For many years the impact of trauma was acknowledged through the presence of PTSD symptoms largely associated with experiencing war or sexual assault. However, trauma encompasses any distressing event or experience that affects a person’s ability to cope and function. We often recognize the effects of trauma through a person’s psychological or emotional responses to the event– varying from confusion, emotional numbness, physical arousal, dissociation, and agitation. As research on trauma has advanced over time, we can now distinguish trauma into two categories: Big T and Little t.
Big T and Little t trauma are labels that can mislead on their own. By differentiating the two in this way, some might assume that one type of trauma is more significant or detrimental than the other. However, this distinction is not intended to dismiss the impact of what qualifies as Little t trauma. While Big T traumas are more commonly acknowledged, research shows that repeated exposure to Little t traumas have been found to cause more emotional harm than singular exposure to a Big T trauma.
Big T trauma often leaves an individual feeling powerless and focused on the lack of control they have over their environment. Events that fall within the Big T category include: serious injury, sexual violence, natural disasters, and life-threatening events. Little t trauma can also lead to feelings of powerlessness, in addition to internalized shame. Little t trauma is made up of events that exceed our ability to cope on our own, as well as events that cause a disruption in our emotional functioning. Examples of Little t events include interpersonal conflict (such as emotional abuse or divorce), loss of a significant relationship, and prolonged stress (including but not limited to financial, systemic, and legal troubles). As evidenced by these examples, Little t trauma is commonly associated with relational trauma and often remains subliminal or undetected by the outside world. Because of each person’s varying levels of resilience and interpretations of what is traumatic, these events are not always easy to identify.
Research shows that individuals who have experienced trauma of any type, Big T or little t, are at higher risk to develop addiction and substance use disorders. In response to traumatic events, our systems engage in “fight, flight, or freeze” mode and often need assistance to relax and recognize that they are now safe. While our bodies are trained to recover quickly, our brains often remain hyper-vigilant in order to protect us from experiencing the trauma again. Remaining in this hyper-vigilant state can cause symptoms including depression, fear of recurrence, avoidance of emotions and activities associated with the trauma, nightmares, exhaustion and fatigue (which can sometimes lead to sleep disorders). These symptoms can lead a person to seek various coping mechanisms, including substances, to calm down or numb themselves both physically and emotionally.
Trauma healing takes place in connection with others–we are social creatures that need support and validation. There is an increased risk for prolonged distress when trauma goes unrecognized or is dismissed by those around us. Research has shown that having interpersonal support while working through traumatic experiences is one of the most important factors in not developing PTSD from Big T trauma or Little t trauma. However, because of the lack of visibility and awareness regarding most relational trauma, one’s ability to reach out to others for support may be hindered. As clinicians, it is important to recognize what our clients are affected by and how they have made meaning of their experiences. How did they make sense of the trauma? And is it affecting how they navigate through life now? Psycho-education is a large piece of healing trauma–both “big” and “little”–as well as normalizing the person’s emotional response and recognizing their development of various coping skills.
Several treatment approaches are available to help a person heal from trauma. CBT (Cognitive-Behavioral Therapy) and EMDR (Eye Movement Desensitization and Reprocessing) focus on working through the negative beliefs and thought processes that we have developed as a result of Big T trauma or little t trauma. IFS (Internal Family Systems) focuses on identifying the parts of ourselves that were established to protect us. Whether it is an isolated incident or a series of events that caused a person to internalize the same beliefs, the effects from both can be detrimental to healthy functioning. Avoidance, numbing, and dismissal may be easy in the moment; however, until we are able to confront the trauma and how we made sense of it, we are only prolonging the healing process.
Written by: Tess Taylor, MS, LPC, LCDC, Specialty Therapist | BRC Recovery