Health Consequences

Trauma has profound effects on physical health (Felitti et al., 1998):

Chronic Conditions:

• Cardiovascular disease
• Autoimmune disorders
• Chronic pain conditions
• Gastrointestinal problems
• Sleep disorders

Health Behaviors:

• Increased risk for substance use
• Poor nutrition and eating disorders
• Lack of exercise or self-care
• Risky sexual behaviors
• Self-harm or suicidal behaviors

Healthcare Utilization:

• More frequent doctor visits
• Higher healthcare costs
• Difficulty trusting medical providers
• May avoid necessary medical care

Mental Health Impact

Trauma significantly increases risk for mental health conditions:

Common Conditions:

• Post-Traumatic Stress Disorder (PTSD)
• Depression and anxiety disorders
• Substance use disorders
• Eating disorders
• Personality disorders
• Dissociative disorders

Cognitive Effects:

• Memory and concentration problems
• Executive functioning difficulties
• Learning and academic challenges
• Decision-making impairments

Relationship and Social Impact

Trauma profoundly affects how people relate to others:

Trust Issues: Difficulty trusting others or being overly trusting

Attachment Problems: Difficulty forming and maintaining close relationships

Communication Challenges: Problems expressing needs or setting boundaries

Social Isolation: Withdrawing from others due to shame or fear

Intergenerational Effects: Impact on parenting and family relationships

Work and Economic Impact

Trauma can significantly affect career and financial stability:

Work Performance: Concentration problems, absenteeism, interpersonal difficulties

Career Advancement: May limit educational or career opportunities

Economic Consequences: Lost income, medical expenses, legal costs

Workplace Relationships: Difficulty with authority figures or colleagues

Simplified Version for Difficult Moments: Trauma happens when something overwhelming occurs that’s too much for your mind and body to handle at the time. It’s not your fault, and it can affect many areas of your life. Healing is possible with the right support and care.

Resilience and Post-Traumatic Growth

Understanding Resilience

Resilience is the ability to adapt and bounce back from adversity. It’s not a fixed trait but a process that can be developed:

Components of Resilience:

• Emotional regulation skills
• Problem-solving abilities
• Social connections and support
• Meaning-making and purpose
• Self-efficacy and empowerment
• Flexibility and adaptability

Building Resilience:

• Developing coping skills
• Strengthening social connections
• Finding meaning in experiences
• Taking care of physical health
• Learning from challenges
• Practicing self-compassion

Post-Traumatic Growth

Many trauma survivors eventually experience positive changes as a result of their healing journey (Tedeschi & Calhoun, 2004):

Areas of Growth:

• Appreciation of Life: Greater gratitude and mindfulness
• Relating to Others: Deeper, more authentic relationships
• Personal Strength: Increased confidence in ability to handle challenges
• New Possibilities: Discovering new interests, goals, or paths
• Spiritual Development: Deeper spiritual connection or meaning

Factors That Promote Growth:

• Active coping strategies
• Social support and connection
• Meaning-making and narrative coherence
• Professional help when needed
• Time and patience with the process

Pathways to Healing

Professional Treatment Options

Various therapeutic approaches can help heal trauma:

Trauma-Focused Therapies:

• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Cognitive Processing Therapy (CPT)
• Prolonged Exposure Therapy (PE)

Body-Based Approaches:

• Somatic Experiencing
• Sensorimotor Psychotherapy
• Trauma-Sensitive Yoga
• Body-Based Mindfulness

Integrative Approaches:

• Internal Family Systems (IFS)
• Dialectical Behavior Therapy (DBT)
• Accelerated Resolution Therapy (ART)
• Neurofeedback

Self-Care and Healing Practices

Recovery involves daily practices of self-care:

Physical Care:

• Regular exercise and movement
• Adequate sleep and rest
• Nutritious eating
• Medical care when needed

Emotional Care:

• Mindfulness and meditation
• Journaling and self-reflection
• Creative expression
• Emotional support from others

Spiritual Care:

• Connection to meaning and purpose
• Religious or spiritual practices
• Connection with nature
• Service to others

Building Support Systems

Healing happens in relationship with others:

Professional Support: Therapists, doctors, support groups

Personal Support: Family, friends, mentors, spiritual communities

Peer Support: Others who have experienced similar traumas

Community Support: Organizations, advocacy groups, online communities

Recommended Reading

For Understanding Trauma:

• “The Body Keeps the Score” by Bessel van der Kolk – Comprehensive look at trauma’s impact on brain and body
• “Trauma and Recovery” by Judith Herman – Classic foundational text on trauma and healing
• “The Myth of Normal” by Gabor Maté – Understanding trauma in the context of modern society

For Healing and Recovery:

• “Complex PTSD: From Surviving to Thriving” by Pete Walker – Practical guidance for healing from complex trauma
• “Waking the Tiger” by Peter Levine – Somatic approaches to trauma recovery
• “My Grandmother’s Hands” by Resmaa Menakem – Understanding racialized and intergenerational trauma

References

1. Brave Heart, M. Y. H., & DeBruyn, L. M. (2019). The American Indian holocaust: Historical trauma and the persistent grief. Journal of Indigenous Wellness, 4(2), 23-38.
2. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245-258.
3. Figley, C. R. (2019). Treating Compassion Fatigue. Routledge.
4. Friedman, M. J., Keane, T. M., & Resick, P. A. (2021). Handbook of PTSD: Science and Practice. Guilford Press.
5. Hall, A. M., Kamper, S. J., Hernon, M., Hughes, K., Kelly, G., Lonsdale, C., … & Ostelo, R. (2021). Measurement tools for adherence to non-pharmacological self-management treatment for chronic musculoskeletal conditions: A systematic review. Archives of Physical Medicine and Rehabilitation, 102(6), 1119-1131.
6. Herman, J. L. (2015). Trauma and Recovery. Basic Books.
7. Maté, G. (2022). The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture. Avery.
8. Perry, B. D., & Szalavitz, M. (2017). The Boy Who Was Raised as a Dog. Basic Books.
9. Porges, S. W. (2011). The Polyvagal Theory. W. W. Norton & Company.
10. Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18.
11. van der Kolk, B. (2014). The Body Keeps the Score. Penguin Books.