Big T Trauma
Big T trauma are those events we associate with PTSD. It involves any situation or event where the survivor felt that their life was in imminent danger. The system becomes overwhelmed. Sometimes, the disturbance from the traumatic impact is not felt until some time after the event, even months.
These are events we can clearly associate as traumatic, such as natural or human disasters: war, the Tsunami of 2004, the twin towers coming down on 9/11, sexual assault, sudden loss of a loved one, and so on. PTSD symptoms usually emerge some time after the event, and when I worked an NHS Trauma service we would advise a waiting period of at least three months before thinking about coming into therapy.
Three Symptoms of PTSD
1. Re-experiencing the trauma. This is a frightening experience where the survivor loses grip on the here and now and is back reliving the trauma. Symptoms are: flashbacks, nightmares, or bodily sensations such as pain, sweating, trembling
2. Avoidance: avoiding places or people or anything that might remind you of the trauma. Emotional numbing, cutting off from what you are feeling as it is too overwhelming. Avoiding talking about the trauma.
3. Hyper-arousal: feeling on anxious or on edge, irritable, angry outbursts, insomnia and not being able to relax.
**please see section on ‘what can help’ at the end of this article.
Little t trauma
Little t trauma are those traumas which are repeated over a prolonged period and sometimes may not seem traumatising, often it is emotional or psychological abuse, a chaotic or toxic home environment, but it can also be more subtle than that. Such as parent/s or main caregiver/s who were unpredictable or inconsistent in their moods and behaviour. As I see it, it is linked to early development and the crucial formative years of a baby’s and young person’s life, when the personality is developing. Even less obvious can be when minor misattunements happen accumulatively, and the child ends up feeling that they are bad, or stupid, unloveable or unwanted. It is the cumulative effect that is damaging: when these misattunements happen over and over again, without being thought about, acknowledged or the ruptures being repaired. They are harder to put your finger on. It could be as subtle as the energy in the environment, which children are acutely aware of: such as being treated in a certain way that results in feeling unwanted, or that you are always in the wrong, in the way, or a burden.
This may be no fault of the main caregiver, they may have loved and cared for you in the best way they knew how. However, they may not have had the skills to be emotionally aware of their own experiences, and therefore unable to give the baby or young person what it needs most: time and attention, assisted space to develop and play, an experience of being understood, and emotions being acknowledged and named. Little t trauma could also be the result of early loss that was too overwhelming to make sense of, such as the separation of parents/main caregivers, or a parent/main caregiver who became unwell for a sustained period of time.
It can be deeply disturbing and lead to a negative sense of self, feeling deprived, and the young person blaming themselves, forming a grudge or feeling depressed or anxious. These are patterns that endure throughout life from the blueprint that was set in the early years. They can be treated in therapy.
Eight Signs of Little T trauma:
1. Negative behavioural patterns that repeat, seem out of one’s control, which cause unhappiness and a feeling of not being able to achieve what one wants in life such as a relationship or work goals.
2. Mood dysregulation. Feeling overwhelmed unexpectedly by negative emotions and lacking the understanding of what they mean or how to help yourself move through them to feel better.
3. Feelings of emptiness or being cut off from oneself.
4. The flip side of emptiness is a state of hypervigilence and feelings of overwhelm/fear, that there is an uncontrollable sense of danger.
5. Feelings of a grudge. It may be directed towards different people/things at different times but is always there in some form.
6. Feeling isolated, like an outsider, as if you don’t fit in, with difficulty trusting people and feeling secure.
7. Shame. Thinking there is something intrinsically wrong with you, feeling “I am bad” or “never good enough”, believing you should be able to manage your feelings or state of mind but can’t.
8. Feelings of hopelessness and powerlessness.
I was surprised to hear, years ago when I was a student undertaking my psychotherapy training, my supervisor say: a child who has been sexually abused and had an experience of being understood, contained, and believed by their parent or main caregiver, will have a much better outcome than a child who has been sexually abused, and been unsupported by their parent or main caregiver, either being told they are being silly, it’s all in their head, or being neglected, ignored or dismissed.
Trauma does not happen in a vacuum, it happens in a relational context. This is why healing from trauma happens within a relationship that feels safe and trustworthy. Porges (2011) talks about the necessity of activating the social engagement system in the healing process.
The ironic thing is, that most trauma survivors have experienced relationships as unsafe, frightening, even life threatening. This is why relationships can sometimes be avoided, and why it can feel frightening to take the step into psychotherapy.Relationships are the tool to healing, through the experience of a different kind of relationship, one that is safe, containing, and consistent.
What can help
1. Talking therapies such as counselling, psychotherapy, EMDR, or trauma focused CBT, Somatic Experiencing. Please check that the practitioner is experienced in treating trauma.
