Trauma and post-traumatic stress disorder (PTSD) are often misunderstood as conditions reserved for extreme or catastrophic events. While war, assault, and natural disasters are certainly traumatic, trauma can take many forms and affect individuals in vastly different ways. As we deepen our understanding of how trauma manifests in the body and mind, it becomes increasingly […]
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Trauma and post-traumatic stress disorder (PTSD) are often misunderstood as conditions reserved for extreme or catastrophic events. While war, assault, and natural disasters are certainly traumatic, trauma can take many forms and affect individuals in vastly different ways. As we deepen our understanding of how trauma manifests in the body and mind, it becomes increasingly clear that effective counseling plays a critical role in fostering recovery.
This blog explores the impact of trauma on psychological and physiological functioning, differentiates between PTSD and complex PTSD (C-PTSD), and outlines evidence-based approaches that can aid in long-term healing. We also examine the prevalence of trauma in various populations and dispel common myths about who is affected and how.
Trauma is the response to deeply distressing or disturbing experiences that overwhelm an individual’s ability to cope. Importantly, trauma is subjective. An event that might not affect one person can be profoundly traumatic to another. Clinically, trauma is often categorized into two broad types: Big “T” trauma and small “t” trauma.
Big “T” trauma refers to events that are universally recognized as traumatic. These include events such as sexual assault, serious accidents, natural disasters, and combat exposure. They typically involve a direct threat to life or bodily integrity. According to the American Psychiatric Association (2020), Big “T” trauma is commonly associated with PTSD.
Small “t” trauma includes events that may not threaten life but still disrupt emotional stability. Examples include emotional neglect, divorce, betrayal, or persistent criticism. These experiences may not be perceived as traumatic by society at large but can cause chronic stress and emotional wounds, particularly when they accumulate over time.
Understanding this distinction is vital. Individuals who experience small “t” trauma may not seek help due to minimization or invalidation of their experience. Yet, the psychological scars can be just as deep.
Trauma is more common than often acknowledged. The World Health Organization (2022) estimates that 70 percent of individuals worldwide will experience at least one traumatic event in their lifetime. In India, trauma-related disorders are significantly underdiagnosed due to cultural stigma and limited access to mental health care (Chopra, Sinha, & Prakash, 2021).
The National Center for PTSD (2023) reports that approximately 6 percent of the U.S. population will experience PTSD at some point. In global populations, studies show varying prevalence rates based on conflict exposure, gender, and socioeconomic status. Women are approximately twice as likely as men to develop PTSD (Olff, 2017).
A landmark study by Cloitre et al. (2019) found that nearly 30 percent of individuals diagnosed with PTSD also met the criteria for complex PTSD (C-PTSD), a condition that has only recently received clinical recognition through the International Classification of Diseases, 11th Revision (ICD-11).
PTSD is a psychiatric disorder that can occur after experiencing or witnessing a traumatic event. The core symptoms include intrusive thoughts or flashbacks, hypervigilance, avoidance of reminders, emotional numbing, and sleep disturbances.
C-PTSD, on the other hand, typically arises from prolonged or repeated trauma, particularly during developmental years. Examples include childhood abuse, neglect, domestic violence, and captivity. While C-PTSD includes all PTSD symptoms, it also presents with:
These additional features often complicate diagnosis and treatment. Individuals with C-PTSD may not identify their experiences as traumatic, particularly if their trauma occurred within trusted relationships.
Trauma has a profound effect on the brain and body. Functional imaging studies reveal that trauma alters key brain structures:
This altered neurocircuitry keeps the body in a chronic state of hyperarousal. Individuals may experience digestive issues, chronic pain, panic attacks, fatigue, or immune suppression. The concept of the “window of tolerance”—the zone within which the nervous system can function optimally—is often narrowed in trauma survivors (Siegel, 1999).
Multiple evidence-based therapies have shown efficacy in treating trauma and PTSD. These approaches aim to re-establish a sense of safety, integrate traumatic memories, and build emotional resilience.
Healing from trauma is not linear. Clients may experience progress interspersed with setbacks. Still, common milestones in recovery include:
Healing does not require forgetting the trauma but rather integrating it in a way that reduces its emotional charge.
There is no standard timeline for trauma recovery. Factors influencing duration include trauma type, chronicity, age of onset, support systems, and access to care. Research indicates that significant symptom reduction can occur within 12 to 20 sessions of trauma-informed therapy, though complex cases may require long-term engagement (Bisson et al., 2013).
Choosing a Trauma-Informed Therapist
Not all therapists are equipped to handle trauma. When seeking help, consider the following:
A good therapeutic alliance is a predictor of positive outcomes. If the client does not feel safe or understood, switching providers is a valid and often necessary step.
Q: Is trauma therapy only for people with PTSD?
A: No. Individuals without a formal PTSD diagnosis can still benefit from trauma-informed care if they struggle with emotional dysregulation, relationship difficulties, or somatic symptoms.
Q: What if I do not remember my trauma?
A: Memory gaps are common, especially in childhood trauma. Therapy can focus on present-day symptoms and body responses without needing full recall.
Q: Will I have to relive the trauma in therapy?
A: Effective trauma therapy does not require re-traumatization. Therapists use titrated exposure and grounding techniques to maintain emotional safety.
Q: Can trauma impact physical health?
A: Yes. Trauma is linked to increased risk of chronic illnesses, including cardiovascular disease, autoimmune disorders, and gastrointestinal problems.
Q: Is online trauma therapy effective?
A: Research indicates that online trauma therapy can be effective, particularly when using structured modalities such as TF-CBT or EMDR. However, therapist experience and client preference matter greatly.
Trauma alters the brain, the body, and the self. But it does not have to define the future. With the right support, recovery is possible. Whether you are grappling with recent loss, childhood adversity, or years of silent suffering, trauma-informed counseling offers pathways back to safety, connection, and meaning.
Healing is not about becoming who you were before the trauma. It is about becoming who you are now, with greater awareness, resilience, and self-compassion.
American Psychiatric Association. (2020). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults.
Bisson, J. I., Cosgrove, S., Lewis, C., & Roberts, N. P. (2013). Post-traumatic stress disorder. BMJ, 347.
Chopra, R., Sinha, V., & Prakash, J. (2021). Prevalence and presentation of trauma-related disorders in India: A scoping review. Indian Journal of Psychiatry, 63(2), 108-115.
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2019). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 10(1).
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Trauma-focused CBT for children and adolescents: Treatment applications. Guilford Publications.
Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.
Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: An update. European Journal of Psychotraumatology, 8(4).
Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Press.
Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. Guilford Press.
World Health Organization. (2022). Global health estimates: Life expectancy and burden of disease.