Defining Trauma

TW gave me Frank Ochberg’s name to look up.  I found his interview by Rebecca Aponte http://www.psychotherapy.net/interview/ochberg-interview

She asked the same question that I wanted to know, “To start, trauma is a word that is thrown around a lot these days. What does it mean when we say someone is traumatized?”

Frank Ochberg: I was part of the team that wrestled with that definition, and I think it is still an interesting challenge because the word is in general use. I think most of us consider something traumatic as usually something frightening, difficult, that could have relatively minor or huge life shattering consequences. Let’s compare it to stress. We get stressed by minor things that get us upset, sometimes mobilized with a lot of energy. But those of us who were part of a new generation that defined Post-Traumatic Stress Disorder really wanted trauma to be way beyond the usual stress.

In the beginning we said a traumatic event is something that is beyond the realm of usual human experience. But then we discovered it isn’t—not in terms of living our whole lifetime. You live long enough and something happens that is terrible, unless you are very, very fortunate. And some people are having terrible things happen with great frequency.

So to try to define this, we said at the time that you have to have been very scared, or horrified, or feeling helpless. And it had to have the characteristic of the kind of thing that could kill you, or kill somebody else, or radically change you in a biological way.

We walk through life with the wonderful myth of invulnerability and we think our humanity is something special, sacred and precious. And then all of a sudden you are treated like a piece of meat, like you are prey to another human being or to a devastating natural event: you are just a bunch of muscle and bone. And when you visualize that transformation in yourself or in a loved one, it is traumatic.

That is the meaning of trauma to those of us who were in the field of traumatic stress studies and are doing therapy with people who have been traumatized.

 

I believe this is a statement that would satisfy most people.  It may not be a perfect definition.  Some people may say that it excludes someone that has suffered emotionally.  I do not want to do a case by case study of this is trauma, this is not.  Trying to define trauma it is not my intent to imply that anyone’s suffering didn’t hurt.  I am not trying to setup a criteria of someone’s suffering is not great enough to be counted as traumatic.  I believe that trauma like so many things in life is on a continuum.  There are events in my life that I consider much more severe than others.  Emotional betrayal hurt as much or more than those events that threatened my life.  I wanted to have the clinical definition establish so that when I say trauma it has the same meaning.  Trauma is just one part of the realm of human suffering.  When I changed counselors, I was asked what kind of abuse had I suffered? I felt a bit irritated because I believe that abuse is abuse and suffering is suffering.  Emotional pain is as real and terrible as physical suffering.  However, when I quote an expert or talk about these issues I want others to realize that the professional field has a very clear and somewhat narrow definition.

This is how I would reword this definition:  ‘at the time that you have to have been very scared, or horrified, or feeling helpless. And it had to have the characteristic of the kind of thing that could kill you, or kill somebody else, or radically change you in a biological or emotional way.’  But it is not my definition to change.  I want the official definition represented so that people will know what it means when I say I have PTSD by clinical standards.  My life was threatened so many times I got to the point of ‘kill me, get it over with.’  A child can feel threatened by a parent telling them they wished they were never born.  The hyperbole of ‘I want to kill you’ is too realistic to a child.  I do believe that mental illness is a killer, it is called suicide, and more die every day.

 

Continuum

 

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