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Key points
- Not everyone who experiences major trauma develops psychiatric conditions.
- Low-grade, cumulative trauma can lead to worse outcomes than major trauma.
- Tiny 't' trauma if often ignored, stigmatized, and invalidated.
- By attending to the full spectrum of trauma we can help build resilience in an uncertain world.
Major trauma, what we call Big T Trauma, such as childhood sexual abuse, leads to diagnosable mental health issues in approximately 30-50% of people who experience these significant events. This means at least half of those who experience Big T Trauma do not have poor mental health outcomes.
Therefore, Big T Trauma cannot, in itself, explain the huge rise in increasing levels of anxiety and depression, particularly in areas like the USA. The World Health Organization states that the COVID-19 pandemic triggered a 25% increase in the prevalence of anxiety and depression worldwide, yet many of these people were not directly affected by the coronavirus.
Therefore, to only focus our help and support on Big T Trauma misses a substantial piece of the puzzle. We are doing a disservice to those who experience low-grade, cumulative, tiny t trauma, which psychologists and therapists like myself see every day. Yet issues such as microaggressions, challenging familial relationships, toxic positivity, and medical gaslighting are so often ignored.
It's easy to forget over time that Post-Traumatic Stress Disorder (PTSD) was only entered into the Diagnostic and Statistical Manual of Mental Disorders in 1980, and its entry was very contentious indeed. Before this, those who experienced major psychological distress from Big T Trauma were very much ignored and excluded from the healthcare they so required.
Our knowledge and understanding of trauma and mental health is an evolution, and with the rise in psychological distress, we must evolve our practice and understanding of tiny t trauma and offer support to those experiencing the entire wide range of life's challenges.
Those who were less impacted by Big T Trauma often cite that they weathered other, perhaps "smaller" difficulties in life, and by experiencing these tiny t traumas they were able to build resilience and coping mechanisms. By attending to tiny t traumas, we can develop coping skills for challenges in the future.
There is very much a sense of playing "Trauma Top Trumps," wherein we only validate the most severe forms of trauma. However, research shows that low-grade, cumulative trauma can result in worse health outcomes than acute, Big T Trauma. This is why it's important to understand tiny t trauma, and validate all lived experiences.
As the saying goes, an ounce of prevention is better than a pound of cure, and in these challenging times, we need forms of psychological prevention rather than waiting for people to reach a crisis point due to invalidation, stigma, and public/professional gaslighting.
