Movies, television shows, and news media are often guilty of oversimplifying trauma and its short- and long-term effects. In reality, trauma can manifest into far more than most people are aware of, and the mechanisms by which it influences people are complex. In our previous blog on trauma, we discussed what it was, its prevalence, and major ways it commonly manifests in individuals. Today’s blog will continue the discussion on trauma. We’ll explore different types of trauma, how it alters brain structure and function, and how unresolved trauma can impact multiple generations.

 

Types of Trauma

The list of potentially traumatic events is endless. More intense forms, like experiencing war, physical abuse, or sexual assault, are well-recognized as trauma. Still, a countless number of subtler – often common – experiences, such as death of a loved one, car accidents, and emotional neglect, make the list of potentially traumatic events much longer than most may initially expect.

Different informal means of categorizing the long list of traumas have been created, such as “Big T” vs. “Little T” trauma. Big T traumatic events are typically severe and may be life or bodily-integrity threatening. These experiences often involve violence and/or abuse, and are typically easier to identify as traumatic by the affected individual and those around them. Big T trauma often leaves a person feeling helpless with little sense of control over their environment. Examples include:

  • War combat
  • Physical and/or sexual abuse
  • Sexual assault or rape
  • Natural disasters
  • Domestic violence
  • School shootings

On the other hand, Little T trauma is less pronounced and often goes unrecognized by the affected individual and those around them until manifestations of the trauma prompts intervention by a professional. These experiences are known to exceed an individual’s capacity to cope and often occur over extended periods of time and multiple exposures. Common examples of Little T trauma include:

  • Discrimination
  • Financial struggle
  • Infidelity
  • Divorce
  • Emotional neglect
  • Abrupt relocation

This type of trauma can be just as damaging as Big T trauma, but because it is less obvious, it often goes unrecognized and untreated. Unfortunately, this is sometimes a result of individuals downplaying or rationalizing certain experiences that hurt them as “common” and assuming they were just being dramatic or sensitive.

Another major way of categorizing trauma is as acute, chronic, or complex. Acute trauma is the result of a single, isolated incident or an experience of short duration. This type of trauma causes immediate distress and often involves an individual being in danger. Examples include a car accident, natural disaster, school shooting, and the death of a loved one. Chronic trauma is the result of repetitive, protracted exposure to dangerous and/or stressful events, such as bullying and domestic violence. It can be difficult to identify chronic trauma because its effects may not be immediately apparent. Finally, complex trauma is the result of exposure to varied and multiple distressing events – often of an invasive, interpersonal nature. Examples of complex trauma include sexual abuse, torture, prolonged neglect/abandonment, and extreme financial instability. The symptoms of complex trauma are often more severe and longer-lasting than those associated with other types of trauma. Complex trauma can also lead to dissociation and major difficulty regulating emotions.

 

How Trauma Impacts The Brain

In discussing outward manifestations of trauma, it may be helpful to also explore the mechanisms by which trauma can grab ahold of a person. Trauma can alter a brain’s hardwiring as a result of neuroplasticity – the brain’s ability to modify, change, and adapt both structure and function throughout life and in response to experience. In other words, trauma can strengthen or weaken certain neural pathways, and subsequently, affect certain brain functions. 

When someone experiences danger or distress, their brain goes into a reactive survival mode commonly referred to as the “fight-or-flight” response. This reactive fight-or-flight mode is characterized by symptoms like increased heart rate, slowed digestion, pupil dilation, and increased respiratory rate – all important physiological preparations for fighting or evading a threat. In healthy circumstances, when the outside danger disappears, the brain then shifts to a restorative mode, which is characterized by opposite symptoms (decreased heart rate, slowed breathing, increased digestion, etc.).

After experiencing trauma, the neural pathways that enable both the reactive and restorative modes often become dysregulated – reactivity typically increases and restoration decreases. In fact, it is estimated that for about 20% of trauma survivors who go on to develop characteristic symptoms of post-traumatic stress disorder (PTSD), their brain rarely shifts from reactive back to restorative. Instead, these individuals’ fight-or-flight neural pathways are overactive, incredibly sensitive, and primed to threat, which holds the affected individual in an almost constant reactive state.

Even for trauma survivors that do not experience a constant state of tense reactivity, several are left with nervous systems that are highly sensitive to threat. This, in turn, means the nervous systems of those affected by trauma are often activated more frequently and for longer periods of time than those of people who have not experienced trauma. Seemingly small stressors like a flat tire or sudden change of plans can read as catastrophic to the primed nervous systems of those affected by trauma.

