We use the word ”trauma” to describe many feelings and circumstances. We say that we are traumatized by divorce, workplace harassment, the death of someone close to us, being sexually assaulted, experiencing a fire or natural disaster. These are different kinds of events but each one may include elements of trauma.

While it is important not to minimize the distress experienced as a result of these events, some are much more serious on the “trauma ruler” than others. Our reactions to trauma can be experienced on a broad continuum ranging from a general upsetness following a “traumatic” event to much more serious and often long-term reactions including Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorders (PTSD). A victim can experience a number of trauma symptoms without experiencing the debilitating effect of PTSD, but often lesser symptoms can interfere substantially with individual and family coping following a traumatic event. For example, experiencing a serious and/or catastrophic loss (e.g., the death of a child) may not result in a diagnosis of PTSD, but the profound and long-term impact of such a loss is similar to that of other trauma events that may be diagnosed as PTSD.

• Trauma can be seen as an all purpose word for what happens when your world is turned upside down.
• Trauma and our reactions to it can be seen on a broad continuum that ranges on one end, from acute grief symptoms through relatively minor and time-limited reactions to trauma events, to, at its most extreme, PTSD.
• “True” trauma occurs when the body reacts by turning on its “fight, flight or freeze” automatic pilot in response to situations involving intense fear, helplessness or horror.
• “True” trauma is not the same as severe distress, but rather what occurs when a person is exposed to real or perceived danger, directly (for self) or indirectly (for other) that results in an extreme set of physiological and psychological responses.

• Lifetime occurrence of post-traumatic stress disorder for general population ages 15-54 in the 1980’s was approximately 1%; in the 1990’s it rose to approximately 8%.
• Occurrence of PTSD is significantly higher for females than for males.
• Occurrence of PTSD is significantly higher for those: in high-risk professions, emergency and crisis workers, victims of war and torture, peacekeepers.
• 11% to 23% of all Canadian children witness some violence against their mother in the home.
• Children witnessing violence against their mother or female caregiver often experience symptoms of PTSD.
• Approximately 6-8% of youth ages 12-17 will experience PTSD.
• 31% of incarcerated young offenders experience PTSD.
• Trauma experienced before adulthood can lead to lifelong impairments.
• Sexual assault results in more PTSD than any other single event.
• PTSD in parents creates greater risk for children because their ability to parent may be affected.
• Many victims who suffer physical injury experience emotional trauma; a large percentage receive no psychological treatment.
• Post-traumatic stress is highly correlated with other disorders including depression, substance abuse, panic disorder and eating disorders.

We frequently refer to events as traumatic. A traumatic event is one in which a person experiences, witnesses or is otherwise confronted with an event that involves actual or threatened death or serious physical injury or a threat to perceived physical integrity of self or others. There is a broad range of traumatic events. Trauma can occur following:

• single-shot trauma events (e.g., accidents, murders, suicides, assaults, disasters);
• chronic trauma occurrences (e.g., physical and sexual abuse, domestic violence, war, torture);
• traumatic loss events (e.g., sudden and unexpected deaths, violent deaths, death of a child).

Traumatic events are characterized by the following:

• threat to life and limb;
• severe harm and/or injury;
• being intentionally harmed or injured by someone;
• exposure to grotesque, violent or sudden loss of a loved one;
• witnessing or learning of violence to a loved one;
• causing death or severe injury to another.

• Witnessing domestic violence.
• Fear and fundamental lack of safety in children living with chronic parental addiction or other situations engendering anxiety, fear and insecurity.
• Losing access to an absent parent or to a primary caregiver whoever that person may have been (e.g., grandparent, aunt).
• Being arrested, being kept in isolation in a custodial facility.
• Being the victim of peer violence, emotional or physical.
• Witnessing or having knowledge of the suicidal intentions or attempt of a family member, especially a parent.

It is important to remember that reactions to trauma are not solely determined by events; rather there are a number of other factors to be considered including past history of trauma and coping strategies.

A number of factors affect how people will respond to trauma. Some of the more significant ones include:

• severity, magnitude and proximity of the trauma event and how prolonged it is;
• degree of fear, helplessness, powerlessness and horror;
• past history of trauma, loss and coping;
• degree and meaning of relationship with those most affected and intensity of the loss;
• degree of and accessibility of support in the environment – family, social, community;
• general ability of victims to cope with emotionally challenging situations.

Major predictors of more serious long-term problems following trauma include the nature and magnitude of previous losses and trauma (especially childhood trauma) and effectiveness of coping strategies.

• Trauma produces inner wounds not visible to the outside observer. Trauma victims often feel “crazy” and will not disclose symptoms unless they are normalized and permission given to discuss them.
• Trauma survivors frequently do not tell us about their experiences because they feel they should not burden us with the horror of them. We, in turn, often have great difficulty in hearing their stories.
• Identifying, assessing and responding to victims of trauma and loss do not mean that they remain victims. Trauma and loss are external factors that transform the lives of those affected by them; victims have tremendous resilience to cope with and heal from trauma.
• Caregivers are an important part of the “recovery environment” of those struggling with the impact of trauma and loss. We must offer our services with respect, sensitivity and knowledge.

• Trauma experiences can affect how we function in all areas of our lives – cognitive, emotional, physical, spiritual and behavioral/social.
• There is no one “standard” pattern of reactions to the extreme stress of traumatic experiences. Some people respond immediately, others have delayed reactions over a period of weeks, months and even years.
• Some experience adverse effects for a long period of time while others recover quite quickly. Serious life events such accidental deaths, suicides, murders, sexual assaults, war, etc., are experiences that we do not just “get over”. They may leave long-lasting scars.
• All loss involves some degree of trauma and all traumas involve a substantial amount of loss and grief.