Types of Trauma & How to Heal – Cleveland Clinic
Think of your mind as a sponge. Whether it’s good or bad moments, our brains can hold onto a lot. That’s why emotional trauma can stick with us long after a traumatizing event has passed.
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Sure, we’ve all had bad — or downright embarrassing — moments that stick with us. Maybe it’s that time you spilled coffee on your way to work or when you just missed your flight that still keeps you up at night.
But trauma is more than that. Trauma is a result of emotionally painful or abusive experiences, and it ranges from something like a physical accident to emotional abuse. The spectrum of what can generate a traumatic response is quite wide, and so the process of healing can look different for everyone.
Registered psychotherapist Natacha Duke, MA, RP, explains the different types of trauma, how they can affect you and what the steps are for healing.
What is trauma?
Trauma is an emotional response that lasts long after an event occurs that causes significant mental and physical stress. Just like a physical scar from a deep cut takes time to heal, recovery from trauma is possible with time and treatment. It’s important to remember that ignoring or avoiding symptoms of trauma isn’t a healthy coping response (in fact, avoiding them can make things worse — more on that later).
When you go through a traumatic event, your mind sometimes remembers how it felt and keeps that trauma response “at the ready.” But Duke also points out, “Some people can’t recall traumatic events for many years.”
In general, trauma affects two parts of your brain:
- Amygdala. This is your brain’s emotional center — it’s responsible for how you react to the good, the bad and everything in between. When trauma occurs … well, let’s just say it starts to do its job a little too well. “And so what can happen is that this part of the brain becomes overly aroused and is more hyper-vigilant to danger,” explains Duke. “For all of us, the amygdala is sort of our protection center, and it tries to keep bad things from happening to us. So, it may start to ring false alarms because it’s always looking for some sort of problem or danger around the corner.”
- Hippocampus. The part of your brain that holds onto memory is also, of course, tied in with trauma. This is because your brain remembers how you felt when the traumatic event happened. When your hippocampus is impacted by trauma, your brain starts to struggle between what’s the past or present, meaning that a memory of a traumatic event could start to feel like it’s happening in the present moment.
This is why certain experiences — or triggers — can set off a traumatic memory and put you in that fight or flight mode, even though there’s no real danger happening. For example, the sound of an overhead plane can take a veteran with PTSD (post-traumatic stress disorder) back to the fear they felt on the battlefield. Or a loud crack of thunder may cause a hurricane survivor to feel the same intense anxiety they felt at the time of that traumatic experience.
So even though it happened in the past, unresolved trauma can affect your present — causing things like panic attacks, depression or an inability to go on with normal routines. In some cases, you may also develop complex post-traumatic stress disorder (C-PTSD), which happens due to prolonged or repeated trauma over time.
So, how do you recognize the painful moments while also healing the emotional scars left behind? The first step is to give your feeling a name: trauma. It’s not just a small setback that you can shake off or need to feel ashamed about — it’s something that becomes a part of your story.
Different types of trauma: big ‘T’ and little ‘t’
The trauma you experience doesn’t have to look a certain way for it to be valid.
According to Duke, trauma can sometimes be understood as big “T” and little “t” trauma. The difference between these two isn’t really a matter of severity (it’s not a competition over which trauma is worse), but rather how it affects your mind.
Big “T” trauma is likely the first thing you think of when you think of trauma: Large, bombastic moments that can alter your physical and mental well-being. “The big ‘T’ trauma would be like a mass trauma and it would be a circumstance that most people, no matter who they are, would find traumatic,” explains Duke. “So, it could be anything that causes emotional distress or that is out of the ordinary.”
Some examples of big “T” trauma are:
- Natural disasters.
- Violent attacks or accidents.
- Military combat.
- Sexual assault.
- Physical abuse.
Little “t” trauma is complex in a different way — it may not affect everyone the same. In some cases, the little “t” trauma can be harder to recognize or define.
Examples of little “t” trauma include:
- Loss of a pet.
- A breakup or divorce.
- Having to suddenly move or relocate.
- Financial or legal troubles.
“What is traumatic to one person really might not phase someone else,” Duke notes. “Bullying is a good example of little ‘t’ trauma. Some people experienced bullying as a child and aren’t very fazed by it, whereas others can really relive being bullied as though it just happened.”
How do different types of trauma affect you?
Whether it’s big “T” or little “t,” trauma can come from many different sources.
Here are some types of trauma and the effects they have:
Childhood and parental trauma
Childhood trauma can stem from physical abuse, verbal abuse or neglect that you experience when you were young. But there are also other things that could fall under this umbrella, like witnessing abuse, being in an accident at a young age or growing up in a stressful home environment.
“In general, when trauma happens at an earlier age, it tends to have more of an impact,” states Duke. Children who experience trauma under the age of 8 are especially vulnerable. If you experience childhood trauma, it’s likely to affect you into your adult years. But it’s possible to address the trauma while you’re still young — if the warning signs are noticed in time.
“The way that childhood trauma tends to manifest into adulthood is a profound sense of shame and guilt,” Duke notes.
