Trauma sounds like something that should only happen to other people. It’s portrayed as an extreme, distorting experience that’s far removed from everyday reality. Trauma is extreme. But it’s far from uncommon, and can disquietingly seep into lives and permeate society.
One year ago, after I had emergency surgery to prevent paralysis while traveling in Costa Rica, I was surprised when the doctors warned me about post-traumatic-stress disorder (PTSD). I read over the definition repeatedly in the months after, trying to figure out whether my psychological symptoms met the criteria. I’m still not entirely sure. But while the medical definition of PTSD is clear-cut and definitive, I realized that trauma itself is not. There’s a spectrum of traumatic experiences and distressing psychological responses to difficult events. And, just as my experiences were somewhere along that spectrum—neither the most extreme nor the least—collective responses to the political events of 2017 and the #metoo movement are part of the same continuum. Trauma is pervasive, and we need to acknowledge it in order to recover.
Laura Brown, a clinical and forensic psychologist who specializes in trauma therapy, agrees that trauma goes far beyond PTSD. “For purposes of diagnosis, there’s a clear and defined construct of what constitutes a diagnosable traumatic event,” she says. “It’s important to understand that, if we leave aside the formal diagnosis, trauma is a subjective experience of un-safety and symptoms of intrusion, avoidance, and hyper arousal.”
Though there is a straightforward diagnosis, the definition evolves with each new edition of the Diagnostic and Statistical Manual of Mental Disorders. “Every time there’s a new edition of the manual they change the definition of trauma, so it’s a moving target,” says Jennifer Freyd, psychology professor at the University of Oregon who developed Betrayal Trauma Theory, which emphasizes how social betrayals create traumatic responses.
Historically, trauma first focused on war and the life-threatening events experienced during combat. Women then showed that civilian life, including sexually traumatic events such as rape, also lead to trauma. In recent decades, theories around trauma increasingly acknowledge how social betrayal after a specific traumatic event can cause significant psychological harm.
Today, PTSD can only be diagnosed in response to a specific event, namely: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Brown says there are many people who have PTSD-like symptoms in response to cancer, heart attacks, major betrayals (such as a partner’s affair), or awareness of widespread hate crimes. She just can’t formally label their experiences PTSD.
“[The diagnosis] doesn’t count the trauma that happens when you’re a member of a target group and you read about the police killing a member of your own group for no apparent reason, or you read about a member of your group being a victim of a hate crime,” she says.
Brown says she’s met several patients whose traumas have been reactivated by the public discussion around #metoo, and has served as a forensic witness in workplace harassment cases where the plaintiff wasn’t physically assaulted but nevertheless suffered intrusive thoughts, flashbacks, nightmares, and hypervigilance. Political policies that target immigrant groups, minorities, and women can be traumatic for members of each group, even those who don’t suffer specific physical events.
It’s important to acknowledge this, says Brown, “rather than saying I’m over-reacting or I’m a baby or why don’t I get over this. To be able to say: What happened to me was not ok. It frightened me, it left me feeling unsafe.”
That’s not to say that acknowledging trauma means it’s easy to overcome. After I recovered from my surgery last January, I expected to be definitively “better,” to have a wonderful life to make up for all I’d suffered. That didn’t happen. Instead, I was told the emergency operation hadn’t worked, and I’d need further surgery.
There was a similar unfounded rise in expectations as 2016 turned into 2017: Many were thrilled to leave behind such a tumultuous year, only to find 2017 even more distressing.
In truth, trauma cannot be easily dealt with and quickly forgotten.
“It’s not something that happens and you treat it and it’s over,” says Brown. “It happens, you treat it, and you learn a way to co-exist with this experience that’s now part of your life and narrative.”
The same treatments used for those with PTSD—such as EMDR (eye movement desensitization and reprocessing) and cognitive processing therapy with a trusted therapist—are helpful for others who experience trauma in general.
Regardless of whether trauma is in response to a specific physical event or distressing political actions, it can take time to adjust. “This is part of your life story, but this doesn’t make you broken or mean you can’t feel better,” says Brown. “It changed your understanding of what the world is and who you are.”
In some cases, recovering from trauma might mean recognizing the difficulty of the events but finding a way to make proactive changes in society. Brown says she’s certainly seen this response to the discussions around #MeToo, where many are demanding equal pay and repercussions for those who commit sexual assault and harassment.
“I think that’s an important next step,” she says. “Now that I’m no longer controlled and haunted by this, what do I do to make the world a different place?” Nothing, though, can make trauma slip easily away. Rather than ignoring or dismissing it, says Brown, “You change your relationship to what did happen.”