What is Trauma? A Psychologist's Guide to Definition, Signs & Healing
- Dr Tiffany Leung
- 9月22日
- 讀畢需時 9 分鐘
What Is Trauma? Understanding How It Shows Up and How Healing Begins
Moments like these remind us: trauma is not only about what happened in the past. It is about how the body carries danger into the present.
What is Trauma?
World renowned psychiatrist Bessel van der Kolk describes trauma as “the imprint left by overwhelming experiences on mind, brain, and body, shaping how we survive in the present.”
Trauma is not always loud or dramatic. Sometimes it lingers quietly in the nervous system, shaped by family, culture, or environment. It can influence how safe we feel, how we relate to others, and how we see ourselves.
Understanding trauma matters because it touches far more lives than we realise, and because recognising it can transform unspoken feelings of sorrow, shame, or anger into compassion.
How Common Is Trauma?
Large-scale studies show that trauma is not rare, but part of many people’s lived experience, sometimes visible, often hidden.
Globally: In a landmark study of 68,894 people across 24 countries, 70% reported at least one traumatic experience, and about 30% had experienced four or more (Benjet et al., 2016).
In the UK: A 2019 study with 2,064 young people found that 31% had experienced trauma by age 18, and nearly 8% met criteria for PTSD (Lewis et al., 2019).
Worldwide risk: The World Health Organization estimates that about 5–6% of people will experience PTSD in their lifetime, with women about twice as likely as men (WHO, 2022).
If numbers don't capture what trauma feels like in everyday life, take Jordan's lived experience as an example:
When Jordan was suddenly laid off, his sense of stability shattered. Even though he tried to reassure himself that he was just one of the many being laid off, he started to hold the belief: I’m disposable. I’m not safe. Months later, panic showed up during a performance review. He hasn't worked since. He pulled away from his family.
Have you ever noticed your body reacting as if danger were present, even when your mind knew you were safe?
What Counts as Trauma?
Trauma is not a single diagnosis. Psychologists often describe it in several forms:
1. Developmental or Relational Trauma
Childhood abuse, neglect, abandonment, lack of safety, or sexual exploitation.
These experiences are often chronic and interpersonal.
They can lead to complex PTSD, where patterns of distrust, shame, and hypervigilance run deep (Yehuda & Biner, 2008; Cloitre et al., 2019).
As Janina Fisher (2017) notes, trauma often fragments the self: parts of us hold fear, while other parts try to carry on as if nothing happened.
At seven, Mel learned that silence kept the peace and less exposure to shouting and yelling. Years later, she still finds it hard to speak up, even when there is no threat around her. In therapy, she starts to relate to the longstanding fear of judgment and threat long held within her...
2. Shock Trauma (Single-Event)
Accidents, assaults, disasters, war, terrorism.
Usually sudden, dangerous, and outside one’s control.
Can lead to PTSD: intrusive memories, nightmares, avoidance, and disruption to daily life.
After the car crash, Maria’s body jolted at the sound of braking, before she experienced panic attacks. She struggled to attend to work and decided to look for psychological help.
3. Other Forms of Trauma
Intergenerational: The effects of trauma passed through families and communities, often through silence or unspoken rules.
Adverse environments: Growing up with poverty, racism, violence, or displacement.
Medical trauma: Painful or invasive medical procedures, chronic illness.
Chronic toxic stress: Living long-term under constant pressure or fear.
'My mum never spoke of the difficulties leading up to her leaving (the home country). Now that I look back, I wonder if we all have grown up under the shadow of her trauma and pain from back there...her outbursts, no-feelings, transactional way of talking...' A client's reflection in therapy
How Trauma Shows Up
Trauma is not just a memory stored in the past. It echoes through body, mind, and relationships, sometimes it is loud; other times, it is subtle, mistaken for “something else.” This trauma definition reminds us it’s not only about the event but the imprint it leaves.
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA, 2014) defines trauma as 'an event, series of events, or set of circumstances experienced as physically or emotionally harmful or life-threatening, with lasting adverse effects on functioning and wellbeing.'
These signs of trauma can be physical, cognitive, behavioural, or emotional; and often overlap.
Physical Signs
Hypervigilance: always on the lookout.
Fatigue and exhaustion.