Along with that, childhood trauma may also lead to:
Childhood trauma can also overlap with parental trauma — when you undergo abuse from a caregiver. “If the abuse happens by a primary caregiver, that tends to have a more profound effect than if it happened with a stranger, or with a more extended family member,” Duke adds.
Sexual assault is likely the first type of sexual trauma that comes to mind. Additionally, any exposure to sexually inappropriate, harmful or violent behavior can cause sexual trauma. Sexual trauma frequently occurs when you don’t (or can’t) give informed consent to a sexual act.
As with other forms of trauma, it’s common for sexual trauma to cause PTSD, which can manifest in your life as nightmares, anxiety-boosting triggers and memory loss. According to Duke, your experience (and healing process) with sexual trauma will vary depending on whether it was a single event or ongoing, as well as your age.
“I’ve seen people who experience flashbacks for a few months, while others experience flashbacks for several years later,” she adds. “It just really depends on so many different variables.”
Sexual trauma can also stay with you in a very physical sense. “Someone may have difficulty with going to the doctor’s office, seeing a gynecologist or having those kinds of exams done,” Duke continues.
Another note about sexual trauma is that in some cases, it can overlap with childhood trauma. This can lead to a tendency for certain behaviors to appear later in life such as:
Relationship trauma can also result from romantic relationships where a significant other didn’t respect your boundaries or an on-and-off relationship that left you feeling drained and confused.
“For example, someone could be involved in a relationship where the dynamic is very manipulative,” explains Duke. “It could also be due to things like gaslighting or a betrayal of trust.”
“The effects of relationship trauma aren’t going to be clear right away,” she says. “But they can affect your sense of self-worth and what you feel you deserve in future romantic partners.
“Some people respond to relationship trauma by really isolating themselves from other relationships. Others have the opposite reaction, which is to jump from relationship to relationship and never want to be — or cannot be — alone.”
Community is one of the main ways we connect with others — both in childhood and in adulthood. And religious groups are a common place to find community. But similar to relationship trauma, trauma can occur if people you once trusted (such as your church community) become manipulative, toxic or abusive. In a religious setting, a certain belief system can be used as a form of shaming as well.
“Religious trauma can come from wanting to leave a certain set of beliefs, practices or a religious figure or group that is making the person feel manipulated or controlled in some way,” Duke explains.
Trauma like this can be especially complicated because it affects who you trust and confide in. If you’re someone who survived the trauma of a cult or a toxic religious setting, you may be hesitant to connect with others and find a new community.
“You may also have difficulty distinguishing what you can and cannot believe in,” says Duke. “Some people may have a lot of fear around death or being punished, especially if that’s been the message that they’ve received throughout their life.”
How to heal from trauma
There are tools available that can help you process your trauma, find peace and not let it take over your life. This doesn’t mean you can “just get over” your trauma. Instead, it means facing it head-on, being kind to yourself and forging a new path.
Duke explains some steps you can take to heal from trauma:
Seek proper therapy
Maybe you’re already aware of your trauma and want to take the next step. Or maybe you’re having trouble figuring out the cause of the trauma that’s manifesting in your everyday life. In both cases, a trauma-informed therapist will be your best ally in the healing process.
“The most important step is to establish a really safe therapeutic alliance before you open up about all the details of your trauma,” advises Duke. This often means that your therapist should let you establish certain boundaries, whether that’s topics of conversation or certain trigger words.
It’s also important that your therapist be informed not only on how to build trust, but also on what tools can help you work through your trauma safely and efficiently.
For example, many trauma-informed therapists may recommend eye movement desensitization and reprocessing (EMDR) therapy as a way to address painful memories. “But you really want to ensure that you find someone who is trained in EMDR because it’s quite a specific type of therapy,” stresses Duke.
Learn your triggers
It’s especially hard when a trauma response hits you when you don’t expect it. You may be at the grocery store or getting gas, and suddenly, a trigger catches you off guard and you feel an immense sense of danger or dread. To help prevent such a reaction, it’s important to learn about your own trauma triggers and what might set them off. This will help you better understand yourself and the healthy boundaries you may need to set.
Try guided meditation
If your brain is constantly bombarded by horrible memories, both meditation and mindfulness can be a healing practice — but Duke recommends not jumping into them without training wheels. An open or freestyle of meditation might be too overwhelming at first. She recommends instead starting with a guided meditation to help ease you into the practice.
Try an app or a YouTube video that’ll guide your thoughts to a focal point. Even a collection of music that keeps you calm and grounded can serve as a useful meditation guide.
In your head, there may be two actors running the show: You and your trauma. So, if your trauma causes you to be unkind or harmful to yourself, it’s important to work against it. That’s why self-care can be an empowering way to make time for yourself — your inner child or simply your past self — who has endured the trauma.
Activities like yoga or exercise have been shown to be beneficial in healing from (or at least alleviating) the effects of trauma. Taking on hobbies you’re interested in, such as painting, boxing, a dance class or just going for daily walks, can also be part of self-care. It’s not a cure-all, but simply something — anything — that brings joy into your life and makes you feel like you can be a source of healing.
And if the response to trauma is greatly impacting your daily life — or that of someone you know — reach out to a mental health expert or connect with a resource or support group for help, such as:
You don’t have to do this alone.