Exploring Trauma series Ep 1

From “The Myth of Normal” by Dr Gabor Maté.

(Dee Cooper, Launceston clinical psychologist)

I have recently started re-reading this great book by Dr Maté, world renowned physician turned mental health lecturer and advocate for addressing childhood trauma and understanding ourselves and our culture in the context of trauma. I will be sharing some of his thoughts on trauma in the forthcoming blog posts and hope that this will stimulate further discussion and learning amongst readers.

What is trauma?

The word trauma itself gets bandied around freely sometimes without due consideration to what it really means.  Trauma in the psychological sense is an inner injury, a lasting disconnection within the self-due to difficult or hurtful events. Dr Gabor Maté states this very eloquently : “Trauma is not what happens to you but what happens inside of you” Trauma is a psychic injury that is lodged in the nervous system, body and mind and continues to impact on a person long after the original incident. The impact of the original incident usually leads to isolated neurological networks forming that are related or similar incidents, or in the case of acute trauma, experiences that are frozen in the neural network. These experiences are all connected together in terms of the common thread of unresolved emotions, coping strategies that were developed at the time which are not adaptive in the present anymore and this then causes further difficulties in terms of relationship dysfunction, addictions and physical illness due to the long term distress trapped in the nervous system..  

Two types of trauma

There are two forms to be aware of; the first involves automatic responses and mind body adaptations to specific identifiable and overwhelming events, which can occur in childhood or later, such as abuse, car accidents, war, physical assaults etc. These traumas contain multiple symptoms and can give rise to many different diagnoses like PTSD, Anxiety, Depression, Bipolar Disorder. It underlies much of what gets labeled as mental illness but also creates a predisposition to physical illness by aggravating inflammation and elevating physiological distress. This type of trauma is sometimes called big -T trauma and is more easily diagnosed due to a specific event(s) being seen as the original cause.

There is another form of trauma that is sometimes referred to small-t trauma, although its impact is by no means little. According to Dr Gabor Maté these traumas are nearly universal in our culture occurring mainly in childhood but with lifelong impact “the less memorable but hurtful and far more prevalent misfortunes of childhood”. These events might include bullying by peers, the well meant but harsh and critical comments from a parent, or even a lack of sufficient emotional connection with nurturing adults. In many ways, the small-t traumas are more reflective of what did not happen for a child in terms of unmet needs such connection and safety. Trauma of this kind does not require overt distress or an identifiable event as in a big T trauma, but it can lead to significant mental health difficulties due to the child having to disconnect from their authentic self because of their core needs not being satisfied.

It is important to remember that in real life there are no clear lines to drawn between these two types of traumas and that trauma most probably is better understood as being on a continuum. There is also much overlap between the two types of traumas as they both lead to a fracturing of self and connection with others and the world. According to Dr Peter Levine trauma “is about a loss of connection – to ourselves, our families and the world around us. This loss is hard to recognize because it happens slowly over time.  We adapt to these subtle changes sometimes without noticing them”

Trauma is a constriction of self, both physical and psychological. It impacts on our inborn capacities and distorts our view of the world and other people. Trauma tends to keep people stuck in the past, denying access to being in the moment. As a coping mechanism we will suppress the hurt and unwanted parts of the psyche, which often leads to fragmentation in personality or ability to cope with life’s challenges. Trauma impacts on a person’s self-worth, impacts negatively on relationships and deters from being able to lead a contented life. In early childhood it can even impact on brain development. It has been proven that trauma is an antecedent and a contributing factor to illness of kinds throughout the life span.

Trauma does not only reside in the individual due to what happened to them specifically; it can also be intergenerational (consider for example the impact of the severe abuse of a grandmother as a child and how this legacy can be passed on to her children, who can them pass this on their children in terms of coping strategies, maladaptive thoughts and heightened emotional responding as a default). Trauma can also exist in the collective sphere as well, affecting entire nations and cultures, such as the legacy of racism, genocide and gender victimization.

There is some good news to the initial chapter of this book. Seeing trauma as an internal dynamic gives people much needed power to heal again. When we see trauma as an external event that happen to or around us, then that means it is part of history and we can’t dislodge that. If trauma is something that happened inside us as a result of what happened, then in terms of the wounding and disconnection healing and connection becomes possible. To this end, it is useful to quote Socrates “ an unexamined life is not worth living. As long as one does not examine oneself, one is completely subject to whatever one is wired to do, once you become aware that you have choices you can exercise those choices”

Dr Maté concludes in this section that liberation is possible via even modest self-examination; a willingness to question “many of the truths we cling to” that can make them seem so real. This is in essence what psychotherapy is about when we support clients to examine the experiences that they present with and to find a way back to healing and recovery.

Dr Gabor Maté “The Myth of Normal – Trauma, Illness and Healing in a Toxic Culture” 2022. VERMILION - MASS MARKET