“Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering.”
-Peter Levine
Trauma is often used in colloquial terms to refer to general upsetting life events and situations, which can sometimes confuse the term used in clinical settings and can emotionally invalidate an experience of trauma for a survivor. Have you ever heard someone say, “I lost my job and that was traumatic”? It likely was very stressful… and may not qualify as a trauma as it is defined clinically. That is because there are very different qualitative experiences in response to traumatic events and stressful events.
Trauma, as it’s defined clinically, takes on a very specific meaning, which first begins with an understanding of the body’s stress response and ability to differentiate between the emotions of fear and anxiety. Fear is an emotion that, at the most primal level, tells us dangerous is present in our immediate environment. Anxiety is an emotion that is experienced when we interpret possible dangers that could arise in a given situation.
Thus, the difference between the two emotions is that fear relates to a known or understood threat (i.e., it is real, definite, and immediate), whereas anxiety is triggered by an unknown or poorly defined threat.
Fear and anxiety are often confused because they both produce a bodily stress response to protect us from danger. This protective reaction is an involuntary mechanism of the sympathetic nervous system known as the fight-flight-freeze response that enables us to either fight, flee/run away, or freeze in response to threat, depending on what is most likely to result in our survival. The fight-flight-freeze response is experienced in our bodies as, for example:
increased heart rate (to pump more blood to your muscles and brain)
shallow breath (to take in air faster to supply your body with oxygen),
dilated pupils (to see better)
Once the threat is gone, our parasympathetic nervous system kicks in and returns our body to baseline.
Psychological trauma is one of those experiences that is real, definite, and immediate, and also generally outside the range of daily human experience, which makes trauma more salient in one’s life. When experienced, trauma evokes a sense of immediate threat to physical and emotional safety and survival. In this regard, psychological trauma triggers fear. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (APA, 2013), a traumatic event involves exposure to actual or threatened death, serious injury, or violence, which is why interpersonal violence is among the highest culprits of psychological trauma. Interpersonal trauma includes experienced or witnessed:
Emotional abuse and neglect
Sexual abuse/assault
Physical abuse/assault
Violence at home or in the community
Trauma, and interpersonal trauma in particular, are experienced as emotionally painful, intense, and distressing. More commonly experienced events (e.g., job loss) relate to anxiety because they are often associated with potential threat to survival, and the anxiety that is experiences usually resolves.
The reason for the narrow definition of trauma, and its distinction from stress more generally, is in part because traumatic events can result in fear-based trauma-related disorders that are often chronic if untreated. This happens when the fight-flight-freeze response becomes generalized to internal experiences (thoughts, emotions, physical sensations) and external people, places, and situations associated with one’s trauma that result in sensitivity to danger and threat. This stress response sensitivity can feel paralyzing for a survivor.
If you or a loved one has experienced psychological trauma and lingering fear, there are highly effective psychological treatments that target the stress response to relieve the constant suffering that can ensue. Seek out a clinician that is trained in working with trauma survivors, traumatic stress, and trauma-related disorders. You do not have to survive or face this alone.