The DSM-5 defines a PTSD trauma as any situation where our life, physical or psychological integrity is threatened. These can be thought of as large ‘T’ traumas which can lead to developing PTSD and can include symptoms such as flashbacks, anxiety, depression, anger changes in personality and often substance misuse. There are also small ‘t’ traumas which don’t necessarily mean PTSD will develop however we may have some PTSD symptoms such as being triggered by situations, not being able to stop thinking about issues, or being unable to recall experiences, being upset all the time, low mood, anxiety and poor energy levels and difficulty engaging fully with life and others.
While we can often deal with small T traumas with assistance or on our own, some people experience lots of small T trauma in their lives. Multiple small T traumas can have a compounding effect and put us at risk for PTSD and can be also misdiagnosed.
Both big T and small T trauma affect quality of life and relationships. It is important to seek assistance to resolve both types of trauma as there is growing evidence that many people who resolve traumas experience a phenomenon called post traumatic growth. This means that not only do they recover, they make positive changes in their lives and actually, cope better than before the trauma. This is because successfully working through trauma causes us to change our world view and the development of new perspectives and life skills.
Small ‘t’ versus Large ‘T’ – Smaller, everyday events can still be traumatic.
Most people recognise a large ‘T’ trauma and tend to think that trauma only effects those who have been exposed to these types of events.
Examples of Large ‘T’ Trauma
Examples of Small ‘t’ Trauma
Small ‘t’ traumas can sometimes tend to be rationalised as common, and therefore we feel ashamed or think that we are over-reacting or not coping. There are also people who may not recognise just how disturbing the event or situation was to them until later.
Not everyone will become traumatised by the same traumatic experience as we are all different. However, everyone can become traumatised if they experience a sufficiently stressful event. Personal reaction to trauma is dependent on predisposing factors, such as our past experiences, personality type, beliefs, perceptions, expectations, level of stress tolerance, values, and morals. One issue to be aware of is both big T and small T trauma is marked by avoidance. When people attempt to avoid their trauma or aspects of their trauma, it makes the trauma response worse and increases anxiety and mood problems.
Developing post-trauma symptoms is by no means an indication of psychological weakness or deficiency. By most standards, these individuals would likely be referred to as “strong-minded” or “tough”; their ability to experience such hardships and seek assistance consider a sign of strong character and self-responsibility. There is some positive news here as there is a significant body of evidence in scientific studies that psychological treatment is very effective for treating both big T and small T trauma. People often find they improve in a surprisingly short period of time compared to the amount of time they have had the trauma. Example of approaches to trauma which are evidence-based include EMDR, CBT, Exposure Therapy, and Psychodynamic therapy.
Common symptoms of trauma include: Mood symptoms: depression and anxiety.
A traumatic event is an incident that causes physical, emotional, spiritual, or psychological harm.
Examples of traumatic events include:
According to the Diagnostic and Statistical Manual [DSM V], the current criteria for PTSD includes the following:
For those who do not meet these criteria, they may be experiencing post-traumatic stress that does not meet the ‘clinical definition’ of PTSD. In both instances professional support can be life-changing.
PTSD is typically related to a single traumatic event, while complex PTSD typically related to a series of events which have a compounding effect, or one prolonged event. Diagnosis by a qualified practitioner of complex PTSD may occur when a person has experienced trauma on an ongoing basis. Most frequently, this trauma involves long-term physical, emotional, or sexual abuse.