If I told you I was about to share “my trauma,” what would come to mind? Would you envision pain inflicted by another’s actions or the echoes of something horrible I went through? Would you view me as a victim, or would you expect me to talk about my resilience?
Trauma became a prominent subject in psychology around the Vietnam War era. Today, “trauma” encompasses not only catastrophic events but also personal experiences of victimization, even in seemingly ordinary situations.
Originally a medical term referring to physical injury, trauma studies have evolved to encompass the psychological impact of severe stress, threat, and danger. Unfortunately, the popular discourse now borders on becoming synonymous with suffering.
The need to understand “trauma” in treatment
The broad use of the term trauma can obscure the nuances of individual experiences and contribute to ineffective treatment. One of the most important elements for the success of therapy is a clear understanding of the client’s situation. By accurately grasping both internal and external factors shaping a client’s life and current situation, clinicians can create targeted treatment plans and select the most appropriate interventions. For instance, emotionally painful memories may require a different approach from those associated with fear.
Hence, when a client describes a difficult event as “trauma” or refers to childhood hardship as “childhood trauma,” it matters to the therapist who will select the best way to help the person. The clinician must first gather a complete picture of what the client experienced, their specific responses, and any resulting present symptoms, before using “trauma” as a clinical diagnosis. If “trauma” is assigned solely based on the event itself, treatment risks becoming ineffective or even harmful.
Imagine a client reporting childhood abuse from their mother. The therapist might immediately engage in trauma-focused therapy, encouraging the client to revisit memories of abuse. However, if the client now shares a positive, repaired relationship with their mother, repeatedly recalling the abuse may feel like reopening a scar. At first, the discomfort might be mild, but as the sessions progress, the pain could intensify, risking new resentment and damage to a relationship that had previously healed through mutual effort.
Trauma, in this sense, should be seen as wounds that remain open, bleeding, and susceptible to further damage or “infection.” Resolved negative experiences from the past, however, should not be treated as trauma—just as scars, once healed, do not require medical intervention.
This example highlights a crucial aspect of trauma therapy: the importance of considering the present context of the client’s life. While trauma-focused therapy can be beneficial for many, it’s essential to avoid retraumatizing the client by dwelling on past experiences that have already healed.
How neuroscience understands trauma
Fortunately, advances in neuroscience provide a more comprehensive understanding of trauma and guide us toward more effective treatments. Today, trauma is recognized as a complex neurobiological, psychological, and social phenomenon.
Psychological Trauma Phenomenon
Source: Antonieta Contreras
Much like the immune system defends our body against external agents (such as viruses or bacteria), the autonomic nervous system initiates a series of survival functions to ensure our protection. These functions are neurobiological in nature, while our reactions, perception of threat, and the relationships we form around the experience are psycho-social. The aftermath—symptoms and injury—are neuro-bio-psycho-social, affecting multiple aspects of our system’s functioning, our relationship with the world, and our sense of safety.
“Trauma is the disruption of an individual’s neurobiological, psychological, and social functioning as a result of unresolved emotional and physiological responses to overwhelming experiences perceived as threatening.”
Psychological trauma versus PTSD
Continuing the analogy of the immune system, let’s explore psychological trauma. Just as an infection occurs when viruses, bacteria, or other microbes enter our body, multiply, and trigger an immune response, trauma happens when an overwhelming threat activates our nervous system to eliminate it. Similarly, as disease typically develops in a small proportion of infected individuals, resulting from cellular damage due to the infection and leading to signs and symptoms of illness, PTSD affects only a subset of those who have had a severe activation of their survival mechanisms. PTSD emerges when the nervous system remains dysregulated, stuck in survival mode, and symptoms persist.
No risk, no trauma
When an infection subsides, it means the immune system has successfully neutralized the threat, allowing symptoms to resolve. Similarly, once the sense of lack of safety resolves, the body gradually returns to its original state, and symptoms fade. If there is no ongoing risk, trauma—the disruption of our functions—should vanish over time. However, people often continue to feel traumatized even after the threat has passed. This persistence can be due to feelings of constant threat or a sense of being trapped in a victim mindset, leading to a lasting state of fear and helplessness.
Some clinicians still believe that painful memories are a sign of unresolved trauma. However, emotional pain is a natural part of being human. Not all emotional pain arises from fear, and memory itself is an adaptive mechanism designed to help us better predict and navigate the future. It may not even be advisable to aim for the complete removal of warnings about what can be hurtful and dangerous.
Memories and emotions—traumatic or not—serve essential roles in navigating our world and should not be viewed as enemies or undesirable. Instead, they should be acknowledged, made functional, and used as helpful tools.
Ultimately, trauma needs not to be a lifelong burden. It is possible to help clients resolve trauma with the right mental approach on both sides. By reassessing the perception of risk, rebuilding confidence in natural abilities, and recognizing trauma as part of the past rather than the present, most people can restore a sense of safety. Embracing this perspective helps us honor the adaptive functions of our memories and emotions, allowing them to guide us with clarity rather than fear. Trauma, then, becomes a memory of what was, empowering us to move forward with strength and hope for a safer future.
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