By Emily Gibson, MS, LPCC
We hear the word “trauma” discussed a lot lately, especially considering the pandemic, political unrest, fears about climate change, and global strife and war. What is traumatic for me might be less traumatic for you. Everyone has their own reactions to traumatic events, and every person’s nervous system responds differently in times of stress. We’re familiar with other “typical” sources of trauma, like combat, assault, rape, natural and man-made disasters, mass shootings, and homelessness, but we don’t always recognize another source of ongoing trauma: adverse childhood experiences. The Centers for Disease Control offers the Adverse Childhood Events (ACES) scale that measures ten types of childhood trauma: physical, verbal, and sexual abuse, physical and emotional neglect, witnessing others experiencing those abuses, having an incarcerated family member, parental divorce, parental addiction issues, parental mental health difficulties, and family member suicide. Every “yes” answer equals one point, and the higher the score, the higher the chances of negative life outcomes, including, but not limited to:
- Alcohol addiction and alcoholism
- Drug addiction
- Early initiation of smoking
- Tobacco/nicotine addiction
- Early initiation of sexual activity
- Multiple sexual partners
- STIs (Sexually Transmitted Infections)/HIV
- Depression and anxiety
- Eating disorders
- Anger management difficulties
- Dissociation
- Suicide attempts
- Liver and other physical diseases
- Hypervigilance
Studies have shown that 78% of children reported more than one traumatic experience prior to age 5 and almost a fourth reported three or more ACEs. It’s clear that traumas sustained in childhood have significant and long-lasting impacts on a person, particularly without intervention, and have imprints on the mind and body that can stay with us for a lifetime. Other ways that childhood trauma might show up include not being seen and heard, having a parent or other authority figure deny your reality (“that never happened”), being told you should not or can’t experience certain emotions – particularly “negative” emotions, having a parent or authority figure who is unable to regulate their own emotions, having a parent or authority figure who is overly focused on their and/or your appearance, and having a parent or authority figure who does not recognize or model appropriate boundaries.
So how do we define trauma? The neurologist Robert Scaer defined it as “any negative life event that occurs in a state of relative helplessness.” Neuroscientist Dr. Bruce Perry noted that “trauma has been hard for the academic world to define and therefore understand in its full scope” and stated too that “part of the challenge is that ‘bad event’ is subjective.” Because of this challenge, the Substance Abuse and Mental Health Services Administration (SAMHSA) brought together a group of clinicians and academics who developed the idea of the “three Es” definition of trauma denoting three key aspects, including the event, the experience, and the effects. You can see that this did not really clear up the waters nor provide a solid definition. The thing is, events and experiences cause different effects in different people, and how this impacts one long-term varies from individual to individual. For example, say that a fire breaks out in a fifth grade classroom. The fifth graders may have lasting impacts from the scary situation, but the firefighter coming to put out the flames may feel excitement, exhilaration, and satisfaction related to putting out the flames. Their experiences with the fire are very different, so their nervous systems react very differently. Two soldiers in combat may fight in the same battle, but one experiences long-term effects while the other does not. Or their trauma responses show up differently – one soldier becomes addicted to alcohol to cope, while another may develop and overactive anger response when provoked. There is no one size fits all when it comes to defining trauma.
Besides the mental health difficulties that accompany trauma, there can be a number of ways that trauma physically lives in the body as well. It can manifest as skin issues, cold hands and feet, tense or sore muscles and joints, digestive issues (very common!), fatigue and exhaustion, ringing ears and other auditory issues, painful jaw and teeth, heart palpitations, and weight gain. Research is starting to connect mental and physical health issues and recognizes that they are inseparable. Hidden stress shows up, as we can see, in a variety of surprising ways.