Small ‘t’ And Large ‘T’ Trauma
When we think about trauma, we tend to think about those who have been exposed to significant traumatic events like natural disasters, terrorism, war, combat, physical or sexual abuse, or catastrophic accidents. These are some of the most debilitating experiences we can endure. However, you don’t need to undergo an obviously distressing event for it to affect you. An accumulation of smaller, less intense events can still be traumatic. This is the difference between small ‘t’ and large ‘T’ trauma.
Small ‘t’ Trauma
Small ‘t’ traumas are occurrences that exceed our ability to cope, disrupting how we emotionally functionhttps://deepwave.co.nz/anxiety/
. These events are not intrinsically life-threatening but could be described as emotionally threatening, as invariably, we are left feeling helpless. Examples include:
- Divorce
- Infidelity
- Social or human-to-human conflict
- Abrupt or elongated relocation
- Legal trouble
- Financial challenges
- Being teased as a child
- Having an overly critical parent
- Living in a high-conflict family
- Experiencing a lot of unpredictability
- Moving a lot as a kid
- Having an unsupportive parent
- Losing a loved one or a pet
- Having a parent who expects perfection
As humans, we have a tendency to overlook small traumas. We do a great job of rationalising our experiences as common and shame ourselves for any reaction that could be interpreted as an overreaction or as being “dramatic.” We either do a great job of avoiding or ignoring the traumatic experience, or we simply don’t recognise just how disturbed we are by the event or situation. This can be compounded further when loved ones or even therapists dismiss reactions or symptoms due to a lack of understanding about the relevance the experience has had on how we function.
The accumulated effect of small trauma is one of the biggest overlooked aspects. While a single small trauma event may not lead to substantial distress, numerous compounded small traumas do. The impact is compounded when multiple traumatic events happen over a short time span, increasing the level of distress and emotional functioning.
Big ‘T’ traumas are what we think of when we think of trauma. “A situation where your life is or feels threatened, such as a car accident, war, rape, assault, and kidnapping,” she explains.
In contrast, small ‘t’ trauma are events that might not seem so traumatic but have a long-lasting impact. “This includes being bullied, a passing remark, failing at something, suddenly realising that something is not the way they thought it was — such as discovering a parent has had an affair — or living with a narcissist, which causes serial repeated small ‘t’ traumas due to manipulative behaviour.”
– Nicola Harker, Dr and transformational coach.
Large ‘T’ Trauma
A large-T trauma is characterised as a significant and extraordinary event that leaves you feeling powerless. Events could take the form of a terrorist attack, natural disaster, sexual assault, combat, plane or car accident. Helplessness is also a significant factor of large traumas, and the extent of helplessness experienced far exceeds that of a small ‘t’ trauma. Large traumas are more readily identifiable and acknowledged by the experts and those closest to them.
Whilst with small ‘t’ trauma, where avoidance is not necessarily recognised, large trauma avoidance is much more overt. We tend to deliberately avoid people, places, and circumstances that would remind us of the event. Be that hiding from the military uniform or avoiding crowded places, events, or celebrations. These attempts to reduce reminders and minimise the distress of the traumatic event are often time and energy-consuming. One large ‘T’ trauma is often enough to disrupt daily life and cause severe distress. The impact of the large ‘T’ event will intensify the longer treatment is circumvented, and avoidance behaviours continue.
Large ‘T’ Trauma
A large-T trauma is characterised as a significant and extraordinary event that leaves you feeling powerless. Events could take the form of a terrorist attack, natural disaster, sexual assault, combat, plane or car accident. Helplessness is also a significant factor of large traumas, and the extent of helplessness experienced far exceeds that of a small ‘t’ trauma. Large traumas are more readily identifiable and acknowledged by the experts and those closest to them.
Whilst with small ‘t’ trauma, where avoidance is not necessarily recognised, large trauma avoidance is much more overt. We tend to deliberately avoid people, places, and circumstances that would remind us of the event. Be that hiding from the military uniform or avoiding crowded places, events, or celebrations. These attempts to reduce reminders and minimise the distress of the traumatic event are often time and energy-consuming. One large ‘T’ trauma is often enough to disrupt daily life and cause severe distress. The impact of the large ‘T’ event will intensify the longer treatment is circumvented, and avoidance behaviours continue.
Trauma Symptoms
Symptoms of small trauma can resemble those of large trauma but are usually less intense. Common symptoms of trauma include:
- Worry, feeling nervous or overwhelmed in everyday situations
- Self-destructive behaviour, such as drinking too much or driving too fast.
- Sleep problems, nightmares and other night terrors
- Flashbacks
- Memory, Cognitive impairments, Confusion, difficulty focusing, and making decisions
- Difficulty enjoying activities that were once pleasurable
- Irritability or aggression, sometimes escalating to rage and threats of physical violence.
- Panic attacks
- Emotional numbness, Low mood
- Being always on edge
- Depression and grief
- Avoidance, Guardedness
- Suicidal thoughts
- Brain chatter
- Being easily startled or frightened.
Trauma Treatment
A normal fear response involves a careful balance and release of several hormones. We see a reduction of serotonin and an activation of cerebral norepinephrine and the adrenals that prepare us for battle. Occasionally, a large ‘T’ trauma or compounding small ‘t’ traumas can cause a never-ending dysfunctional activation of the fear response. Simply put, we can get stuck in an endless triggering of our fear response, which physically and psychologically fatigues us.
Unfortunately, no adequate medical treatment or drug for trauma exists today. While electroconvulsive therapy (ECT) or pharmaceutical agents may relieve depression associated with trauma, these can often drive the brain further into disorder. This can leave us feeling emotionally numb and struggling with increased cognitive and social impairments.
However, there are therapy options to support symptom reduction. Trauma-focused therapy generally includes evidence-based treatments such as prolonged exposure and cognitive processing therapy, as well as EMDR. These research-based treatments effectively reduce, if not remove, trauma symptoms. Each treatment is a little different; however, they incorporate strategies such as remembering and reducing the memory of the trauma and managing and reprocessing thoughts, memories, and beliefs. In addition to therapy-based treatments like EMDR and CBT, there are also some emerging alternative trauma treatments, like brainwave entrainment.
Brainwave Entrainment is an alternative trauma treatment that can detach those experiencing trauma from destructive distressing thoughts. Brainwave Entrainment also increases blood flow, calms the limbic system, normalises brainwave and neurotransmitter production, restores the adrenals, and produces somatic relaxation. The subjective benefits of brainwave entrainment are improved sleep and mood, reduced anxiety, increased energy, improved relationships, improved productivity and reduced physical problems.
Brainwave entrainment is not a treatment for trauma, in the same way, that exercise is not a treatment for obesity. However, it’s a mental self-care option that offers a simple way to re-balance the brain, help with mood stability, and reduce symptoms of mental wellness conditions, which gives your nervous system a chance to relax and your mind and body some breathing space from the daily impact of your symptoms.
Conclusion
Although there is no quick fix or “cure” for trauma, it is possible to eradicate or significantly improve the impact of the traumatic memory on our lives. Although finding a treatment option that works for you can take time, avoiding the symptoms only compounds the impacts felt. So, look at all treatment options, and include alternative treatments that may offer support and relief from the everyday symptoms you may be experiencing.
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