Trauma

There are two main categories of trauma. Type 1 and Type 2

Type 1 Trauma

Type 1 refers to single-incident traumas which are unexpected and come out of the blue. They can be referred to as big T trauma, shock or acute trauma. A condition related to big T trauma or Type 1 trauma is Post Traumatic Stress Disorder.  Many individuals are aware of PTSD as it related to those that served in the military and were actively engaged during war times.  However PTSD in only one result of trauma in a long list of what can occur after a traumatic event or events.

Examples of type 1 trauma might include:

• Severe illness or injury
• Violent assault
• Sexual assault
• Traumatic loss
• Mugging or robbery
• Being a victim of or witness to violence
• Witnessing a terrorist attack
• Witnessing a natural disaster
• Road accident
• Military combat incident
• Hospitalization
• Psychiatric hospitalization
• Childbirth
• Medical trauma
• Post suicide attempt trauma
• Life threatening illness or diagnosis

Type 2 Trauma

Complex trauma describes trauma which may have been experienced as part of childhood or early stages of development.

Repetitive trauma refers to trauma which has been repeated over a period of time and is often part of an interpersonal relationship where someone might feel trapped emotionally or physically. They may also feel as if they have been coerced or powerless to prevent the trauma.

A condition related to type 2 trauma is Complex Post Traumatic Stress Disorder.

Examples of type 2 trauma include:

• Sibling abuse
• Childhood emotional abuse
• Domestic violence
• Emotional neglect and attachment trauma
• Abandonment
• Verbal abuse
• Coercion
• Domestic physical abuse
• Long term misdiagnosis of a health problem
• Bullying at home at school or in a work setting
• Sexual abuse
• Emotional abuse
• Physical neglect
• Overly strict upbringing sometimes religious

Historical, Collective or Intergenerational Trauma

This trauma is characterized by psychological or emotional difficulties which can affect large populations, communities, cultural groups and generations. Adaptive coping patterns can be passed intergenerationally. Examples might include:

• Racism
• Slavery
• Forcible removal from a family or community
• Genocide
• War
• Disease, plague, or pandemic

Vicarious or Secondary Trauma

This type of trauma can occur when someone speaks to someone who has experienced a trauma or witnessed a trauma firsthand. The person listening can experience secondary trauma and experience symptoms experienced by the person explaining the trauma.

Little t trauma is less prominent and discussed less often. Little t traumas are experiences which are part of the everyday and are an expected part of life. They may however be very traumatic. Examples might include:

• Loss of a loved one (not traumatic bereavement)
• Moving to a new house
• Losing a job

Another area of trauma which is not talked about often enough is childhood and even adult sexual abuse and physical abuse.

After physical or sexual abuse, survivors may feel their bodies are not really their own. Survivors often report feelings such as embarrassment, shame terror, and even guilt.  Often, many blame themselves for the assault.

Due to the trauma and negative emotions linked to sexual and physical abuse, survivors may be at risk for mental health conditions. Survivors of childhood and adult abuse may develop:

• Depression: The loss of bodily autonomy is often difficult to cope with. It can create feelings of hopelessness or despair. It may also reduce one’s sense of self-worth. Depressive feelings may be mild and fleeting, or they can be intense and long-lasting.
• Anxiety: The loss of bodily autonomy can also cause severe anxiety. Survivors may fear the attack could happen again. Some may experience panic attacks. Others may develop agoraphobia and become afraid to leave their homes. In some cases, a survivor may develop a chronic fear of the type of person who harmed them. For instance, someone who was raped by a tall, fair-haired man with blue eyes may instinctively dislike, mistrust, or fear all men who match that description.
• Posttraumatic stress (PTSD): Someone who survived sexual assault may experience intense memories of the abuse. In some cases, flashbacks may be so disruptive they cause a survivor to lose track of surroundings. A person may also develop a related condition called complex posttraumatic stress (C-PTSD). C-PTSD yields a chronic fear of abandonment in addition to symptoms of traditional PTSD. Some people with C-PTSD also experience personality disruptions.
• Personality disruptions: Sexual abuse and physical abuse can sometimes result in personality disruptions such as borderline personality. The behavior linked with personality disruptions could actually be an adaption to abuse. For instance, a characteristic of borderline personality is a fear of abandonment. That fear might not be adaptive in adulthood. Yet avoiding abandonment might have protected someone from sexual abuse as a child.
• Attachment issues: Survivors may find it challenging to form healthy attachments with others. This is especially true among children who have been abused. Adults who were abused as children may have insecure attachment patterns. They could struggle with intimacy or be too eager to form close attachments.
• Addiction: Research suggests abuse survivors are 26 times more likely to use drugs. Drugs and alcohol can help numb the pain of abuse. Yet substance abuse often leads to the development of different concerns.

Physical and sexual abuse do not only leave psychological scars. They can also have long-lasting health consequences.

A person who is assaulted may sustain bruises and cuts. They could also have more severe injuries such as knife wounds, broken bones, and damaged genitals. Others may develop chronic pain without an obvious physical cause. Somatic symptoms such as “phantom pain” or undiagnosable pain may be a result of violence or harm. Some survivors experience sexual dysfunction and fertility issues. Others may develop sexually transmitted infections.

Seeking Counseling After Trauma:

Many survivors develop mental health conditions after trauma. Having a mental health concern does not make you “weak” or “broken.” People cope with trauma in different ways.

People who have survived traumatic experiences can obtain help from a mental health professional. Therapy offers a safe, confidential and engaged place to get help free from judgment. You do not have to handle your problems alone.  It is important to recognize trauma in any form is not your fault.

© 2023 by Stacey Inal, CA LMFT #120626 Los Angeles, California.