But as clinicians continued to practice, they realized that other events (perhaps not traditionally defined as “trauma”) were causing the same emotional and physical impact. “Some people were dealing with stressors that caused the same symptoms,” Moutier says—even if the stressors weren’t as life-threatening as, say, a natural disaster, deadly illness, or an abusive relationship. Clinicians and mental health professionals realized the importance of recognizing and classifying these “smaller” distressing experiences as legitimate forms of trauma in their own right. They define traumatic experiences in two categories—big “T” trauma and little “t” trauma.
Difference Between Big “T” Trauma and Little “t” Trauma
Big “T” trauma (sometimes called large “T”), which can often lead to an official PTSD diagnosis, consists of catastrophic, life-threatening, and intensely distressing events. You probably think of these when you hear the word “trauma”—a plane crash, active military combat, a sexual assault, or witnessing others’ trauma. Little “t” trauma (sometimes called small “t”) refers to relatively smaller-scale, more personal, distressing events that anyone can go through at some point in life, and they’re often not life-threatening or as (obviously) scarring. These might include a stressful move, a job change (or layoff), a non-life-threatening injury, chronic pain, working for a difficult boss, a financial emergency, or a complicated divorce. But don’t let the wording convince you that one trauma is more or less important than another— the definitions are meant to help point clinicians toward the best treatment method for different patients. What’s often so tricky about little “t” events is their cumulative impact, wreaking havoc psychologically over time or with repetition. Why were some people able to work through the trauma more easily than others? Dr. Moutier likens it to a patient with heart disease. The basic preventive “prescription” for anyone to take care of their heart may include getting regular exercise and watching what they eat, but someone with heart disease may need to do all of those things plus implement additional therapies. “We’re all predisposed to understand trauma,” explains Haylie Yakrus, a mental health clinician from Berman Psychotherapy in Atlanta. “It may be genetic, [environmental] (i.e., [whether or not you felt] safe and protected), or a traumatic experience when we were [children].” But certain triggers may affect individuals completely differently—or not at all. Sometimes a little “t” trauma can immediately cause an individual to enter that fight-or-flight high-stress mode with real physiological symptoms, while it may barely phase the individual next to them. Much of how intensely you’re affected by little “t” stressors depends on how resilient you are. “There is a direct correlation between the resilience reservoir and how we process the trauma,” Dr. Moutier says. People who tend to have more emotional resilience (the capacity to cope and bounce back in the face of adversity)—or a larger “resiliency reservoir,” as Dr. Moutier puts it—are better equipped to deal with trauma, particularly that of a smaller, less life-threatening scale. And if you’re exhausted and not taking care of yourself, trauma may have an unintended bigger impact on you. Some of it is genetic—certain people are born with the ability to recover more quickly or let things roll off their backs more easily—but there’s a huge spectrum, and many are not as lucky. The promising news is that filling that resilience reservoir can sometimes be as simple as getting the sleep, hydration, nutrition, and exercise you need. RELATED: Sleep, Exercise, and Diet Are the Wellness Trifecta—but This One Is Most Important for Mental Health, Study Finds The physical manifestations of trauma come in many forms. It can be anything from easily losing your temper to having migraines, sweating, an increased heart rate, or obsessive-compulsive behaviors. Yakrus gives an example: “If you just went through a divorce or bad breakup and you refuse to date, that could actually be a reaction to the trauma.” Noticing patterns and acknowledging they might stem from something deeper is important. Validating the need to prioritize your mental health is a huge first step—whether by talking with a friend, a therapist, or journaling about your experiences. It’s hard to pinpoint when you’re in the fall-out of smaller trauma, but “…by putting it out there, you realize how it’s truly significant,” Dr. Moutier says. And before you write off self-care as an ineffective luxury—think again. Understand that a lack of taking care of yourself—whatever that means to you—your mind and your body “…can have dire ramifications for your physical and mental health,” Dr. Moutier adds. RELATED: It’s Probably Time for a Self Check-in—Here’s How to Do It Once you recognize the trauma, create self-care outlets that work for you and continue to use them. Consistent breaks, moments of self-compassion, and making small, healthy decisions for you are crucial for working through it. “Keeping up with a consistent routine is key, and so is a form of release,” Yakrus says. It could be as simple as splurging on a better brand of coffee, taking a long, hot shower, and going for a leisurely walk with a friend to talk. Schedule non-negotiable time on your calendar to do something that fills up that resiliency reservoir: things that make you happy, fulfilled, accomplished, satisfied, and connected. Also consider things that give you something to wake up for and look forward to—a sewing class, a yoga session, a great book, or baking. Know when you need a mental health day. Yakrus insists we need to start normalizing mental health days from work just as we do sick days. Yakrus reminds us: “…we should normalize that [the COVID-19 global pandemic] was a collective trauma. As life resumes, we need to take time to ground ourselves, to take a breath, and recognize there is added anxiety [leftover].” Talk to a therapist. You can practice all the self-care in the world, but there are times when you need more than a bubble bath or a cup of tea. Sometimes you need someone (who knows what they’re doing) to hold you accountable, who isn’t yourself or a friend—and that’s where therapy comes in. Cognitive behavioral therapy is a common starting point for working through trauma and a great step toward breaking free of trauma-triggered behaviors. Dr. Moutier also points to EMDR (eye movement desensitization and reprocessing) as another treatment option, which can “…help the brain file these memory files to a new place in the brain that isn’t so charged up.” “In America, we [tend to] grow up thinking that things happen to us, but we aren’t powerless,” says Dr. Moutier. If we retrain our brain, we can start to work through the trauma and alleviate the physiological symptoms we feel. The good news is that with some work and consistency, trauma is something people can work through and even feel stronger and more resilient on the other side. RELATED: 8 Apps for Anxiety and Depression That Can Help You Manage Your Mood
