Trauma is the unique individual experience of an event or enduring conditions in which the individual’s ability to integrate his/her emotional experience is overwhelmed and the individual experiences (either objectively or subjectively) a threat to his/her life, bodily integrity, or that of a caregiver or family (Saakvitne, K. et al, 2000).
The Early Trauma Treatment Network, which is funded through the National Child Traumatic Stress Network, defines trauma as an exceptional experience during which powerful stimuli overwhelm the child’s capacity to regulate emotions. The NTCSN works predominantly with children under the age of six, and defines trauma with developmental considerations in mind. However, both definitions of traumatic experience suggest that the perception of danger or subjective appraisal of trauma will vary greatly depending on both age and stage of development. For example, the most significant trauma for a child under the age of four may be observing the threat of a viable caregiver.
It is important to keep in mind that not all traumatic experiences will lead to a trauma-related disorder. It is normal and expected for trauma-related signs and symptoms to persist for up to one month after an individual undergoes a significant traumatic experience, but this does not necessarily mean that these responses will develop into a post-traumatic stress disorder. However, if related symptoms begin disrupting emotional and social health, interrupting the consistent routine of daily life, and continuously meeting a certain set of diagnostic criteria, the trauma may be categorized in one of two types of diagnosis.
Two Types of Trauma Diagnosis
- Complex Trauma
The term ‘Complex Trauma’ was first introduced in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). Complex Trauma (or Developmental Trauma Disorder) described how prolonged or repeated exposure to trauma affects the ongoing development of children. Complex Trauma begins in early childhood, directly involves the child’s primary caregiver and/or social environment, and is chronic. This specific type of trauma typically involves child maltreatment, either simultaneous or sequential, and may include neglect, physical or sexual abuse, psychological maltreatment, or the witnessing of ongoing domestic violence. In adolescence and adulthood, individuals may be better equipped with the support and psychological tools to buffer the potentially traumatic results of such experiences. In early childhood, however, exposure to traumatic experiences typically result in severe emotional dysregulation, which contributes to a loss of direction, safety, and ability to identify danger cues. These developmental hindrances, in turn, may lead to repeated (or subsequent) exposure to trauma throughout adolescence.
- Post-Traumatic Stress Disorder
Post-traumatic stress disorder (commonly referred to as PTSD), refers to recurrent symptoms associated with a traumatic event (such as a car accident, natural disaster, rape, or the witnessing of a violent act). These symptoms may include flashbacks, recurrent nightmares, loss of interest in day-to-day activities, ongoing physical reactions, avoidance, startle reactions, and the avoidance of people, places, and things related to the event or experience. These symptoms can be further broken down into four main symptom clusters: avoidance, intrusion, alterations in reactivity and arousal, and negative alterations in cognition and mood.
Types of Traumatic Experience
The National Traumatic Stress Network provides comprehensive definitions of all varying types of traumatic event, differentiating them based on who was involved in the event, what the event actually consisted of, and the role of the law in the specific event. Each varying type of trauma is briefly described below:
- Physical Abuse or Assault
Attempted or actual infliction of physical pain, with or without the use of a weapon or weapon-like object, including severe corporeal punishment.
- Sexual Abuse or Assault
Attempted or actual sexual contact that was not consensual or appropriate, unwanted or coercive sexual contact, exposure to sexual environments or materials that were not age-appropriate, or sexual exploitation.
- Emotional or Psychological Maltreatment or Abuse
Acts of commission against a minor or child, including emotional abuse, emotional neglect, verbal abuse, intentional social deprivation, or excessive and unrealistic demands on a child’s performance. This specific type of abuse frequently leads to harshly negative self-image and disrupted behavioral patterns.
Failure of the primary caretaker of the child in question to provide age-appropriate care despite financial ability to do so. Forms of neglect may include physical neglect, educational neglect, and medical neglect.
- Forced Displacement
Forced relocation to an entirely new home and environment during a crucial phase of development, typically related to politics – for example, immigrants fleeing political persecution.
- System-Induced Trauma
Traumatic removal from the home during a crucial phase of development, often relating to sibling separation, traumatic foster placement, or numerous placements over a short period of time.
- Traumatic Grief or Separation
The death of a primary caretaker (such as a parent), the death of a sibling, the abrupt, unexpected, or untimely death of a close friend or family member, or unexplained and indefinite separation from a primary caretaker, sibling, or parent due to uncontrollable, outside influences.
- School Violence
Violence that occurs in a school setting, such as bullying, the suicide of a classmate, interpersonal violence amongst classmates, or a school shooting.
- Witness to Domestic Violence
Exposure to emotional, physical, or sexual abuse between a primary caretaker and another adult within the home, or between an adolescent and one or more adults within the home environment.
- Serious Illness, Accident or Medical Procedure
Undergoing an unintentional injury or accident, having a life-threatening and physically excruciating illness, or undergoing a painful or life-threatening medical procedure (such as a surgery).
- Victim or Witness to Community Violence
Often refers to an early exposure to gang-related violence within the community, or exposure to another, similar form of extreme violence within the community.
- Manmade or Natural Disasters
An unintentional result of a natural disaster such as a flood, fire, or hurricane, or a major accident resulting from a manmade event.
- War, Terrorism, or Political Violence
Exposure to violent acts such as shooting, bombing, looting, or acts relating to terrorist activity, either perpetrated by a political group or an individual acting in isolation if he or she was decidedly motivated by a political or terrorist group.
- Victim or Witness to Extreme Interpersonal or Personal Violence
Includes extremely violent acts such as homicide or suicide occurring personally or interpersonally.
Next Chapter and Trauma
Clearly, the definitions and effects of traumatic experience are exceedingly far reaching and comprehensive. Trauma can range from emotional neglect at an early age to physical mutilation resulting from direct involvement in war or terrorism. Regardless of what type of trauma took place, psychological results (if left undiagnosed and untreated) can severely compromise one’s quality of life. We at Next Chapter focus intensively on the effects of trauma occurring in early childhood, and integrate trauma recovery into nearly every aspect of our comprehensive, therapeutic program. We understand that trauma of any kind which occurred during a crucial stage of development may have dramatically hindered developmental health, resulting in a slew of potential symptoms (including substance abuse) that may greatly impact adequate adult functioning. In order to resolve related issues, underlying trauma must be addressed and corrected. We focus on healing individuals who were touched by trauma in any form. For more information on our intensive program of therapeutic and holistic recovery, please contact us today.