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What is Trauma?

Trauma can take many forms. Sometimes in the field of psychology, we differentiate between little “t” trauma and capital “T” trauma. Some events might be experienced as “traumatic” in the sense that they were highly impactful but not be considered capital “T” trauma. Capital “T” trauma is an event in which there was exposure to actual or threatened death, serious injury, or sexual violence. Little “t” trauma might include other types of life experiences, which can be extremely difficult and highly impactful such as a divorce or a miscarriage for example. In order to develop PTSD, someone must have experienced a capital “T” trauma, which, once again, means an event in which there was exposure to actual or threatened death, serious injury, or sexual violence. This could be directly experienced, witnessed, or someone may have learned that such an event occurred to a close family member or friend. It could also be experienced in the form of repeated or extreme exposure to the details of a traumatic event, for example, first responders collecting human remains at the scene of an accident.

What is PTSD?

In order to be diagnosed with PTSD someone must also experience symptoms for each of the four clusters of symptoms:

Reexperiencing: People with PTSD experience recurrent, distressing memories, nightmares, or flashbacks.

Avoidance: People with PTSD try to avoid distressing memories, thoughts, and feelings, or external reminders of the event such as people, places, activities, objects, and situations.

Negative changes in their mood and thought processes: For example, someone with PTSD may be unable to experience positive emotions, have decreased interest in participation in things, and feel detached from others. They might also think that they are to blame, that they cannot trust anyone, or that the world is dangerous and feel emotions such as fear, anger, horror, guilt, or shame.

Arousal: People with PTSD also experience changes in arousal and reactivity, for example, having irritable outbursts, being hyperaware of their surroundings due to safety concerns, or engaging in reckless or self-destructive behaviors.

Treating PTSD

Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE) are strongly recommended forms of treatment for PTSD, whereas other popular approaches such as Eye Movement Desensitization and Reprocessing (EMDR) are conditionally recommended. You can learn more about the American Psychological Association's (APA) recommendations for the treatment of PTSD here. Medications can also play a role in the treatment of PTSD.

In my experience, one of the most important factors in treating PTSD is working with what is called moral injury. Moral injury occurs when one has acted in ways that defy their own deeply held morals beliefs. Moral injury often occurs in the context of war, but may occur in other contexts as well. It can lead to guilt, shame, and even thoughts of suicide or self-directed violence.

If you are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or chat online, available 24 hours a day, 7 days a week. You can also call 911 or go to the nearest ER.

For this reason, as a part of the treatment of PTSD, it can be important to integrate interventions such as mindfulness, acceptance, and compassion to help people learn to face their shame and heal.


The National Center for PTSD from the VA is a wonderful resource to learn more about PTSD. The VA also has apps to help with PTSD including PTSD Coach, PTSD Family Coach, CPT Coach, and PE Coach. You can learn more about trauma and PTSD at One of my favorite workbooks for PTSD is Overcoming Trauma and PTSD workbook. You might also be interested in my book!

If you are interested in learning more or in working with me please go to my homepage to contact me or schedule your free 15-minute phone call.

Please note that the information in this blog is intended for informational purposes only. It should not be used as a substitute for psychological or medical care. If you are looking for professional help, visit my resources page for guidance on how to find a therapist. If you are experiencing a mental health emergency, call 911 or go to the nearest ER.

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