What is Trauma?: Types and Therapy for trauma
Updated: Jul 1
Published by Aaradhana Reddy,
Counselling Psychologist (M.Sc Counselling Psychology)
Trauma can have a very big impact on our daily functioning and changes our worldview. Emotional/psychological trauma, the symptoms that occur and follow during and after traumatic events are complex and differ from person to person. In the following sections we will try to understand what exactly trauma is, the types, symptoms, how therapy helps and the major therapeutic treatments for trauma. It is estimated that 70% of the global population will experience at least one traumatic event in their lives (WHO, 2024). Hence, understanding and knowing how to deal with it becomes essential.
Contents
What is Trauma?
Trauma can be understood as significant emotional distress which includes persistent fear, helplessness, dissociation, confusion and others which are a result of events that shatter the world views and sense of safety of the individual (American Psychological Association , 2026). Trauma can also be understood as emotional psychological distress to events that far exceed the individual’s ability to cope (Jae, 2024).The word ‘events’ here refer to traumatic events; which are events that cause psychological trauma during and after. The nature of resulting trauma, can depend of the following:
event itself
its occurrence (single, repeated etc.),
severity
first hand or vicarious
sudden/unexpected
Examples of traumatic events can be divided into three types:
Manmade: Manmade events include war, mass shootings, abuse (physical, sexual, emotional), neglect, rape etc.
Environmental: Environmental include natural disasters such as earthquakes, tsunamis, storms, hurricanes, tornados, pandemics etc.
Human Experiences: Human experiences include accidents (road, air, water), death of loved ones (child, spouse, parents) and other painful experiences.
Traumatic experiences usually change attitudes and behaviors of a person due to their effect on worldviews and sense of safety of an individual. A person’s sense of trust in people or the world, ability to meet, connect and engage with people, ability to find pleasure in hobbies and other activities etc., maybe affected.
As we mentioned earlier that a significant portion of the world population might experience at least one traumatic event in their lifetime; the resulting mental health conditions of trauma have become a major public mental health concern. Trauma and stress related disorders include Post-Traumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD), adjustment disorder etc. The lifetime prevalence of PTSD worldwide is 3.9% (WHO, 2024; Pan American Health Organization , 2026; Koenen, et al., 2017). Prevalence of PTSD in India is low, but this is most likely due to low treatment seeking behavior, limited access to mental health care and western centric diagnostic tools etc. (Chandna, et al., 2023).
Types of Trauma
There are four major types of Trauma.
Acute Trauma: Acute trauma is a result of single, one-time, short lived distressing/traumatic event. For example a car accident, medical emergency, death of a loved one, natural disaster, an attack etc. It leads to intense psychological distress during and after the event. Acute Stress Disorder (ASD) may follow immediately after the event and if left untreated it can lead to Post- Traumatic Stress Disorder (PTSD). ASD symptoms immediately after (3 days-1 month) may involve:
a. irritability
b. low mood
c. anger outbursts
d. dissociation
e. avoidance of places/people/details of the traumatic event
f. flashbacks/nightmares.
Social support (familial, peers and community) and immediate help (therapy/counselling) for the psychological distress caused, may subside helping the individual make a full recovery (Jae, 2024).
Chronic Trauma: Chronic trauma occurs due to repeated and prolonged exposure to a traumatic event. Prolonged physical/psychological/verbal bullying, ongoing domestic violence (physical/psychological/sexual), childhood neglect/abuse, chronic medical conditions, living in a war zone/prolonged military deployment etc. cause chronic trauma. Aspects of inescapability and the nature of chronic trauma, its effects can be intense, complex and cause lasting mental health concerns. Individuals may go on to develop anxiety, depression, suicidal tendencies, substance abuse, self- harm etc. (Jae, 2024).
Complex Trauma: While chronic trauma is repeated and prolonged exposure to single event (war, bullying, abuse etc.); complex trauma is prolonged, repeated exposure to multiple traumatic events. Complex trauma mostly occurs in formative years (infancy and childhood) within close relationships (caregivers). Childhood abuse and neglect with physical, psychological, sexual abuse and also exposed to domestic violence with physical, controlling and psychological violence etc. are examples of complex trauma. Apart from exposure to multiple traumatic events, factors such as the following can have lasting psychological impact:
i. shattered sense of trust
ii. disrupted attachment styles/relationship with caregivers
iii. betrayal etc.
Complex trauma is associated with:
i. Low self-esteem
ii. difficulty forming and maintaining relationships
iii. emotional dysregulation (feeling too much or too little (numb)
iv. chronic shame
v. isolation
vi. dissociation
vii. PTSD and Complex PTSD (C-PTSD)
viii. anxiety
ix. depression (Jae, 2024).
