What is psychological trauma?
Psychological trauma has become recognized as a common risk factor for many problems that individuals experience, both psychological and somatic. Recent reviews of research have identified exposure to trauma as a risk factor for a wide range of psychiatric diagnoses. While trauma is has been specifically etiologically implicated in the diagnoses of Post traumatic stress disorder (PTSD), Acute stress disorder (ASD) and Dissociative identity disorder (DID), research has indicated that trauma exposure accounts for significant parts of the variance of the development of depression, anxiety disorders, Cluster B Axis II disorders, somatoform disorders, and some kinds of psychosis. Additionally, trauma exposure is frequently present in the histories of people with compulsive and addictive behaviors, with substance abuse being one of the two most frequently diagnosed co-morbid conditions for individuals with PTSD. Trauma is a biopsychosocial/spiritual-existential phenomenon whose effects can be seen in the forms of distress and dysfunction on almost every variable of human functioning.
What constitutes a trauma is often, naively, thought of as self-evident. Some traumas are large, frightening, uncommon events that engender fear, horror, helplessness, numbness, or disgust. However, for psychotherapists wishing to competently address experiences that are responded to with post-traumatic symptom pictures, an expanded understanding and definition of trauma is necessary. Some events that constitute a trauma are not perceived as so until years after the fact, although post-traumatic symptoms will be emerging well before the individual appraises themselves as having been exposed to a traumatic experience. Some trauma exposures are apparently small and private, more confusing or disorienting in the moment than horrifying. Some post-trauma symptoms manifest immediately, but are masked by their very nature because they are symptoms of numbness and disconnection. Other symptoms are florid, dysregulating, and sometimes daunting to the clinician, not only the client, sometimes leading to misdiagnosis and inappropriate care. Trauma can take the form of extreme betrayals of trust in which what is harmed is the relationship. It can also take the form of smaller events, known as insidious traumas or micro-aggressions. A person can also experience complex trauma, which refers to the experience of repeated exposure to trauma or neglect, often in childhood.
To learn more about my work on the topic of trauma, I invite you to investigate the resources that follow.
Upcoming talks and workshops about trauma
- Forensic issues in trauma psychology (August 9, Washington DC)
- Your turn for care: Surviving the aging and death of perpetrators in your family (October 5, Seattle WA)
Written work about trauma
This list represents all of the books and CE courses I’ve written about trauma, as well as some recent chapters and journal articles, and some older works that are frequently cited. A complete list of my work on this topic is available in my CV.
- First do no harm: Is it any longer safe to write case reports?
- Treating the effects of psychological trauma
- Your turn for care: Surviving the aging and death of the adults who harmed you
- Emotional and cultural competence in the trauma-aware therapist
- Treating trauma: Basic skills and specific treatments
- Motivated forgetting and misremembering: Perspectives from Betrayal Trauma Theory
- Becoming a trauma-aware therapist: Definitions and assessment
- Lesbian, gay, bisexual, and transgender issues in trauma psychology: A topic comes out of the closet
- Guidelines for treating dissociative identity disorder in adults, Third revision: A tour de force for the dissociation field
- True drama or true trauma? Forensic trauma assessment and the challenge of detecting malingering
- Cultural competence in the treatment of complex trauma
- Cultural competence in trauma therapy: Beyond the flashback
- Feminist therapy and self-inflicted violence
- Trauma and dissociation in convicted offenders: Issues of gender, science, and treatment
- Sexuality, lies, and loss: Lesbian, gay, and bisexual perspectives on trauma
- Symptomatic clients and memories of childhood abuse: What the trauma and child sexual abuse literature tells us
- The private practice of subversion: Psychology as Tikkun Olam
- Recovered memories of abuse: Assessment, therapy, forensics
- From alienation to connection: Feminist therapy with Post-traumatic stress disorder
Recorded media about trauma
- Laura talks about Your Turn for Care on The Mary Waldon Show
- Cultural competence in trauma treatment
- Multiple identities in context of trauma: Increasing cultural competence
- Can we create social justice? Toward an ethic of justice for trauma psychology
- Finding my center: Martial arts on the way to Tikkun Olam
- Working with men survivors of trauma and abuse
- Working with women survivors of trauma and abuse