Disturbed sleep.
Chronic pain, headaches, or digestive issues.
“I’m tired, but I can’t switch off. I put off going to bed, and when I finally lie down, my mind just won't switch off.”
Cognitive Signs
Intrusive thoughts or images.
Nightmares.
Poor concentration and memory.
Disorientation or 'blanking out'.
At work, Emma forgot tasks she knew well. Her mind went blank in meetings. In therapy, she learnt her concentration struggles weren't just 'stress', but also her nervous system remembering.
Behavioural Signs
Avoiding reminders of the trauma.
Social withdrawal.
Losing interest in activities once enjoyed.
'I want my friends to see I'm okay...but then I lash out, and they get tired of me...' A client's sharing in therapy
Emotional Signs
Grief, sadness, and detachment.
Anger, guilt, or shame.
Anxiety and panic: Difficulty coping with everyday stress.
'I thought therapy was just talking about feelings. No one explained my nervous system before. For the first time, it made sense. I wasn't broken and I was just reacting to trauma. I finally understood why I am this way, and I didn't have to blame myself anymore.' A client's feedback
💡 Trauma can also show up as dissociation (feeling detached or unreal), substance misuse, or fawn responses (people-pleasing to stay safe). These are survival responses—not flaws (Mind, 2020).
When Trauma Gets Misunderstood
Too often, trauma responses are misread:
“Lazy” → when the body is conserving energy after exhaustion.
“Impulsive” → when the brain reacts rapidly to protect from danger.
“Doesn’t learn from mistakes” → when survival patterns override logic.
“Overreacting” → when emotions flare because the body senses risk.
In fact, self-blame and shame are the true experiences underneath the 'lazy, emotional and overreacting self'. Many individuals who have gone through trauma, say “It’s my fault” as a way to preserve control. Framing this compassionately can reduce stigma against our trauma, allowing us to prevent re-traumatization.
An example of 'Reframing work in therapy': “You are not broken. You adapted.” Self-blame and shame are adaptations, protective strategies that once have kept a person alive. When we move away from blame and see these reactions as survival patterns, a door opens: we can start to support healing instead of reinforcing shame.
How Trauma Affects the Body & Mind
The 3E model of trauma shows that it is not defined only by the event, but also by the person’s experience of it, and the effects that ripple through life afterwards (SAMHSA, 2014).
3E model: Event – Experience – Effect
Event — what happened. A single accident, or repeated events over time.
Experience — how the person makes sense of it. The meaning, the feelings, the survival response.
Effect — the impact, whether immediate or delayed, on health, emotions, and relationships.
The 5Fs of Survival
Our bodies automatically respond to danger with 5 responses, known as the 5Fs: fight, flight, freeze, flop, and fawn. These automatic reactions are part of our biology, not weakness. As Pat Ogden (2006) highlights, trauma is carried not only in memory but also in posture, gesture, and muscle tension.
The effect of trauma can unfold over years. A relationship breakdown, for example, may retraumatise when old fears of rejection or abandonment resurface. Without support, people may cope by shutting down, avoiding reminders, or blaming themselves. These response patterns may protect the self (from that immediate pain) in the short term, but create suffering in the long run.
Think of a time when your reaction felt “bigger” than the situation. Could it be your nervous system remembering an old wound?
Trauma, Culture and Identity
Trauma does not appear in isolation. It is shaped by the cultural scripts we grow up with, the communities we live in, and the identities we carry.
Silence in families: Some cultures value harmony over confrontation. Pain may be swallowed to “protect” others, leaving trauma unspoken but deeply felt.
Migration ruptures: Leaving one’s homeland can bring loss, disconnection, and unprocessed grief.
Racism and exclusion: Daily experiences of “othering” can accumulate as chronic, toxic stress.
Intergenerational transmission: Families may pass down survival strategies: silence, hypervigilance, shame, without ever naming them as trauma. These patterns often show up in young people and families I work with. You can learn more in my page on my blog Feeling Misunderstood? Why Gen Z Are Overwhelmed
🔗 Related reading: Teen Counselling — How Therapy Supports Young People
Trauma compounds when identities intersect. For example, a young woman of colour navigating both sexism and racism may face layers of stress that are invisible to those around her.
