The word trauma originates from Ancient Greek, meaning “wound,” and carries meanings such as “injury,” “destruction,” or “defeat.” It has entered many languages with these meanings.
We often experience moments that cause sadness or distress, but we do not call all of them trauma. So what do we mean by trauma?
In medicine, trauma refers to physical injuries occurring in tissues or joints as a result of an external force on the body.
Psychological trauma, on the other hand, refers to an event or series of events that are often extraordinary and unexpected, pose a serious threat to a person’s physical or psychological integrity, and typically cause intense feelings of fear, terror, or helplessness. It is also an experience that can disrupt and shatter a person’s belief system. Trauma may occur not only through direct exposure, but also by witnessing a traumatic event affecting a loved one or through repeated exposure to such events due to one’s profession. Examples include natural disasters, violence, traffic accidents, war, and sexual assault. Trauma may result from a single major event or from prolonged exposure over time.
For an experience to be considered traumatic, it must also be perceived as such by the individual. In other words, the meaning a person assigns to the event is crucial. One of the main reasons people respond differently to the same event is the personal context and meaning it holds for them. Trauma can lead to conditions requiring psychological support, such as Post Traumatic Stress Disorder (PTSD), depression, generalized anxiety disorder, or substance misuse.
Post Traumatic Stress Disorder (PTSD)
In PTSD, symptoms may include exaggerated startle response, intrusive memories of the event, sleep disturbances, nightmares, persistent hypervigilance, irritability, and avoidance of reminders of the event. A person may feel as though they are reliving the event, and the sense of danger may continue even after the actual threat has passed. Children may show different reactions compared to adults.
After a traumatic event, what we call acute stress reactions commonly occur. Experiencing the symptoms mentioned above within the first month after the event is considered normal and natural. However, if symptoms persist beyond one month with similar intensity and are accompanied by additional difficulties, the condition may be diagnosed as PTSD.
Normal stress responses are automatic reactions based on the sympathetic and parasympathetic nervous systems. In moments of danger, the sympathetic nervous system activates to prepare the body for action causing changes such as increased heart rate, rapid breathing, muscle tension, sweating, and digestive changes. When the danger passes, the parasympathetic nervous system restores the body to its normal state. This interaction is healthy and adaptive.
However, in some cases, the sympathetic system remains activated for such a prolonged and intense period that the parasympathetic system struggles to restore balance. At this point, trauma related complications may develop. Research shows that structural changes can also occur in the brain during this process for example, a reduction in the volume of the hippocampus (associated with memory) or hyperactivation of the amygdala (involved in emotional processing, especially fear responses). Prolonged activation of this “alarm system” is harmful to both psychological and physical health. Fortunately, with appropriate psychological support, these neurological effects can improve.
Traumas caused intentionally by other people are particularly likely to lead to PTSD. Social support mechanisms also play a crucial role in determining whether trauma develops into PTSD.
For example, a person who experienced sexual assault may have responded with a freeze reaction due to intense fear. If later blamed by others with statements such as “Why didn’t you speak up?” or “Why didn’t you resist?”, this can create secondary trauma. If the individual also begins to feel guilt or shame even irrationally the trauma can become more complex.
In addition to psychiatric medical treatments provided by psychiatrists, psychotherapy and psychological counseling are highly effective in the treatment of PTSD. As mentioned earlier, trauma often alters belief systems and cognitive processes. In this regard, Cognitive Behavioral Therapies (CBT) can be beneficial. EMDR therapy is another evidence based approach proven effective in trauma treatment.
While we have discussed trauma from an individual perspective, it is essential to acknowledge its social dimension. In societies where both individual and collective traumas are common, not only individual support but also preventive and restorative social efforts are necessary. Making psychotherapy accessible is important, but after collective traumatic events, additional steps are crucial such as acknowledging losses openly and impartially, restoring a sense of justice, initiating official measures, creating memorials, or organizing annual commemorations. Such societal rituals and recognition are highly important for the psychological well being of survivors and those who have lost loved ones.
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