The literature around trauma uses a lot of different terms to describe different categories of experiences, reactions, and events. It is difficult to understand what you’re reading if you don’t know the language. This post is a cheat sheet for terms to help you navigate articles, videos, and discussions about trauma.
Micro, Mezzo, Macro
Trauma can impact individuals, families, communities, institutions, governments, ethnic groups, countries, or even humanity as a whole
Trauma: exposure to “actual or threatened death, serious injury, or sexual violence” through direct personal experience, directly witnessing the trauma of others, indirect exposure through family members or a close associate, or repeated/extreme exposure to details of traumatic events (American Psychiatric Association, 2013, p. 213). This definition of trauma is drawn from the Diagnostic and Statistical Manual (DSM-V) which is by mental health professionals to diagnose psychiatric disorders. Exposure to events of this nature is the first criteria required for diagnosis with Post Traumatic Stress Disorder.
This is not the only definition of trauma, however. Much of the literature refers to the broader definition of trauma as exposure to an event or events which cause “the individual’s ability to integrate his/her emotional experience [to be] overwhelmed” or “the individual experiences (subjectively) a threat to life, bodily integrity, or sanity” (Pearlman & Saakvitne, 1995, p. 60). In other words, any experience which overwhelms the individual’s ability to cope is traumatic. This definition encompasses a broader range of experiences and accounts for developmental, cognitive, environmental, and other factors that influence how a person copes with adverse events. For example, a child who is made fun of every day at school may experience this series of events as traumatic as the child is less psychologically mature than an adult.
Because we often think of trauma as an even that happens to an individual it is possible to overlook the social implications of trauma. Trauma can impact individuals, families, communities, institutions (businesses, schools, etc.), governments, ethnic groups, countries, or even humanity as a whole. I think about the different types of trauma, which will be explored more below, like the ripples on a pond. When you throw a stone into the water it makes a splash at the site of the impact and the rings expand outward from there. We can use the terms micro, mezzo, and macro to describes these increasingly large groups of people.
Vicarious Trauma
“the emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured” (American Counseling Association)
Vicarious Trauma: “the emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured” (American Counseling Association). In this case, emotional residue refers to the emotional, physical, and social toll that occurs as a result of working with people who have been traumatized. Vicarious trauma has also been called compassion fatigue (Figley, 1995) , which aptly describes how working with traumatized individuals can lead to feeling exhausted or drained. Signs of vicarious trauma often mirror those of the clients the helper is working with such as disrupted sleep, anger or irritability, easy startle, feeling hopeless or helpless, changes in appetite, social withdrawal, and changes in world view. New professionals, clinicians with a history of personal trauma, and lack of self-care all put a person at greater risk for developing vicarious trauma.
Collective Trauma
“psychological reactions to a traumatic event that affect an entire society” (Hirschberger, 2018)
Collective Trauma: “psychological reactions to a traumatic event that affect an entire society” (Hirschberger, 2018). Examples of collective trauma include war such World War II, genocide such as the Holocaust, slavery, and forced relocation. The trauma impacts not only those who were directly involved but often their decedents for several generations. The events become part of the cultural identity of the groups involved. Arguably, members of the groups outside of the trauma are also deeply impacted due to threat such horrors pose to our collective humanity. A related term is historical trauma which refers to the multi-generational oppression of a marginalized group such as the Native Americans in the United States.
Shared Trauma
A communal disaster that has been experienced both by a client and the clinician who is treating this individual at the same time (Baum, 2010)
Shared Trauma: A communal disaster that has been experienced both by a client and the clinician who is treating this individual at the same time (Baum, 2010). Examples of shared traumas include natural disasters (hurricanes, floods, earthquakes), man made disasters (nuclear plant failures, oil spills), terrorist attacks, active shooter situations, and viral outbreaks such as COVID-19. Shared trauma refers to a “shared reality” between the client and the clinician (Kretsch, 1997). Baum (2010) developed four criteria for shared trauma: 1. the event is traumatogenic (a disaster capable of overwhelming a person’s ability to cope) 2. currently happening (not a historic trauma or event from the distant past) 3. the survivor and the clinician are both part of the impacted community and 4. the clinician is exposed as both a helper and a member of the community.
Shared trauma differs from other forms of trauma because it impacts the clinician on multiple levels simultaneously. As an individual you have primary exposure (what happens to you and your family), secondary (what happens to people you care about and are responsible for), and vicarious (listening to the stories of clients who are also experiencing exposure) (Saakvitne, 2002). This can create changes in the therapeutic relationship due to involuntary self-disclosure (Saakvitne, 2002), increased use of self (Kretsch, 1997), and disruptions in the asymmetry of the therapeutic relationship where the therapist isn’t only the “helper” and the client isn’t the only one being helped (Baum, 2010). Many disasters can also create changes to the physical environment such as scarcity of supplies, blocked or disrupted transportation, or destruction of the office space which necessitates the therapist assuming more of a holding role for the client (Boulanger, 2013).
Trauma Organized System
“When a system becomes fundamentally and unconsciously organized around the impact of chronic and toxic stress, even when this undermines the essential mission of the system.” (Bloom 2012)
Trauma Organized System: “When a system becomes fundamentally and unconsciously organized around the impact of chronic and toxic stress, even when this undermines the essential mission of the system.” (Bloom 2012). Trauma doesn’t only impact individuals. Institutions such as businesses, schools, and governments, among others, are vulnerable to the impacts of stress, chronic stress, and traumatic events. One can observe similar behaviors, thoughts processes, and affects among the individuals who make up that system and the way the system operates. For example, following violence in the workplace an organization may make attempts to rebrand itself and avoid discussing the incident publicly. These behaviors parallel the type of denial that may happen within an individual (or a family) who has suffered abuse. The organization itself may demonstrate the defense mechanism of denial in order to avoid dealing with the feelings of terror, sadness, and anger stirred up by the violence. Workplaces may also be reactive rather than proactive, which is similar to the affective dysregulation and hyper-vigilance someone who has experienced a trauma may demonstrate.
The National Child Traumatic Stress Network has also developed a glossary of terms which you can view here.