Secondary and Vicarious Trauma: Secondary and vicarious trauma is a result of indirect exposure to traumatic events of others, of parents etc. This type is mostly found in caregiving professions like doctors, first responders and mental health professionals. These professionals may also experience compassion fatigue. In my counselling practice with children and adolescents, their exposure to domestic violence (intimate partner violence) or extreme parental conflict can affect their performance in school, their concentration and their ability to resolve conflict. It also affects their emotional regulation and social skills. Children and adolescents exposed to attacks, witnessing crimes, gun violence etc. also experience vicarious trauma. They may exhibit the same effects of victims and if left untreated it may also lead to PTSD (Davis, et al., 2020).
Therapy for trauma
Even though trauma and all the above information maybe overwhelming, there is help available. It is of utmost importance to seek help from a trauma informed mental health professional. It is important that individual expresses their thoughts and emotions to a professional. Therapy helps people to express their trauma safely, especially for individuals who find it difficult to express. Early intervention helps, leading to better recovery and prognosis rates.
Trauma focused Cognitive Behavior Therapy: It is important that individual expresses their thoughts, emotions and behaviors to a professional. Trauma Focused Cognitive Behavior Therapy (CBT) is widely used to deal with the thoughts about the event, why it happened and how event changed their thoughts about themselves, the world and others. Disputation, cognitive restructuring, CBT worksheets, thought records, symptom maintenance cycles for client awareness are some techniques that are used. Behavioral techniques like biofeedback, grounding techniques, guided imagery, deep breathing etc. maybe used throughout the sessions in case of triggers, flashbacks causing panic, anxiety/distress. CBT also helps with processing emotions that result from the unhelpful thought patterns.
Cognitive Processing Therapy (CPT): CPT was developed by Dr. Patricia Resick, to help with Post-Traumatic Stress Disorder (PTSD). CPT can be especially helpful for individuals who cannot remember their trauma or does not want to talk about their trauma. CPT like CBT helps deal with the unhelpful thought patterns that could result from trauma. These thought patterns can make the individuals feel "stuck" and CPT can help with deal with them and replace them with more helpful and balanced thoughts. CPT can be a first line and short term treatment lasting from 2-3 months.
Prolonged Exposure Therapy: Prolonged exposure therapy helps with carefully exposing the individual to things and situations that they may have developed fear towards and avoidance because of their trauma.
Eye Movement Desensitization and Reprocessing (EMDR): EMDR Uses left and right (bilateral) eye movements or hand taps during emotionally charged expressions of traumatic experiences. It helps reduce the emotional impact of the experiences due to the dual-task stimulation which affects how the emotions are stored in our brain.
Note: These techniques are mentioned for awareness purposes. They must be done/used under the supervision of a trained mental health professional or in collaboration with one. Please refrain from using them by yourself without consulting a professional first.
In my counselling practice, I notice that environment of the individual also plays a major role in recovery. Adaptive social support systems can aid in recovery and even lead to post traumatic growth (PTG). Post traumatic growth is where an individual following a traumatic event and recovery experiences personal growth with shift in perspectives about life, new appreciation for life, spiritual enrichment, new meaning in life and its purpose and even psychological well-being. Social support can help individuals form new adaptive self-narratives, lead to self-discovery and actualization. This can result in eudaimonic and subjective well-being.
“…continued dialogue with relational partners over time could aid in the generation of new self-narratives and a redefined understanding of one’s character, meaning, and purpose (e.g., a newfound belief in one’s abilities after man aging reactions to traumatic event).” (Calhoun, et al., 2022, p. 957).
When to seek professional help?
It is important to seek professional help as early as possible after a traumatic event. Safe spaces for venting and processing the thoughts, emotions and behaviors can help a great deal with reducing how much impact trauma will have.
It is also important that family or other support systems are involved during treatment with trauma. Helping family or other support systems understand trauma can be very helpful in providing healthy support for the individual processing trauma.
You can also reach out to us for any further questions.
About
Aaradhana Reddy is a Counselling Psychologist with over 8 years of experience with both adolescents and adults. She specializes in adolescent mental health concerns and in dealing with various mental health disorders and other psychological concerns. She is a trained and experienced Cognitive Behavior Therapist and a passionate writer about mental health and well-being. She aims to raise awareness on mental health through her practice and blog.
FAQs about trauma
What is Trauma?
Trauma is the psychological, emotional, behavioral and attitude changes that are brought about after experiencing a distressing event. This event has the ability to change worldviews, shatter their sense of safety, trust and exceeds a person’s ability to cope. Depending on the type of trauma, its effects can have significant effect on a person’s mental and physical health.
