Psychological trauma
Also known as psychological trauma, Emotional trauma, Psychotrauma
The emotional aftermath of events that threaten life, body or safety.
At a glance
In plain words
The event and the response, Traumatic coupling, Stuck in the present tense …
See all 4Examples
Traumatic coupling, Everyday trauma reminders, A flashback …
See all 6Kinds of trauma
Situational, Moral injury, Vicarious trauma
See all 3How therapists work with it
Common ingredients, Best-supported treatments, Phase-oriented work …
See all 4Connections
Post-traumatic stress disorder, Complex post-traumatic stress disorder and 28 others
See all 30
Also on this page: Key facts · Links · Sources · Related pages
- Psychological trauma is an emotional response to severely distressing events, such as violence, abuse or disaster.
- Most people who live through such events are distressed but do not become traumatized.
- Reminders can trigger the past as if it were happening now.
- Some people go on to develop post-traumatic stress disorder.
- Cognitive behavioral therapies have the strongest support, and EMDR has moderate evidence.
Why it matters
- Trauma is the root concept behind PTSD, complex PTSD, trauma-informed care and many therapy approaches; understanding it is the first step.
Key facts
- In short
- An emotional response to severely distressing events such as injury, sexual violence or threats to life1
- Not inevitable
- Most people who face a potentially traumatic event do not become psychologically traumatized1
- Common after-effects
- Flashbacks, nightmares, insomnia, panic attacks, emotional dysregulation, relationship difficulties1
- Triggers
- A harmless cue linked to the event, such as a sound, can become a trauma reminder1
- Field of study
- Psychotraumatology1
- Treatment
- Psychotherapy such as CBT and EMDR; sertraline and paroxetine are FDA-approved for PTSD but not first-line1
In plain words
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The event and the response1
Trauma is not the event itself but the lasting emotional response to it; people react to similar events very differently.
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Traumatic coupling1
A benign stimulus, such as a motorcycle engine, can get wired to the memory and set off re-experiencing.
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Stuck in the present tense1
Traumatic events can be experienced as if happening now, with spells of high arousal followed by exhaustion.
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What protects people1
Temperament, environment, resilience and willingness to seek help explain why some people are affected and others not.
Examples
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Traumatic coupling1
The sound of a motorcycle engine can set off intrusive thoughts or a sense of reliving a traumatic event that involved a similar sound. The harmless noise has become a trauma trigger.
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Everyday trauma reminders3
News reports, seeing an accident or hearing fireworks are examples of reminders that can make someone relive the event.
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A flashback1
A flashback is a dissociative experience where the person feels the event is happening again. It can range from mild distraction to completely losing awareness of where they are.
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Numbing1
Someone who dissociates from painful emotion may numb all emotion and seem flat, preoccupied, distant or cold to others.
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Moral injury1
Illustration: a person who believes they failed to act when someone needed help, and is left mainly with guilt and shame rather than fear, fits the definition of moral injury: distress after a moral transgression.
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Vicarious trauma1
Workers can be affected by witnessing trauma in the course of their job, for example through violence at work or reviewing violent video tapes. A therapist who listens with empathy to many trauma accounts is also at risk.
Kinds of trauma
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Situational1
Caused by other people, disasters, war, abuse, violence, collisions or medical emergencies.
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Moral injury1
Guilt or shame after a moral transgression; linked to PTSD but distinct, which centres on fear.
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Vicarious trauma1
Affects workers who repeatedly witness their clients' trauma, including therapists.
How therapists work with it
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Common ingredients1
Trauma therapy usually combines psychoeducation, emotion regulation, cognitive processing and processing of the trauma memory itself.
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Best-supported treatments1
Institute of Medicine guidelines name cognitive behavioral therapies most effective; a 2018 review found moderate evidence for EMDR.
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Phase-oriented work1
For complex PTSD and dissociation, a phase-oriented approach is described as working better than a simple cognitive one.
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What does not help1
Debriefing everyone straight after a critical incident has not been shown to reduce PTSD.
Connections
Related
- Post-traumatic stress disorderTopicThe best-known disorder that can follow trauma
- Complex post-traumatic stress disorderTopicFollows prolonged or repeated trauma
- Trauma-informed careTopicA framework for helping without re-traumatizing
- EMDR (Eye movement desensitization and reprocessing)TopicOne of the therapies designed for trauma
- Internal Family SystemsTopicListed among approaches designed with trauma in mind
- Cognitive behavioral therapyTopicHas a large body of support for trauma-related symptoms
- ShameTopicMoral injury after trauma brings guilt and shame
- Window of toleranceTopicTrauma narrows the range of arousal people can handle
- Adaptive information processingTopicExplains trauma symptoms as unprocessed memory
- Accelerated experiential dynamic psychotherapy (AEDP)TopicFocuses on adults with childhood attachment trauma
- Bessel van der KolkPersonHas researched traumatic stress since the 1970s
- Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and ProceduresBookAlso applied to complex trauma and moral injury
- Father-Daughter IncestBookChildhood sexual abuse within the family
- Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR TherapyBookFrom small setbacks to major traumas
- Internal Family Systems Skills Training Manual: Trauma-Informed Treatment for Anxiety, Depression, PTSD & Substance AbuseBookFramed as trauma-informed treatment
- Judith HermanPersonHer life's work is the understanding and treatment of trauma
- No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems ModelBookPresents IFS as a way to heal trauma
- Polyvagal theoryTopicApplied to trauma pathophysiology and treatment
- Schema Therapy for Borderline Personality DisorderBookEmphasizes emotional processing of traumatic experiences
- Stephen PorgesPersonStudies trauma through the Kinsey Institute consortium
- Studies on HysteriaBookTraces symptoms to painful past experiences
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of TraumaBookIts subject
- The Mosaic Mind: Empowering the Tormented Selves of Child Abuse SurvivorsBookAbout survivors of childhood abuse
- The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulationBookProposed implications for treating trauma
- The Reality SlapBookCovers trauma alongside grief and loss
- The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life ExperiencesPaperExtends trauma treatment to everyday adverse experiences
- Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political TerrorBookIts subject, in a social and political frame
- Trauma-Focused ACT: A Practitioner's Guide to Working with Mind, Body, and Emotion Using Acceptance and Commitment TherapyBookCovers the full spectrum of trauma-related problems
- Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and SocietyBookBiology, memory and social effects of trauma
- Truth and Repair: How Trauma Survivors Envision JusticeBookJustice as part of recovery from trauma
Links
Sources
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