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Retraumatization

In mental health circles, the term trauma refers to a psychological phenomenon involving a sudden, life-threatening, or horrifying experience, often followed by troubling memories and reactions. The term traumatization refers to the process by which a trauma occurs or is experienced, including both objective and subjective aspects about the event and a person's reactions to the event. Unfortunately, many people have more than one traumatic experience in their lifetimes. When individuals experience multiple traumas or traumatizations, it can often be said that they have been retraumatized.

The effects of retraumatization are thought to be cumulative, such that the experience of multiple traumatic events has a greater psychological impact than does a singular trauma. Research supports that supposition, finding that multiple traumas are associated with more psychological symptoms than are singular traumas. Individuals who have experienced prior trauma have also been found to be at increased risk for developing posttraumatic stress reactions with subsequent trauma exposure. For instance, recent research with military personnel found that individuals who had histories of being physically or sexually assaulted were twice as likely to develop combat-related PTSD compared with individuals with no prior assault history. Retraumatization is also thought to increase the risk for the intergenerational transmission of trauma. Together, these findings emphasize the critical importance of considering this issue of retraumatization for all trauma survivors.

This entry reviews what has been learned about retraumatization, including the multiple ways in which it can be defined and what alternative labels can be used to describe different types of retraumatization. This entry also explores the common risk factors and protective factors for retraumatization to help elucidate when and how retraumatization is most likely to occur. Finally, treatment considerations and clinical interventions for retraumatization are discussed.

Definition

In both the research literature and in common usage, a variety of different terms have been used to describe the process of retraumatization. For instance, the word retraumatization is often used interchangeably with labels such as revictimization, repeated trauma, continuous trauma, and multiple traumatization. Furthermore, the term retraumatization is often defined in more than one way in the literature. Primarily, the term is used in two distinct ways: (1) to describe the idea of retraumatization as revictimization, and (2) to describe the idea of retraumatization as the reactivation of trauma-related distress. Both definitions are discussed in some detail here.

The use of the term retraumatization to mean revictimization refers to an individual's exposure to a traumatic event that occurs after exposure to other traumatic events. This can occur when individuals are victims of the same type of trauma on more than one occasion, or when individuals are exposed to multiple types of trauma over time. Examples of reexposure to the same type of trauma would include physical abuse as a child and domestic violence as an adult, or multiple car accidents at different times over the life span. This reexposure to the same type of trauma at different points in time is sometimes referred to as serial trauma. Instances of exposure to multiple different types of trauma over time include the case of an individual who experiences sexual abuse in childhood and then becomes exposed to community violence in young adulthood, or a person who survives a natural disaster and then is later exposed to military combat trauma. This repeated exposure to different types of trauma is sometimes termed sequential trauma. Both serial trauma and sequential trauma incorporate the idea of multiple victimizations or traumatizations and are subsumed under this initial definition of retraumatization.

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