‘Trauma’ as a topic is very “in”. Psychotherapy, medicine, yoga, self-help books and yes, also bodywork and massage increasingly deal with traumas and the effects of such.
An example of this is the ICD- 11 World Health Organization (WHO) catalogue. in which trauma is recognized as a possible origin of a wide range of symptoms.
Because of the increase in awareness and publicity for this topic, we often encounter many questions and worries about it in our training courses:
- How can I recognize trauma?
- Can I retraumatize people?
- How can I deal professionally with traumatized clients?
These are all important questions which we also cover in other articles. But in this article I want to step back a little and talk about the following question:
"What is trauma, actually?"
In many discussions (between bloggers, therapists, Journalists and even respected authors) the word “TRAUMA” is used very differently and sometimes imprecisely. In extreme cases, every unpleasant or stressful experience can be referred to as “traumatic”.
That’s why I want to create some clarity in this article and offer a more subtle perspective on this topic. My hope is that after this article you can answer for yourself what trauma actually is.
The etymological origin of the word Trauma lies in the Greek: trá͞uma (Τραῦμα) literally meaning ‘wound, injury, damage ‘. Since the 18th century, it has been used as a term for a ‘psychological shock’.
Modern trauma researchers, such as Stephen Porges, Peter Levine and Bessel van der Kolk, emphasize the role of the autonomic nervous system in cases of such shock. They call trauma a chronic activation of evolutionarily old structures of our nervous system, which affect our perceptions, actions and thoughts at any moment.
PDF-Handout: What is Shock-Trauma?
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Trauma is the shock that remains after an event
To be precise about trauma, it is important to introduce a distinction that is often overlooked or mixed up: A traumatizing event is not the same as the traumatic effects it has.
Yet, both are referred to as Trauma in conversations and the literature:
Event: “The accident was a trauma” or “the events were traumatic.”
Impact: “The accident caused a trauma” or ” it left the person traumatized”.
In the narrower definition of the aforementioned researchers and Holistic Bodywork, ‘trauma’ refers to the effects that remain after an event. ‘Trauma’ is the soul’s shock that remains and negatively affects our life, even if the incident is long done.
(This understanding of trauma coincides with the neurophysiological perspective that trauma refers to the chronic activation of the nervous system .)
A very simple example: I have a bicycle accident (event) and then an injury to the calf (wound) – The wound remains, even if the accident is already over.
Without a lasting effect, an event is only an event – not a trauma. An event can only be called a traumatizing event if it has traumatic effects. And it cannot be objectively predicted, which event has traumatic consequences for which person.
What are features of traumatic events?
Each of us has a lot of experiences – including many negative ones. Few of them are actually traumatizing. What is the difference between normal experiences and traumatizing ones?
For an Event to be potentially traumatizing, it must meet two main criteria:
- It is unbearable – I experience a situation as existentially threatening or unbearable
- It exceeds the individual coping mechanisms – I have (in my experience) no possibility to cope with the situation, I am at its mercy
(Different researchers stress experienced feelings of helplessness, horror, etc. These can be understood as a consequence of the first two points.)
Important: It can not be said which situation is traumatic for whom, as it depends on how an individual experiences the situation (unbearable ) and whether the individual has opportunities to deal with the situation that situation (no way to do something).
Back to the example of the bicycle accident: The spoke of my bike pushes on my calf and it is unbearable for my physical structures – they can no longer withstand the pressure. Due to the position of the calf, there is no way for the tissue to escape. So the spoke punctures my calf.
And transferred to a mental trauma: Due to the spoke in my calf, I have strong, unbearable pain. Because of my injuries, I cannot move – I have no way to act but feel helpless.
This situation could be traumatic – but it does not have to be. That depends on what happens afterwards.
When / Why do traumatic effects develop?
An event only becomes a trauma if we cannot process it. No matter how overwhelming and unbearable a situation may be, as long as we process, metabolize, and complete what has happened, there must be no lasting (“emotional”) impact on our lives.
We process, metabolize and integrate an event by
- Discharge the survival energy from the nervous system(trembling, movement …)
- Feel and let go of emotions connected to the situation (anger, fear …)
- Develop a coherent and healthy mental orientation about what happened (coherent memories, clear narrative …)
- Can learn from it and develop alternative behavioural options that we can use in the future (imagining them, practising them…)
If these steps do not take place, aspects of the event get “stuck” in our system and affect future situations
- Our nervous system is chronically activated, we feel insecure, annoyed, overreact to simple situations
- Old emotions stay in our system and can be triggered quickly- we suddenly get angry, sad in simple situations
- We develop an unhealthy understanding of our self & the world(beliefs) – “it’s all my fault”, “I’m bad”
- We are stuck in rigid patterns of behaviour – avoidance strategies and repeating patterns
The traumatic effects make an event traumatizing
It needs the traumatic effects of an event so that we can describe an event as traumatic. If no effects remain, the event was not traumatizing.
In other words: we cannot look at a situation from the outside and say, “THAT is a trauma” When an event is completely processed, it has no effects on the “soul” or neurophysiology – and thus also not the person’s future.
That’s why in Holistic Bodywork we also use the word ‘ trauma ‘ to denote the lasting effects that remain stuck in a person’s system.
How trauma affects our lives:
What we could not process from past events affects our lives negatively – not the event itself.
Old emotions, activation and beliefs remain stuck in our system and influence our behaviour, feeling and thinking here and now, even if the event is long gone and forgotten.
This happens without us being aware that these are old traumas.
- When my nervous system is chronically inFight-Flight Mode due to my cycling accident, I feel tense, anxious and angry in my life – but I do not know where that feeling comes from.
- If old emotions are triggered, I feel helpless, angry or panicked now – even though these emotions are from the past
- And I believe my compulsive behaviour to avoid bicycles and roads are necessary and correct – even though they mess with my life.
We do not experience trauma from the outside. But it influences our present life from within.
Trauma is the wound that remains after an event is over and affects our life negatively. Trauma ‘refers to the traumatic effects that remain when we could not process an unbearable event in the past so that emotions, nervous system activation, beliefs and behaviour got stuck and influence our behaviour, thoughts and feelings in the future from the inside.
In the following articles:
Based on this article, we can now turn to the distinction between shock- and developmental trauma. But more about this in Part 2 of this series …