By: Dimitri Dionisatos, B.Sc. RP (Qualifying)
Do you ever look at your child/adolescent and wonder what’s going on with them? Does your child/adolescent seem to only throw “fits” when reading or doing math?</p > Psychological trauma is the result of an experience or series of experiences that is perceived by an individual as emotionally or physically damaging or threatening, and that has long-term adverse effects on an individual’s various domains of wellness, including their emotional, social, physical, and/or spiritual well-being (Substance Abuse and Mental Health Services Administration, 2012).
If you were to take a poll of what ten people on the street think trauma is, you would find that many of them would cite examples like being exposed to war, physical or sexual abuse, and life-threatening accidents. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) has reinforced the notion that an individual has only experienced trauma if they were exposed “to actual or threatened death, serious injury, or sexual violence” (American Psychiatric Association, 2013). These can be classified as Big ”T” Traumas. However, trauma can also result from divorce, infidelity, rejection by peers, or work termination, which may not sound as debilitating but these Small “t” Traumas also can have profound and lasting effects on an individual’s well-being.
Here, it is important to note that not everyone exposed to Small “t” Trauma or Big “T” Trauma events will go on to develop a mental health diagnosis or long-lasting adverse effects of the trauma.
Big “T” Trauma
A Big “T” trauma typically involves exposure to serious injury, an actual or threatened death, during a natural disaster, war or combat, serious accident, or sexual violence. These events can leave an individual feeling shocked, despondent, and/or helpless. The literature examining the short-term and long-term effects of Big “T” traumas is clear – exposure can lead to flashbacks, nightmares, avoidance of potentially traumatic events, strong feelings of fear, guilt, horror, or shame, and hypervigilance.
Small “t” Trauma
Small “t” traumas are life experiences that can create long-lasting difficulties that may lead to a specific mental health diagnosis or contribute to additional symptoms (Leeds, 2016). While Small “t” traumas may seem less significant from an adult perspective, they can be particularly damaging and terrifying to a child (Morrisey, 2013). For example, not feeling loved as a child is linked with fear of survival because the child is dependent on their parents for their survival. Other examples of Small “t” trauma include being bullied, constant criticism from peers or parents, separation, or divorce, financial or work stress. These experiences can harm an individual’s self-esteem and trust by altering an individual’s beliefs about themselves, others, and the world. Furthermore, the effects of these Small “t” Traumas may compound over time, creating even more distress.
Treatment for Trauma
Some individuals are more vulnerable to the adverse effects of traumatic exposure than others. Certain factors, such as an anxious disposition and exposure to past trauma, have been correlated with an individual’s vulnerability to future trauma. Investigating these factors need to be a component of planning and providing treatment and cultivating resilience.
Whether you have experienced Small “t” traumas, Big “t” traumas, or a combination of the two, there are effective psychotherapeutic treatments. Evidence-based treatments for trauma include exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing (EMDR).
These treatments can substantially reduce symptoms of trauma through various psychotherapeutic activities, such as the reprocessing of memories, thoughts, and beliefs.
Working through any form of trauma can be exhausting and difficult, but with the help of a trained mental health professional, there is hope for relief of symptoms and regaining a high quality of life.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Morrissey, M. (2013). EMDR as an integrative therapeutic approach for the treatment of separation anxiety disorder. Journal of EMDR Practice and Research, 7(4), 200-207.
Substance Abuse and Mental Health Services Administration. (2012). vSAMHSA’s working definition of trauma and guidance for trauma-informed approach.