What are the main types of trauma?
There are three main types of trauma. They are acute, chronic and complex trauma. Acute trauma is exposure to a single time event that is very distressing like an accident, death of a loved one etc. Chronic trauma is repeated and prolonged exposure to a distressing event like childhood abuse/neglect, domestic violence etc. Complex trauma is prolonged exposure to multiple traumatic events often during childhood, like abuse along with witnessing domestic violence, gun violence and death. Additionally, there is also vicarious trauma.
What are the common symptoms of trauma?
Common symptoms of trauma include anxiety, persistent fear, hypervigilance, flashbacks, nightmares, sleep disturbances, irritability, avoidance of places/people, guilt, shame etc. Symptoms differ from person to person and also based on the type of trauma.
Can trauma be healed completely?
People have experienced significant improvement and recovery from trauma with appropriate therapy. People have experienced improvements with their quality of life and psychological well-being, with appropriate interventions, coping mechanisms and support. Healing may take time and recovery differs from person to person.
Can trauma affect physical health?
Yes trauma does have an effect on physical health. Headaches, chronic pain, gastrointestinal issues, fatigue, appetite issues are common. Due to chronic stress, physical issues associated with stress such as blood pressure, cardiovascular issues may also arise.
What is the difference between trauma and PTSD?
Trauma is the emotional, cognitive and psychological changes that occur as a result of a traumatic experience, while PTSD is a mental health disorder that a person may develop as a result of a traumatic experience. PTSD involves intrusive flashbacks, nightmares, avoidance, hypervigilance etc.
How does childhood trauma affect adults?
Childhood trauma may affect self-esteem, ability to trust, ability to form and maintain relationships, shame and guilt, emotional regulation etc. Individuals may develop and have a higher chance of developing mental health conditions such as anxiety, depression, substance abuse/addictions and other psychological concerns later on in life.
When should someone seek professional help for trauma?
You should seek professional help when trauma starts to interfere with your daily functioning, work, education, appetite and sleep, emotional regulation etc. If these symptoms persist even after weeks or months of trauma, seek help. Early intervention can be very helpful.
How can I support someone who has experienced trauma?
Listening to understand and without judgement, acceptance, empathy and unconditional support must be provided while helping an individual process and heal their trauma. It is important to provide a supportive environment by creating safe spaces with trust, empathy and acceptance.
What are the most effective therapies for trauma?
The most effective therapies for trauma include Trauma Focused Cognitive Behavior Therapy (TF-CBT), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure Therapy (PE). They maybe used as standalone or as a combination, tailor made to the individual’s concern and based on the type and effects of trauma.
What happens to the brain after trauma?
Significant alterations happen in the brain after a traumatic event. It brings activity changes in key brain areas such as the amygdala, hippocampus, prefrontal cortex, hypothalamus and other areas in our limbic system. This affects how we process emotions, memories and alters neural connections about trust, safety etc.
References
American Psychological Association . (2026). Trauma. Retrieved from American Psychological Association : https://www.apa.org/topics/trauma
Calhoun, C. D., Stone, K. J., Cobb, A. R., Patterson, M. W., Danielson, C. K., & Bendezú, J. J. (2022). The Role of Social Support in Coping with Psychological Trauma: An Integrated Biopsychosocial Model for Posttraumatic Stress Recovery. Psychiatric Quarterly, 949–970.
Chandna, A. S., Suhas, S., Patley, R., Dinakaran, D., Manjunatha, N., Rao, G. N., . . . Benegal, V. (2023). Exploring the enigma of low prevalence of post-traumatic stress disorder in India. Indian Journal of Psychiatry, 1254–1260.
Davis, H., Whitfield, A., Judge, S., Beverly, B., Minter, J., DeLaney, E., & Walker, C. (2020). Vicarious Trauma Exposure and Its Effects on Mental Health among Adolescents and Adults: A Narrative Research Review . Undergraduate Reserach Posters .
Jae, S. (2024). Analysing the Different Types of Trauma and their Impact . Neuropsychiatry (London), 1-2.
Koenen, K. C., Ratanatharathorn, A., Ng, L., McLaughlin, K. A., Bromet, E. J., Stein, D. J., . . . Haro, J. M. (2017). Posttraumatic stress disorder in the World Mental Health Surveys. Psychological Medicine , 2260–2274.
WHO. (2024, May 27). Post-traumatic stress disorder. Retrieved from World Health Organization : https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder#:~:text=Around%2070%25%20of%20people%20globally,trained%20mental%20health%20care%20providers.
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