When addressing trauma it is important to understand that there are two very distinct types of trauma that we will come across.
What is Trauma?
First let’s define trauma. DSM-V (the US psychiatric manual for psychological disorders) defines trauma as “Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: directly experiencing the traumatic event(s); witnessing, in person, the traumatic event(s) as it occurred to others; learning that the traumatic event(s) occurred to a close family member or close friend (in case of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental); or experiencing repeated or extreme exposure to aversive details of the traumatic event(s)” (p.271).
I would offer a simpler definition of trauma. Trauma is any event or experience where the person feels overwhelmed by the demands of the situation and that these demands are greater than the resources available to them to deal with it. In this we cover a multitude of possible scenarios, not just risk of physical injury to life or limb as suggested above.
However, we define trauma it is important to recognise that there are two very distinct types of trauma. Each type needs very different handling and resolution.
The first is called Event Trauma. This type of trauma can occur either because it is experienced directly, or because we witness something traumatic happening to others, especially someone we love and care about. So for example, being raped is clearly traumatic. Witnessing a rape could be equally traumatic even if you were not raped yourself.
Event Trauma covers a wide range of experiences and we may easily imagine many of the categories of Event Trauma. These would include:
- Physical violence: Parental violence, domestic abuse, severe bullying, war, torture
- Emotional abuse: Dominating or controlling parents or partners, emotional bullying, extreme criticism from a parent or other
- Injury and accident: Car crashes, severe injuries, natural disasters
- Sexual trauma: abuse, rape, inappropriate touch and even more subtle forms of abuse such as inappropriate looks may be experienced as trauma
- Medical trauma: any surgical procedure is a trauma for the body and nervous system, not matter how life-saving and necessary it may be
- Birth: being born is traumatic as any osteopath working with infants will tell you
- Birthing trauma: giving birth is often traumatic. I’d include in this not only incomplete births (miscarriages, terminations, still-births) but also stressful births (where the baby is upside down, has the cord around their neck) and painful births (including vaginal or perineal tears, episiotomies, prolapses, etc.)
- Social trauma: the loss of status through loss of job, home or partner (wife or husband), unexpected change in social standing due to events beyond ones control
Event Trauma may also include witnessing any of the above. So Emergency Workers called in to sites of natural disasters and so on may also experience trauma even if they were not involved in the original event directly.
So far all of these types of trauma are of one kind; either a singular event or a series of similar specific events causing the trauma. All of this is Event Trauma.
This arises because in childhood we have innate needs for love, safety and connection that are not met. Instead we experience connection (primarily with parental care-givers) as unsafe or conditional. We ‘learn’ that the world is not safe and that it is not safe to be in intimate connection with others. We ‘learn’ that there are parts of ourselves that are acceptable (for example, a child may be praised for being happy, intelligent, pleasing of others) and other parts of our selves that are not acceptable or safe to express (a child may learn that it is not ok to be sad, angry, vulnerable).
With Developmental Trauma it is possible that it has a specific experience as its focus but it will be more widespread over a longer period of time. Often Developmental Trauma is less easy to identify than Event Trauma. If we were held at gunpoint, say, in a robbery it is easy to accept that this is traumatic. If we receive subtle messages that we are not good enough, that we are criticised by our parents on a regular basis, this is likely to feel ‘normal’ for us, so we do not perceive it as trauma. Nonetheless these more subtle but more chronic experiences are likely to have at least as big an influence on how we express ourselves in life and especially in intimacy.
Healing Developmental Trauma vs Event Trauma
Since Developmental Trauma is a whole different category of trauma and has many strands and types each of which is based on the child’s unmet needs and how it is received in its childhood environment. This is a whole topic in itself and I will look at this in later blogs. It is important to note, however, that Event Trauma and Developmental Trauma look and feel different and that they must be resolved in different ways. Event Trauma relates to a single or series of events and will likely impact the person’s relationship with that type of event or aspects around the event. For example, we can easily imagine that someone who has experienced sexual abuse may likely feel unsafe in sexual or intimate situations. If that person is a woman who has been attacked by a man, then it also makes sense that this woman may feel unsafe around men in general; or around anger or aggression.
Healing Event Trauma requires a number of steps including building resources, developing resilience, increasing awareness of the various activations of the Autonomic Nervous System, developing the ability to self-regulate one’s nervous system, exposure therapy of some kind, re-patterning or re-conditioning of the nervous system and integration of the trauma experience. Again this is a big topic that I intend to cover in later blogs and a book. In essence though, healing of Event Trauma requires an enhanced ability to regulate one’s nervous system so that we can face what triggers us without reverting into trauma reactions such as dissociation or flashbacks and without withdrawing from contact with the world and other people.
Developmental Trauma is more about the unmet needs of our childhood and, whilst regulating and re-conditioning the nervous system may be a part of the healing of this, what will always be a part of the healing of Developmental Trauma is retracing the roots of the trauma and repairing the damage caused by these unmet needs. The healing journey for Developmental Trauma is to engage in dialogue with the inner child and uncover what that child needed in order to feel safe back then and finds ways to repair the unmet needs now. The healing of Developmental Trauma asks us to find the resourced adult in ourselves and use that part of us to heal, protect, nourish and love the wounded inner child.
It is important when addressing trauma then to understand the differences between these two types of trauma and how to address them, of what is needed in each case and how to apply it.