It is not easy to characterize trauma or its consequences.
Traumatic experiences obviously involve something bad happening. So, we might try to say more about what trauma is by asking what kind of bad things are traumatic.
As a first step, we might think about damage. On the physical side of things: if we allow any damage to count as trauma, then any injuries to our bodies will be physical traumas. Some traumatic experiences will be minor (like a papercut) and some will be major (like a gunshot wound). We could try doing the same sort of thing on the psychological side. So, we could try thinking about psychological trauma as the bad things involving damage not (only) to your physical body, but to the many important features of you that constitute your psychology. Damage to your psychology, or psyche, could include “injuries” to things like your emotions, your beliefs, your sense of self, your goals, your dreams, and so on. Again, sometimes the damage will be minor (a dirty look), but other times it might be major (abandonment).
Normally, the word ‘trauma’ is reserved to talk only about major damage. In medicine, traumas are serious, life-threatening damages. Different scales can be used to determine the severity and seriousness of injuries and we might think of these as ways of measuring how traumatic an injury is. The same is true for psychological damage: we don’t usually consider every psychological injury to be traumatic. The blow to your psychology has to be massive before we consider it a trauma.
A traumatic experience, then, is not just a bad or unpleasant thing. It’s a Big Bad Thing.
Part of the difficulty characterizing trauma, however, is that different events are traumatic for different people. This is true in the physical case to some degree, since the bodies of different people can have different responses to the same damage event. Breaking a hip, for instance, can be major for some people, but minor for others. There are some things, however, that are going to be traumatic to all bodies: a shot to the head is a traumatic event for all bodies. While it seems that there are also some things that will be traumatic for every psyche, most will be different for different people. The same event will be a Big Bad Thing for some people and not others.
We might try to deal with this difficulty by focusing on the consequences of the event. After all, part of what makes a Big Bad Thing so big and bad is that it has big, bad consequences for someone. So, Mirriam-Webster gives as their “simple” definition of ‘trauma’: “… a very difficult or unpleasant experience that causes someone to have mental or emotional problems usually for a long time.” If this is right, then our common usage of the word already includes our recognition of nasty consequences. Likewise, on their website, the American Psychological Association characterizes trauma (and they obviously mean psychological trauma) as “…an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms like headaches or nausea.”
The horrible consequences of traumatic experiences are perhaps clearest in post-traumatic stress disorder (PTSD). People with PTSD can suffer from reliving the traumatic event through flashbacks or nightmares, disrupted relationships, being easily startled, becoming quickly aggressive or reckless, and a host of other symptoms. PTSD can also cause further psychological disorders like depression or phobias.
Even as we noted that the same event might be traumatic for some people but not for others, we also know that undergoing a traumatic experience can result in some people developing PTSD, while others do not. According to the US Department of Veteran Affairs, for instance, a 2008 study of service persons deployed to Iraq and Afghanistan found that 13.8% of participants had PTSD. Similarly, a study by Perkonigg et al (2000), found that 26% of male participants and 17.7% of female participants had undergone a traumatic event, with 1% of males and 2.2% of the females evidencing symptoms warranting a diagnosis of PTSD.
Every case of PTSD is tragic, but what I want to think about in the remaining space is people who have undergone traumatic events—major damage to their bodies or psyche—but did not develop PTSD. It is entirely appropriate that research has focused more on cases of people who need help (as in PTSD) than cases of people who do not. But the focus on people for whom Big Bad Things have big, bad consequences has, I think, given us a limited understanding of trauma.
While PTSD is a well-known phenomenon, there is a distinct phenomenon that we are only beginning to understand called post-traumatic growth (PTG).
In a landmark piece, Tedeschi and Calhoun (2004) define PTG this way:
“Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life.”
PTG is now well documented. Sometimes, when Big Bad Things happen to people, not only do they not develop PTSD, they develop a range of positive symptoms. Their relationships with others, personal projects, and everyday experiences are enriched. Their lives are filled with new joy, meaning, and value. PTG is not just resilience: people who undergo PTG do not just get over it or get back to normal. They acquire significant, positive benefits.
The robust existence of PTG evidences that sometimes Big Bad Things cause growth and leave a person better than they were before. Big Bad Things sometimes have Good consequences.
As with developing PTSD, theories about why some but not all people undergo PTG after a traumatic event abound. I lack the space and expertise to shed light on this issue. I also want to be especially careful: I don’t want to judge—in any way—either persons with PTSD or who have evidenced PTG. Indeed, it is worth noting that there is good reason to think that some people both undergo PTG and develop PTSD [see, for instance, the remarkable studies by Solomon and Dekel’s (2007) and Jin et al (2014)].
Instead, I want simply to emphasize that PTG exists, because its very existence seems to me significant.
Just knowing that Big Bad Things sometimes have positive consequences has, for me, made a difference. In particular, it gives me hope. Hope that the Big Bad Things that have happened to me, to people I know, and even to the people that I’ve never met need not always result in big, bad consequences. Or, at the very least, that they need not only result in big, bad consequences.
When horrible things happen—and sometimes horrible things do happen—I am comforted that they do not always get the last word. Big Bad Things do not always render their sufferers as forever sufferers. Perhaps this doesn’t make them any less horrible or terrible, but it helps me cope. It gives me a way of being in the world that has more options and more possibilities.
Of course, we need to better understand the whens, whys, and hows of the good and bad consequences of trauma. It’s important that research in this area continue and advance. But there is some comfort, in the meantime, from knowing that the consequences of traumatic experiences are not solely bad. Sometimes people not only survive major damages to their bodies and psychologies, but they thrive as a consequence.