The official definition of trauma has changed so much that it’s hard to keep up. So what does it really mean? Should health professionals define it in terms of events or reactions? The answer is important considering that funding, legal compensation and treatments rely on it.
The term originally referred to bodily injury, but has expanded to include psychological injuries as well. Early theories suggested that a traumatic event was only significant in revealing a weakness of character. Thinking began the change at the end of World War II, and evolved into our modern concept of trauma.
Should we base the definition of the term more on what happens to you, or the consequences of the experience? One attempt to define events as traumatic is written into the PTSD (Post-Traumatic Stress Disorder) definition, but the definition changes each time the diagnostic manual is revised.
Everyone has their limit in terms of stress, but the margins of what we find acceptable to represent a trauma are still disputed. Many large research Aussies have cited figures that show over 70% of people have experienced a traumatic event in childhood. That rises to 80% or more for adults, suggesting that 4 out of 5 adults have been traumatized.
Other than the medical definition there are many other concepts of trauma, such as the traumatization of social or cultural characteristics of a people, as well as the shattering of a person’s self-image or damage to their ability to trust others. There is poverty, divorce, prejudice and all the violent results of these situations. All are clearly negative occurrences in a person’s life but are they necessarily traumatic?
Do you have to be directly involved in an event to have it count as traumatic? Previously the answer was no, but this led to people reporting post-traumatic stress after seeing news reports of traumatic events, such as news reports of terrorist attacks or footage of war. To avoid this, the definition was revised too only include those traumatized by “electronic media” if it pertained to their job.
We are still actively negotiating the borders of what is considered traumatic. There are many types of social damage and mental health problems that do not need to be traumatic to be worthy of attention. In a sense, all the debate and attention given to defining the word “trauma” in a clinical sense, has traumatized these sufferers by obscuring that fact.
What do you think? Should we base a diagnosis of trauma on events or reactions? (or both?)
Tell me your thoughts in the comment section.
(Originally posted on April 9, 2015)