What did your culture teach you about expressing fear, sadness, or anger? Which emotions felt safe to show, which had to be hidden?
In practice, trauma never looks the same for everyone. For some, it shows up as silence; for others as anger; for some as physical pain instead of feelings. How we hurt and how we heal, is always shaped by our cultural and social worlds. For a deeper dive into this, you might like to read my reflections on Culturally Responsive Therapy: how therapy can honour identity, migration, and cultural difference.
At Maya's home, positive feelings had been almost non-existent; crying was regarded as weakness. At school, Maya was the outsider, being seen as the 'quiet and boring type'. She learnt to silence herself everywhere, as she was never sure where it was safe to feel.
Stages of Recovery in Therapy
Recovery is not linear, but many survivors move through phases (Herman, 2023):
Stabilisation and coping — learning to feel safe day-to-day. Steph first learned to breathe through panic, not to erase it, but to soften it.
Processing and working through — slowly exploring the impact of trauma. Later, she started to share her story in fragments. Session by session, they developed into a fuller narrative.
Reconnection — finding hope, trust, and meaning in relationships and community. After months, she spoke about experiences of laughing with her partner and friends, when she still remembers her trauma.
Alongside therapy, small daily practices matter too.
Explore more:
Part 2: how trauma-informed therapy looks like
Conclusion
Understanding Trauma Is the First Step. Trauma touches lives across countries, families, and generations. Sometimes it arrives in one sudden moment. Other times, it weaves quietly through childhood, culture, or daily life. It shows up in our bodies, our thoughts, our relationships, and in the ways we try to protect ourselves from pain.
But here is the truth:
'Trauma is not a sign of weakness. It is the mark of survival.'
Every intrusive memory, every withdrawal, every shutdown, these are your nervous system’s ways of saying, I am trying to keep you safe.
When we understand this, shame begins to soften. We can start to look at ourselves, or at those we care for, with greater compassion. And from compassion comes possibility: healing, connection, and finding safer ways to live in the present.
As a psychologist, I have seen again and again that people are not defined by what has happened to them. With the right support, they can reclaim their story and discover new ways of being.
Next, we will look at what this support can look like in therapy: What does it mean for therapy and care to be trauma-informed? How can therapists create safety, and how can clients know when a space is truly healing?
If you are just beginning to explore, you may also find my guide on How to Start Therapy helpful: it walks you through what to expect and how to decide if therapy is right for you.
📖 Further Reading
Bessel van der Kolk (2014). The Body Keeps the Score. A powerful, widely-read book that explains how trauma lives in the body and how healing can happen through both therapy and body-based practices.
Judith Herman (1992/2023). Trauma and Recovery. A classic work that frames trauma not only as an individual wound but as a social and political issue — still relevant today.
Peter Levine (1997). Waking the Tiger: Healing Trauma. Introduces a somatic perspective on trauma, describing how the body’s natural survival responses can be gently released.
Janina Fisher (2017). Healing the Fragmented Selves of Trauma Survivors. Parts work for complex trauma.
Pat Ogden (2006). Trauma and the Body. Sensorimotor psychotherapy and somatic recovery.
📚 References
Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., … Koenen, K. C. (2016). The epidemiology of traumatic event exposure worldwide: Results from the World Mental Health Survey Consortium. Psychological Medicine, 46(2), 327–343. https://doi.org/10.1017/S0033291715001981
Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2019). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 10(1), 1555293. https://doi.org/10.1080/20008198.2018.1555293
Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge.
Herman, J. L. (1992/2023). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books.
Lewis, S. J., Arseneault, L., Caspi, A., Fisher, H. L., Matthews, T., Moffitt, T. E., … Danese, A. (2019). The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. The Lancet Psychiatry, 6(3), 247–256. https://doi.org/10.1016/S2215-0366(19)30031-8
Mind. (2020). Understanding trauma. (Public resource used for survivor-voice framing and practical concepts.)
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton.
SAMHSA. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. Rockville, MD.
World Health Organization. (2022). World mental health report: Transforming mental health for all. Geneva: WHO.
Yehuda, R., & Bierer, L. M. (2008). Transgenerational transmission of cortisol and PTSD risk. Progress in Brain Research, 167, 121–135. https://doi.org/10.1016/S0079-6123(07)67010-5