Such heightened state of arousal can be damaging to the brain over time, and may also lead to more changes in the structure and function of the brain. An overwhelming amount of research has found that short- and long-term impacts of trauma often involved three major forms of brain function dysregulation.

First, is the overstimulation of the amygdala – a small mass located deep in the brain. The amygdala is primarily responsible for detecting and processing threatening stimuli, regulating emotions (especially strong emotions like fear and anger), and associating emotional meaning to our memories. After trauma, the amygdala can get caught in a highly alert and activated loop during which it seeks and perceives threat everywhere. Additionally, disrupted amygdala function makes regulating emotions far more difficult and less consistent. This can result in the affected person frequently experiencing intense and overwhelming feelings that are challenging to manage.

Second, is an underactive hippocampus. The hippocampus is a brain structure primarily responsible for learning, memory encoding, and memory consolidation. Excessive amounts of one of the body’s main stress hormones, cortisol, kills cells in the hippocampus – making memory formation less effective. This interruption in memory is important because it enables the body to remain in a reactive fight-or-flight mode longer since the brain takes longer to receive the message that an outside threat has ceased to exist or is now in the past.

Third, and lastly, is the development of ineffective stress variability. As a result of increased stress hormone (cortisol) and the reactive state of the nervous system, the traumatized body’s ability to regulate itself decreases. The highly activated state of a body coping with trauma requires large amounts of physical and psychological energy, which can take away from the reserve used for other bodily functions. Therefore, those affected by trauma may experience overall body fatigue, weakened immune systems, digestive issues, muscle/weight loss, and much more.

 

How Trauma Can Impact Future Generations

In a previous blog, we introduced some of the most notable and easily identifiable ways in which past trauma can manifest in the future – PTSD, attachment/relationships, and chronic diseases (specifically as seen with ACEs). In this final section of today’s blog we’ll touch on another insidious way trauma can manifest long after the experience – difficulty with parenting.

An important concept to understand when discussing this topic is parental reflective functioning. It refers to parents’ mental capacity to reflect upon their own internal mental experiences as well as those of their children, and it has been identified as a key predictor of sensitive parenting. As children impacted by trauma transition into adulthood and parenthood, situational reminders of their traumatic experience(s) can make parenting extra challenging. Research suggests that an individual’s exposure to trauma in childhood has the potential to derail their parental capacity and attention for their children, especially in moments of distress. One study investigating the role parents’ childhood trauma and attachment had on their parental reflective functioning found that the presence of physical neglect and insecure attachments had particularly damaging effects on maternal reflective functioning.

Like any other person, the parenting styles of childhood trauma survivors are greatly affected by their past experiences – especially if their trauma went untreated. For some, they may become over-involved and controlling as a way to try and protect their child from anything that could be remotely dangerous or harmful. They may also be hypersensitive to any signs of threat or difficult emotion in their child and react in ways that are obsessive, intrusive, or damaging – even if their intention is only to protect their children. Others may be emotionally absent or detached from their child as a result of the negative association they have when it comes to a parent/child relationship. Some childhood trauma survivors may also struggle to be emotionally present or supportive in healthy ways because they are still coping with feelings of numbness or disconnectedness.

Please note – experiencing trauma does not mean an individual is condemned to a life of mental illness, chronic disease, or poor parenting. The point of discussing trauma is the last few blogs has been to explore its complexity and significance, while detailing just a few of the several ways it can have lasting effects on an individual. If you or someone you know has experienced trauma, please reach out to a mental health professional – it can make a difference.

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Early Connections Staff. (n.d.) Trauma-Informed Care. Missouri’s Early Care & Education Connections. https://earlyconnections.mo.gov/professionals/trauma-informed-care#:~:text=There%20are%20three%20main%20types,of%20an%20invasive%2C%20interpersonal%20nature
Elyssa Barbash, PhD. (March 13, 2017) Different Types of Trauma: Small ‘t’ versus Large “T.” Psychology Today. https://www.psychologytoday.com/us/blog/trauma-and-hope/201703/different-types-trauma-small-t-versus-large-t 
Michele Rosenthal. (June 10, 2020) How Trauma Changes the Brain. Boston Clinical Trails. https://www.bostontrials.com/how-trauma-changes-the-brain/#!/ 
San Cristobal P, Santelices MP and Miranda Fuenzalida (2017) Manifestation of Trauma: The Effect of Early Traumatic Experiences and Adult Attachment on Parental Reflective Functioning. Front. Psychol. 8:449. https://doi.org/10.3389/fpsyg.2017.00449
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