Understanding Trauma: Types of trauma and Therapy

Published by Aaradhana Reddy,

Counselling Psychologist (M.Sc Counselling Psychology)

Trauma just like stress is a loosely used word today. But emotional/psychological trauma and the symptoms that occur and follow during and after traumatic events are complex, differing from person to person. In the following sections we will try to understand what exactly trauma entails, the types, symptoms and its impact both physically and mentally. 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

1. Understanding and Defining Trauma

2. Types of Trauma

   2.1 Acute

   2.2 Chronic

   2.3 Complex

   2.4 Secondary and vicarious

3. What Helps

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). 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 event itself, its occurrence (single, repeated etc.), severity, first hand or vicarious, sudden/unexpected etc. Trauma can also be understood as emotional psychological distress to events that far exceed the individual’s ability to cope (Jae, 2024).

            Examples of traumatic events can be divided into three types. Firstly, manmade events include war, mass shootings, abuse (physical, sexual, emotional), neglect etc. Secondly, environmental include natural disasters, pandemics etc. And thirdly, 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. They are as follows:

1. 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 irritability, low moods, anger outbursts, dissociation*, avoidance of places/people/details of the traumatic event, flashbacks/nightmares etc. But with social support (familial, peers and community) and immediate help (therapy/counselling) psychological distress may subside, helping the individual make a full recovery (Jae, 2024).

2. 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. Aspects of inescapability and the nature of chronic trauma, its effects can be intense, complex and lasting mental health concerns. Individuals may go on to develop anxiety, depression, suicidal tendencies, substance abuse, self- harm etc. (Jae, 2024).

3. 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, domestic violence with physical, controlling and psychological violence etc. are examples of complex trauma. Apart from exposure to multiple traumatic events, factors such as a shattered sense of trust, disrupted attachment styles/relationship with caregivers, betrayal etc. can lead to lasting psychological impact. Low self-esteem, difficulty forming and maintaining relationships, emotional dysregulation (feeling too much or too little (numb), chronic shame, isolation, dissociation etc. are all associated with complex trauma. PTSD and Complex PTSD (C-PTSD), anxiety, depression are associated as well (Jae, 2024).

4. 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 of doctors, first responders and mental health professionals. These professionals may also experience compassion fatigue. Children and adolescents exposed to intimate partner violence at home (domestic violence between parents), 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).

What Helps?

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. Early intervention helps, leading to better recovery and prognosis rates. It is important that individual expresses their thoughts, emotions and behaviors to a professional. Cognitive Behavior Therapy (CBT) is widely used to deal with the thoughts and their consequent behavior and emotions. 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.

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.  

Additionally, 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)

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.

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.