What is trauma?

The word trauma comes from the Greek word for wound. Our modern understanding of the concept of trauma and the related term of “posttraumatic stress” stems in part from the 1970s and the problems experienced by US veterans of the war in Vietnam. That said, awareness of battle-associated stress has a long history – the Greek historian Herodotus described an Athenian soldier in 490 BCE who became blind after witnessing the death of a fellow soldier although he did not appear to suffer from a physical injury.

In the field of psychiatry, there has been much discussion on how to define the experience of trauma within the diagnosis of “posttraumatic stress disorder” or what is often just called PTSD. In general, criteria for PTSD requires a history of exposure to a traumatic event and symptoms from each of three groups: intrusive recollections of the trauma event, avoidance of reminders of the event and emotional numbing, and hyperarousal.

This psychiatric definition of trauma has been challenged, partly due to an increasing awareness of the prevalence and long-term effects of abuse and interpersonal violence. These days, most professionals have a more sophisticated and broader understanding of the causes and consequences of trauma.

Stephanie Covington, well-known for her work in the area of women and addictions, states:

“The terms violence, trauma, abuse, and posttraumatic stress disorder (PTSD) often are used interchangeably. One way to clarify these terms is to think of trauma as a response to violence or some other overwhelmingly negative experience (e.g., abuse). Trauma is both an event and a particular response to an event. The response is one of overwhelming fear, helplessness, or horror. PTSD is one type of disorder that results from trauma.” (Covington, 2008, p.379)

The work of Covington and others working in the field of treatment for women’s addictions has shown us the importance of recognizing the high prevalence of violence and other types of trauma in women’s lives and the importance of  providing services that are “trauma-informed.”

References:

Covington, S. (2008). Women and Addiction: A Trauma-Informed Approach. Journal of Psychoactive Drugs, SARC Supplement 5: 377-385.

Hegadoren, K.M., Lasiuk, G.C., Coupland, N.J. (2006). Posttraumatic Stress Disorder Part III: Health Effects of Interpersonal Violence Among Women. Perspectives in Psychiatric Care, 42(3): 163-173.

Kirmayer, L.J., Lemelson, R., Barad, M. (2007). “Introduction: Inscribing Trauma in Culture, Brain, and Body.” In Understanding Trauma: Integrating Biological, Clinical and Cultural Perspectives. Cambridge, UK: Cambridge University Press.

Learn more about trauma-informed care:

 

Klinic Community Health Centre. (2008). The Trauma-informed Toolkit, a resource for service organizations and providers to deliver services that are trauma-informed. Winnipeg, MB: Klinic Community Health Centre.

Poole, N. and Urquhart, C. (2009). Trauma-informed Approaches in Addictions Treatment, Gendering the National Framework Series (Vol. 1). Vancouver, BC: British Columbia Centre of Excellence for Women’s Health.