What does Trauma Mean?
Trauma has become a common word in everyday conversation but how it is defined seems different for everyone. Let’s break down what therapists mean when they’re discussing trauma.
Trauma is a word we hear often in everyday conversations, but its meaning varies from person to person. Let’s break down what therapists really mean when they talk about trauma.
Trauma is defined by the Diagnostic and Statistical Manual-5 (DSM-5) as, “Exposure to actual or threatened death, serious injury, or sexual violence”. But I’m sure many of you can think of situations, relationships, or events that, while not necessarily life-threatening, were still profoundly traumatic. The good news? Most counselors agree that trauma exists on a much broader spectrum than just life-or-death scenarios. One way counselors separate trauma from the DSM-5’s definition is by dividing it into 2 categories called Little T Trauma and Big T Trauma.
Big T Trauma aligns with the DSM-5’s definition, encompassing events that threaten someone’s life or bodily integrity, robbing them of a sense of safety. These are the traumas that typically come to mind when we think of post-traumatic stress disorder (PTSD)—things like military combat, major car accidents, assaults, sudden and unexpected loss, abuse, domestic violence, or mass shootings. Our culture often recognizes and validates these experiences, granting them the compassion they deserve.
On the flip side, Little T Trauma refers to experiences—or often a collection of experiences—that lead to chronic feelings of unsafety or intense emotional dysregulation. These events can overwhelm our ability to cope, triggering fight or flight responses, dissociation, depression, or a significant blow to our sense of self. Common Little T Traumas I see in my clients include feelings of being unloved or emotionally abandoned, infidelity, job loss, financial insecurity, or major rejections from peers.
Both Big and Little T Traumas can trigger intense emotional reactions, avoidance behaviors, dissociation, and negative core beliefs. As therapists, we’re trained to observe these patterns of triggers, behaviors, and beliefs to uncover what drives our clients’ struggles. Often, during the first session, I notice Little T Traumas that clients have tucked away, assumed they’ve “gotten over,” or overlooked because of the more overt Big T Traumas.
Believe me when I tell you that Little T Trauma does not mean little impact.
In therapy, we work together to explore how the past shapes present difficulties. Sometimes there’s a clear connection—like recurring nightmares or intrusive thoughts about a traumatic incident. More often, clients come in wanting to improve their communication with kids or partners, grappling with high expectations or feeling walked all over and unable to voice their opinions. Some may want to boost their confidence at work, battling the belief that they’ll always mess up.
One of the first questions I might ask is, “How long have you noticed that behavior?” or “What does this behavior remind you of?” or “When was the first time you felt this way?” Together, we’ll dig into the memories, people, and feelings linked to that behavior. If I’m using EMDR, for example, we’ll work on desensitizing those connections, creating space for your brain to form new, adaptive pathways that enhance your current functioning. EMDR employs a technique called Bilateral Stimulation while the client focuses on a distressing memory. This process helps us become desensitized to the haunting memory, reducing the emotional distress associated with it. Once that distress is significantly diminished, an EMDR therapist will guide you in identifying a positive belief about yourself that you want to embrace from that experience. Using Bilateral Stimulation again, you’ll hold that memory in mind as we create space for your brain and nervous system to adopt that positive belief, filling the void left by the trauma.
Ultimately, when therapists discuss trauma—whether it’s Big or Little T—they focus on the events and experiences that shape the challenges you face today, how you interact with others, and the beliefs you hold about yourself. What happens to us defines us only as much as we allow it to, and we have the power to choose what we take away from those experiences. Experiencing trauma isn’t a life sentence or a badge to carry for eternity. There’s a fulfilling life waiting for you beyond your past. If you’re interested in exploring how to reach that life, don’t hesitate to reach out!