If you have been on the internet or social media anytime in the past decade or more, chances are high that you already know how ubiquitous the term trauma is in common language, almost to the point that it starts to lose meaning. But what is trauma when it comes to therapy and mental health? Let’s take a deeper look at different types of trauma, its link to chronic and toxic stress, and ways to find relief and support.

Defining Trauma

person alone with knees pulled close and head down

A wide review of research literature and published books will tell you that trauma is everywhere, whether as acute one-time traumas—also known as micro-traumas—or as complex traumas associated with repeated exposure to traumatic events or prolonged abuse. These are sometimes referred to as Type I and Type II traumas, or as little ‘t’ and big ‘T’ traumas. Depending on the circumstances, developmental and relational trauma, bullying, community violence, intimate partner violence, medical trauma, and traumatic grief will fall somewhere within those main umbrella categories.

The term “trauma” is aptly derived from the late 17th century Greek word meaning wound. In the Diagnostic and Statistical Manual of Mental Disorders (DSM) trauma- and stressor-related diagnoses are defined as exposure to a traumatic or stressful event where psychological distress in the aftermath can vary on a spectrum from fear and anxiety, to a full clinical presentation of PTSD.

Bonnie Badenoch, PhD, author of Transforming Trauma, summarizes trauma as “any experience of fear and/or pain that doesn’t have the support it needs to be digested and integrated.” It is also widely accepted that traumatic experiences are stored in the body on a neurobiological level, and can carry consequences to one’s mind, brain, body, and way of experiencing the world, both internally and externally.

Developmental Trauma

Developmental trauma describes early childhood exposure to chronic abuse, neglect, adversity, or overwhelming stress as early as in-utero through to early adulthood. The impacts are wide-ranging and often include complex emotional, cognitive, and physical illnesses across the lifespan. Donna Jackson Nakazawa, the author of Childhood Disrupted, provides in-depth information about the ways emotional trauma and adversity can cause biochemical changes in the body and brain. Excessive stress hormones can reset one’s stress response, with devastating effects on immune function, mental health, and physical health.

The Adverse Childhood Experiences (ACE) study illustrates the connection between childhood trauma with a “dose-response” relationship of long-term effects on biology, nervous system, mental health, emotions, behavior, physical illness, and disease. The more adverse experiences, the higher the impact. A short assessment tracks experiences in three main categories:

Abuse (physical, emotional, sexual)
Neglect (physical, emotional)
Household Environment (family members with mental illness, witnessing intimate partner violence, substance or alcohol use, divorce, incarceration)

Just as we have the study of epigenetics on the DNA-level changes due to trauma, the presence of developmental trauma also speaks to the likelihood of legacy and intergenerational trauma passed down from generation to generation, both as personal lived experiences, and as collective trauma linked to a culture, generation, -isms, or other identity markers.

Complex and Relational Trauma

On the surface, the term complex trauma can be used to describe Type II or big ‘T’ traumas. However, complex trauma more often speaks to multifaceted experiences of trauma with repeat exposure to various forms of abuse or neglect. Complex trauma can also include a family home environment with inconsistent care, comfort, or sense of safety.

Relational trauma describes trauma that occurs in the context of relationships with others. For children, this most often happens with parents, caregivers, and close family members.

Relational trauma often includes themes of attachment injuries, incest, abandonment, betrayal, manipulation, parentification, and enmeshment.

Relational trauma is often a series of experiences that compound over time and feel like they will never end. If these experiences overwhelm one’s capacities, or there is one to turn to for support, or if there is nowhere to go to find safety, the outcome of those chronic experiences can sometimes result in complex PTSD, or CPTSD.

Although it is not a formally recognized diagnosis in the DSM, the World Health Organization includes CPTSD under the category “Disorders specifically associated with stress”.

Chronic and Toxic Stress

What is chronic stress and how does it link to trauma? Stress is defined as both a physiological and psychological response to adverse or demanding circumstances. The link between trauma and chronic stress is drawn through their physiological similarities: the fight-flight-freeze stress response in humans is a protective factor intended to ensure survival, yet that can become chronically activated for prolonged periods of time with ongoing experiences of trauma.

Chronic stress can be further understood using the term allostatic load, which describes cumulative exposure that wears on an individual through significant adversities and chronically challenging conditions. Stress can be described in three categories: positive, tolerable, and toxic, where toxic stress is tied to overwhelming allostatic load. Risk factors for toxic stress include trauma, childhood adversity, physical and psychological abuse, substance abuse, domestic violence, and poverty. The resources one uses to cope and the chronicity of traumatic experiences and/or toxic stress can influence the severity of effects on an individual’s physical and mental health.

But what if I had a good childhood?

One of the most common questions I get as a trauma therapist is centered around some version of this question, when someone has trauma-related symptoms but cannot recall specific traumatic experiences. What if I had a good childhood? What if I have happy memories and we celebrated all my achievements and milestones? Basic needs were objectively met. Sibling relationships ran the typical course. At least one parent or caregiver was consistent and present.

This can be true and there can still be trauma that is carried into adulthood. Unhealthy relationship dynamics. Bullying. Feeling misunderstood or overlooked. The list goes on.

Sometimes trauma can be the absence of certain thing things.

It can be about things that didn’t happen but should have. About implicit messages that we had to do, be, or act certain ways in order to be accepted and loved. These small moments can gather up over time to impact one’s sense of self and so much more. Sometimes, it is not until many years later that it dawns on someone that they have been carrying beliefs about themselves are a result of something that happened—or didn’t happen—in the past.

The Lasting Impacts of Trauma

The impacts of trauma are wide-ranging, complex, and multifactorial. Ongoing challenges can arise in any of the following domains:

Personal/self-care
Daily life tasks and activities
Family/interpersonal/social
Educational/occupational
Finances/money
Health/medical

There might be challenges with attachment and relationships to others. Trust, self-esteem, self-concept, and interpersonal challenges can mingle with past injuries around relational trauma. Learning, cognition, chronic illness and pain, and nervous system dysregulation can tell a story of adverse experiences that words cannot. Coping patterns can show up in the form of reactivity, numbing out, substance or alcohol use, disordered eating, hypervigilance, people-pleasing, and much more. However, the signs can also show up in our lives in much more subtle ways.

Imparting Hope

Posttraumatic growth and resilience have been an important focus in traumatology research in recent years. There is evidence to support the need for addressing trauma on a more somatic, nonverbal, and psychobiological level than by merely addressing working memory and cognitive awareness of traumatic events.

Through experience, many will learn that they cannot think their way out of visceral reactions and traumatic triggers.

Internal Family Systems (IFS) therapy is a trauma-based approach that offers a transformative, gentle, and effective way to heal from trauma, especially in the context of relational healing in a safe and trusting therapeutic relationship.

Let’s Connect

You deserve support and the possibility of greater fulfillment, connection, and joy. Reach out to request a free 20-minute consultation with Alicia.

Alicia Dabney, LMFT, LPCC, ATR-BC is a Level 3 trained Certified IFS therapist and IFS Approved Clinical Consultant licensed in California. She has been a Program Assistant for IFS Institute Level 1 and 2 trainings and presented with Marianne Turley, LMFT at the IFS Annual Conference in 2022. Special topics of additional training include Somatic IFS, intercultural competence, IFS and grief, IFS-informed psychedelic preparation and integration, addictive processes, anxiety and depression.

Transforming Trauma