Understanding PTSD and Trauma

As a therapist who spends about half of my time working with trauma-related issues and Post Traumatic Stress Disorder (PTSD), I want to reflect on how to understand PTSD and trauma. We know much more about trauma now than we did even twenty years ago. Our understanding of PTSD and trauma is much deeper now. Previously, we often classified trauma as something so deep that only some folks experienced it. But we now know that this was not entirely accurate and that all of us can experience trauma of some kind.

Understanding Different Traumas

I often distinguish between trauma with a small-t and trauma with a big-T in order to help my clients differentiate their experiences. Small-t traumas can be just as frightening as big-T traumas – they just don’t necessarily have the same fallout after the event. That is, they do not have as big an impact on our ability to function. Big-T trauma often has a much deeper and usually more debilitating impact on our ability to function. I use these two ways of viewing trauma in order to help people understand that traumatic experiences can exist on a spectrum. Even more importantly, those wounds impact each person differently, based on factors that are too numerous to list in this article.

Defining Trauma

Having said this, it might be beneficial to have a definition of trauma. Traumatic Stress is an emotional wound that results from experiencing a highly stressful, horrifying event over which one feels that one has no control, and in which one feels powerless and threatened by injury or death to oneself or someone else (STAR Manual: Eastern Mennonite University).

Trauma Brings a Loss of Control

Trauma is essentially a wound that results in a loss of control. And that loss often shakes the foundation of everything one once knew about the world. It changes the symbolic meaning of one’s life in so many ways. When I worked as a pastor, I knew a deeply committed Christian man who was in New York City on September 11, 2001. He was on the outer edge of the downtown area and witnessed both planes hit and bring down the towers. When I asked him how this event impacted him, he noted that it changed his view on God’s sovereignty and protection in a sinful world. He said, “I used to believe that because I was a Christian nothing could hurt me. I learned that day that no matter how religious I was, I might be hurt and could experience serious suffering … and I did.”

It is these types of events that rock the foundation of everything we know. This is why they are traumas. But it is important to look beyond the big-T and to realize that trauma with a small-t can be just as difficult. I used to work with little children as a therapist. I knew of several children that had chronic health issues and had undergone multiple surgeries from birth to age four years. I remember one case where a little girl woke up during a major operation to fix her spine. The drugs they gave her and the restraints on the operating table meant that she could not move and she was terrified. She had very little memory of this event, but it had a major impact on her early childhood development and behavior at home and at school. This was not a mass casualty event, but it still had all the possible spiritual and psychological variables that accompany big events. Traumas can also include the events we don’t think of as traumatic, such as minor car accidents, divorce, the loss of a pet, getting lost in a foreign country, etc. If scary enough, any event can be traumatic to a point.

Trauma Can Be Treated

Trauma can be managed. Everybody experiences trauma differently and its impact is different for each person. Some heal faster, some slower. The symptoms of traumatic stress can range from being managed PTSD can help considerably.” to “The reality is that symptoms of traumatic stress can range from being managed really well, to completely disappearing. While there are no promises of outcomes, really digging in with a qualified therapist can help.

Treatment for traumatic stress is often long term and depends on both the therapist and you doing the work. Treatment for trauma takes longer for many reasons, but one of the most important reasons is the time it takes to build trust with the therapist. When we have been traumatized, our trust is diminished because trauma redefines most of what we once thought was safe. Therefore building trust takes time and demands a willingness to become vulnerable once again.

Christian Counseling for PTSD and Trauma

As a Christian counselor, I have witnessed the impact that PTSD and trauma can have on people’s lives.