How To Understand Psychological Trauma
Image via Thomas Kinto
It is interesting to note the difference in definitions between physical and psychological trauma, and important to elucidate this distinction because of the increasing adoption of the word trauma into the general lexicon. This is a welcome change, but it also brings the risk of unfettered use of the word trauma, and words that suffer from overuse come to mean so many things that they eventually mean nothing.
Physical trauma is a serious injury inflicted upon the body, either through blunt force or penetration while psychological trauma is an emotional response to a terrible event that is perceived as life threatening or harmful. The former acts upon the body while the latter acts from the body, which is an important distinction worth exploring. Other forms of trauma are not my focus here, neither is trying to change the definition of psychological trauma, but to elaborate on how it functions with hopes of improving the understanding of it.
The psychic trauma can be identified by the negative emotional state that it produces. The induction of fear, guilt, anxiety, shame, or some combination may produce the psychic trauma. Whether or not an event causes a response within a person powerful enough to qualify as a psychic trauma is conditional. Variables within and around the individual such as genetic predisposition, overall health, social environment, prior history of traumatic experiences, and current perception of events all affect the quality of response. This is why the same event can produce a variety of responses amongst people, with some being traumatized and others not. Psychological trauma is recognized as a discrete category, but the contents contained within that make up the category are an amalgamation of experience.
Clinical experience seems to indicate that psychic trauma is a phenomenon of non-intent that often functions in obscurity. The actions that cause psychic traumas are often intended for other purposes and are frequently the byproducts of mis-attunement. For example, a child who is repeatedly punished by their family via physical discipline in the form of frequently being hit, and verbal rebukes characterized by threats of going to hell to suffer eternal damnation. The child internalizes these messages and unknowingly develops responses to avoid these punishments; namely they become perfectionistic, enforcing an unrealistic standard of behavior on themselves, and they begin to engage in self-harm (scratching, hitting, cutting, burning, or some other method) anytime they fall below this standard. What has occurred is the development of a psychic trauma response that on the surface appears irrational but protects the child from the greater pain of harsh discipline from their caregivers. Perfectionism and self-harm mitigate the original psychic pain and feelings of fear associated with it.
The parents only intended to discipline and discourage laziness and did so within the perceived parameters of appropriate child-rearing. And yet, the child’s response reveals a different understanding of what has happened, which matters greatly in the discussion of psychological trauma.
Because psychic traumas are unique in how they manifest, the treatment for them must also be unique and specific to the symptoms. Psychotherapy has continued to develop various responses to psychic trauma, therefore hundreds of psychotherapeutic theories exist and each offers their own ideas on how to heal psychic trauma. Skepticism would be warranted, but in psychic healing a broadminded approach is preferable because of the complex nature of the human psyche.
To effectively treat psychic trauma, you cannot simply bandage the invisible wound, but must also cleanse it, which involves helping the client to acknowledge its existence. The irony of the psychic trauma response is that it contains both remembering and forgetting at the same time. The emotional experience of the event is retained but the memory of the event itself fades from awareness. Proper healing involves helping the client to intentionally remember what has happened so they can make sense of how it affects them. The child in the previous example, without intervention, becomes the adult with only partial awareness of their psychic pain—prone to acting out, motivated by excessive guilt, self-recrimination, and suffering needlessly.
The conditions must be right for the stimulus (terrible event) and response (psychic trauma) to take place. Biology and ecology combine to produce certain outcomes in a complex process in which some factors may ensure the psychic trauma response and other factors may act as prophylactics against it. Psychotherapy can provide enough stability, consistency, nurturance, and proper attunement to act as a protective factor.
Without such protections, psychic trauma produces a force that is not necessarily blunt and occurs all at once, but one that compounds and over time is corrosive to the psyche. The cumulative effect of multiple psychic traumas weakens the psyche, leaving it vulnerable to future stressors and less capable of defending against them. When the psychic trauma response becomes apparent, it is as if the dam has finally broken, and the system can no longer contain what was held within. It is important to understand that the presentation of a psychologically traumatized person is a snapshot, a small part of the bigger picture. You must understand the deeper processes by which the image was made in order to know what you are looking at. Only then can you heal the original psychic pain and the connective scar tissue linking it to the present.
All this to say, once again, there is a clear difference between physical and psychological traumas—how we understand them and how we treat them. Failure to realize these differences can lead to a devaluation of psychic trauma and its attendant symptoms and crucial details of a person’s experience will be left out of the clinical picture.