2. Trauma sensitive yoga, or any movement practice where the survivor has autonomy and choice over the movements they make with their body. The aim is to make friends with the body in a safe environment, as trauma survivors experience the body as a frightening place where symptoms are overwhelming and unpredictable. There is more info on trauma sensitive yoga on my website.
3. A breathing practice. For some people this will feel anxiety provoking so see if it works for you. Any yoga breathing, Butekyo breathing, box breathing or cardiac coherence breathing (I will post instructions on breathing in another post).
4. Trauma sensitive mindfulness. NOTE- this is different from the common mindfulness that most people are aware of. The best resource for this is a book by David A. Treleaven called ‘Trauma Sensitive Mindfulness’ (2018).
If you are experiencing anything that has been mentioned in this post, or if something in the post has resonated with you in some way, please reach out to me. I would be happy to talk about how I can support you. Simply call me on 07710 819 485 or email email@example.com.
There are many different reasons why people might come into therapy, and oftentimes what clients find is that as the therapy progresses, that different, more pressing or significant reasons than that which originally brought them, start toemerge. The human psyche is incredible, and complex. Every person is different. And as the work gets going , sometimes it can seem like an onion, when one layer is peeled off, another one is there underneath.
Recently, a client asked me if their problems were significant enough for therapy, which has inspired me to write this post.Because I think it is worth knowing, that if you have thought about therapy, then the chances are, that you would benefit from it. It may be a question of whether you are able to allow yourself to receive help. Of course, there are exceptions to the rule. Some people may come for help with something unexpected that has happened in their lives, and after 8-16 sessions, they are restored and able to carry on with their well functioning and fulfilling lives.
Sometimes it is more straight forward for people who come into therapy knowing they need help. Perhaps they have experienced abuse growing up, or a chaotic or unpredictable environment as a child, or were neglected by parents struggling with their own addictions or mental health issues. Or perhaps a traumatic event happened and it became clear that there was post traumatic symptoms that therapy could help with. They are aware of their struggles, and are willing to give therapy a go, and are have hope that it will help.
Other people reach out to a therapist when things have hit crisis point. Perhaps a partner has threatened to leave them, or their experience of the pandemic has been difficult to manage. It could be a health condition diagnosis, a divorce, or a life transition such as children leaving home.
With these clients, they know they are struggling with this one thing. And sometimes, this is right, once they have sought help adjusting to their new reality, the work is done and they no longer need therapy. For others, once the crisis or trauma has been worked through in therapy and begun to be integrated within their psyche, other issues emerge that may not have been known about before. Then, it becomes like the onion: there is more work that can be done, if the client chooses to do so.
It is not unusual to be unsure about whether therapy could help you. Sometimes, we are so used to looking after everyone else: family, friends, colleagues- that we don’t give much thought to what we ourselves might need. We might be so busy that we don’t have time to stop and think, or we may not know the depth of our unhappiness, if it is all we have ever known. It may be that things just don’t feel right or good or satisfying in life, for no apparent reason, often when everything on the outside seems good. You may have everything you need and want materially, and yet still, are not happy. It may be that you grew up in an environment where emotional health was not something to be taken seriously or even thought about, with feelings being dismissed. You may feel like a burden, telling yourself there are people worse off.
If you have thought about therapy, then chances are you would benefit from it. Sometimes it is the unconscious part of us that has a drive towards healing that reaches out to a therapist, and then the self-sabotaging part gets in the way and says something like ‘don’t be stupid, you don’t need therapy’.
Sometimes it’s a repeating pattern that is an indicator that something needs to be addressed in therapy, such as relationships always breaking down, or an inability to commit to a job or place. The pattern can seem out of your control and cause a lot of pain and heartache. Maybe, you’ve never had an experience of your emotional struggles being taken seriously, so therapy seems indulgent. Or it may be that there is no ‘big T trauma’ in your history, and you think ‘are things really that bad?’
In my professional opinion, suffering is suffering. Pain is pain. Unhappiness is unhappiness. There is no measure on whether these feelings are valid, if they are your experience, then if you want it, you deserve help.
Unfortunately, we cannot put right what has happened in the past. We cannot control the people around us, or what happens in the world. But we do have a choice. We can choose how we respond in our minds and in our behaviour. This may come across as unsympathetic, or downright impossible. We feel powerless, out of control, at the mercy of a cruel world. There is truth in this – we can’t control the world around us: a bullying culture at work, a recession or redundancy, or a dysfunctional family. But we can choose how we react to these things. By understanding the meaning behind our beliefs and feelings. We can choose what meaning we make of things. And we can choose whether to make use of our capacities: to make use of what we do have. Therapy can help you to understand the meaning behind your motivations, behaviours and beliefs. It can help you to have a choice.
If you are struggling, and unsure about whether therapy may be of help, please reach out to me. I would be happy to talk with you about how I can support you. I'm seeing clients face-to-face in Raynes Park, and globally online. Simply call me on 07710 819 485 or email firstname.lastname@example.org.