Trauma, Definitions of

Definition of Terms Related to Trauma

Before addressing trauma itself, let us define some terms used in conjunction with trauma. They are often confused with trauma itself.

Stress is an unpleasant state of strain, tension, or being taxed. In stress, physical, psychological, and social life-enhancing processes are challenged but not permanently dislodged. The source of stress is called a stressor, and the person is said to be stressed. The context of stress is a stressful situation or a crisis. However, biological, psychological, and social stress responses can still restore prior life-enhancing equilibria.

Stress can lead to further aggravation or resolution. In the latter situation, stress can even be beneficial through achievement of more favorable processes and learning how to cope with future stressful situations. This is called resilience.

In trauma, the situation is different. Imagine a stressed bone, which, even if bent, can spring back to its original shape and function. But a fractured bone is a traumatized one, and no matter how well set and healed, a scar and a vulnerability will remain permanently.

The context in which trauma occurs is a traumatic situation. The source or cause of trauma is a traumatic stressor. The internal state of disrupted processes is a traumatic state, and the person in that state is said to be traumatized, or to be in a state of trauma. The often-used term traumatic stress is confusing because it sometimes denotes a traumatic stressor, at other times a state of trauma, and sometimes even the consequences of trauma.

The confusion is increased further because traumatic stress is determined post hoc by the occurrence or not of posttraumatic stress disorder (PTSD). If PTSD does not occur, the event in retrospect was not a traumatic stress, even though the same event, if at another time it did produce PTSD, was a traumatic stress. The term posttraumatic stress, used for symptoms that correspond with PTSD symptoms but are not part of PTSD, confuses the picture even more.

The reason for the confusion is the lack of differentiation between stress and trauma. Yet as we saw, they are two different concepts. This is evidenced by the fact that each has its own body of literature; there are, for instance, separate encyclopedias devoted to the two concepts.

History of Definition of Trauma

A major problem in the definition of trauma is that it, and the experience of it, produces wordlessness and thoughtlessness. The history of trauma has been its repeated disappearance, for instance, from official psychiatric diagnoses. It requires major catastrophes, such as wars, to force trauma into awareness.

Even then, trauma has often been described only through one or more observable consequences resulting from trauma. In the U.S. Civil War, nostalgia was emphasized; in World War I, shell shock and cardiac neurosis; in World War II, combat fatigue and digestive symptoms. More generic descriptions were psychic shock and being overwhelmed.

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