Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes their sense of self and their ability to feel the full range of emotions and experiences.

It does not discriminate and it is pervasive throughout the world. A World Mental Health survey conducted by the World Health Organization found that at least a third of the more than 125,000 people surveyed in 26 different countries had experienced trauma. That number rose to 70% when the group was limited to people experiencing core disorders as defined by the DSM-IV (the classification found in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition). But those numbers are just for instances that have been reported; the actual number is probably much, much higher.

While there are no objective criteria to evaluate which events will cause post-trauma symptoms, circumstances typically involve the loss of control, betrayal, abuse of power, helplessness, pain, confusion and/or loss. The event need not rise to the level of war, natural disaster, nor personal assault to affect a person profoundly and alter their experiences. Traumatic situations that cause post-trauma symptoms vary quite dramatically from person to person. Indeed, it is very subjective and it is important to bear in mind that it is defined more by its response than its trigger.

Common Responses and Symptoms of Trauma

Response to a traumatic event varies significantly among people, but there are some basic, common symptoms.

Emotional signs include:                                     

• sadness
• anger
• denial
• fear
• shame

Common physical symptoms:

• nausea
• dizziness
• altered sleep patterns
• changes in appetite
• headaches
• gastrointestinal problems

Types of Trauma

As mentioned above, trauma is defined by the experience of the survivor. But there is a delineation of trauma levels. Broadly described, they can be classified as large ‘T’ traumas and small ‘t’ traumas.

Small-T traumas are events that exceed our capacity to cope and cause a disruption in emotional functioning. These distressing events are not inherently life or bodily-integrity threatening, but perhaps better described as ego-threatening due to the individual left feeling notable helplessness. Some examples include:  Interpersonal conflict, Abrupt or extended relocation, Legal trouble, Financial worries or difficulty

Large-T trauma is distinguished as an extraordinary and significant event that leaves the individual feeling powerless and possessing little control in their environment. Such events could take the form of a natural disaster, terrorist attack,sexual assault, combat, a car or plane accident, etc. Helplessness is also a key factor of large ‘T’ traumas, and the extent of experienced helplessness is far beyond that of a small ‘t’ trauma. Large ‘T’ traumas are more readily identified by the experiencer, as well as those who have any familiarity with their plight.

Alpine
Managing Editor
Journal of Orthopedic and trauma.
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