Most everyone experiences some form of trauma in life. It may not be out on the battlefield dodging bullets and bombs, but even the death of someone close to you can sometimes be traumatic.
Recognizing trauma and its effects is beneficial for mental health.
Still, a stigma exists, and talking about trauma and a diagnosis of post-traumatic stress disorder (PTSD) can be problematic.
These diagnostic labels can help understand trauma, but you run a risk on over-identifying with the diagnosis. You risk becoming mired even more in the past. Being overly focused on the label can create even more imbalance than the original traumatic event. Your mental health already has some malfunction, so you need to focus on healing not labels.
What qualifies as trauma?
It can be a difficult issue to get right. Some trauma is easily recognizable, while others may be more subtle. However, the effects can be the same.
During World War I, some soldiers came home with what we now call PTSD, although then it was called shell shock. As such, PTSD was typically associated with the horrors of war. Current knowledge suggests that trauma resulting in PTSD can be from a wide range of experiences. Our experience with the COVID-19 pandemic included traumas from quarantines, ruined businesses, lost jobs, curfews, isolation, and strained or destroyed relationships that have negative psychological impacts like depression, insomnia, and PTSD-like symptoms.
But, is it actually PTSD?
It seems that we are making distinctions between the scale and nuances of trauma even in the field of psychiatry.
“Psychiatry, as a subspecialty of medicine, aspires to define mental illnesses as precisely, as let’s say, cancer of the pancreas, or streptococcal infection of the lungs,” says Bessel van der Kolk in his book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. “However, given the complexity of mind, brain, and human attachment systems, we have not come even close to achieving that sort of precision. Understanding what is ‘wrong’ with people is currently more of a question of the mindset of the practitioner (and of what insurance companies will pay for) than of veritable, objective facts.”
We have a greater understanding now of the complexities of trauma responses, which has helped educate the larger public. Still, the public messaging about mental health could backfire and minimize the seriousness of the illness.
The messaging seems to promote the notion that negative emotions and experiences automatically become “disorders” or mental illnesses. Too many people experiencing normal negative feelings about difficulties in life are told there’s something wrong with them. They need to be fixed by mental health professionals. Again, that ignores the reality of life, which sometimes presents us with problems that aren’t traumatic.
Trauma does not always result in PTSD. Not every soldier comes home with shell shock. And certain life events like divorce, losing a job, or losing a loved one, typically don’t qualify towards a diagnosis of PTSD. The psychological disorder is rather rare and results from extremely traumatic events like military combat or torture. Yet there remains significant blurring around the edges of defining trauma.
“Trauma, like pain, is not an external phenomenon that can be completely objectified,” explains the US Department of Veterans Affairs National Center for PTSD. “Like pain, the traumatic experience is filtered through cognitive and emotional processes before it can be appraised as an extreme threat. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds.”
This means that two people can experience very similar traumas, yet only one may develop PTSD symptoms. The center notes that “rape, torture, genocide, and severe war-zone stress are experienced as traumatic events by nearly everyone.”
Mis- and missing trauma diagnoses
Thus, we have a subjective element in addition to greater public messaging about trauma. We now hear people casually saying they have PTSD from a divorce or losing a job. They self-diagnose. And, they minimize the true nature of PTSD and its seriousness.
“If everyone has PTSD, including people with transient, mild symptoms, then the term loses value for people who are seriously unwell,” says Foulkes. “Mental health problems lie on a spectrum. This is an inconvenient truth, because it reveals that our experiences cannot be neatly packaged and labeled as ‘healthy’ and ‘unhealthy.’ Different parts of the spectrum require different levels and types of support.”
And this inclination means that misdiagnosis of PTSD may lead to a disbelief about the disorder, a disbelief that it is a severe mental health problem.
Foulkes notes that highlighting the psychiatric basis of disorders like PTSD, schizophrenia, and obsessive-compulsive disorder could help lessen the casual misuse of these terms. Hopefully, that leads to greater understanding and support from those who truly suffer from the illnesses.
Becoming a “Trauma-Conscious” society
Still, everyone experiences some form of painful trauma even if that event doesn’t qualify as so traumatic that it leads to PTSD. And, our society promotes hiding our pain rather than seeking compassion and sympathy. We sweep the painful events under the rug.
“We are fundamentally social creatures—our brains are wired to foster working and playing together,” van der Kolk says. “Trauma devastates the social-engagement system and interferes with cooperation, nurturing, and the ability to function as a productive member of the clan.”
If we can learn to see other individuals as possibly dealing with some painful event, we might become a more trauma-conscious society. We might be far more compassionate towards those who recently became divorced or faced the death of someone close. Recognition of trauma can help protect “our sources of joy, creativity, meaning, and connection,” in van der Kolk’s words, that get left behind after traumatic events.
Emotional intelligence begins with identifying your own feelings and tuning into the emotions of those around you. It requires becoming familiar with our inner feelings and identifying what scares or delights us. Talking about our painful experiences is a start.