Acute Stress

All trauma is not the same

We talk about and treat trauma as one thing. As if it were like other diseases that we believe to have one origin or one set of symptoms. But psychological trauma is not one thing. When a traumatic event happens once, as in a car accident or a gunshot wound, the normal system of psychological defenses is temporarily overwhelmed. Like water breaking through a levee during a great flood, your body is flooded with adrenaline in such large amounts that the system actually builds new receptors to take in that extra adrenaline.⁠1

When the adrenaline levels recede, the extra receptors create an ultra-sensitive environment where the smallest amount of adrenaline is immediately picked up by the brain and nervous system—producing what is known as the ‘startle response.’ In short term trauma, the system is overwhelmed, and the effect is an over-sensitized system. It is as if the body becomes allergic to anything that might remind itself of the trauma—any loud noise, any fast motion. The psychological and physical after effects of a one time trauma, if they persist for at least a month, are diagnostically called post-traumatic stress disorder (PTSD).

PTSD is defined by a set of symptoms: startle response, flashbacks, nightmares, hypervigilance, difficulty eating, difficulty sleeping, difficulty concentrating, or persistent avoidance of anything that reminds the person of the traumatic event.⁠2 PTSD sometimes describes the aftereffects of short term trauma, but something it never seems to capture is the full picture of long term trauma. A soldier in Edward Tick’s War and the Soul states, “PTSD is a “name drained of both poetry and blame.” The soldier he quotes prefers soldier’s heart because it is a ‘disorder of warriors, not men and women who were weak and cowardly but….who followed orders and who at a young age put their feelings aside and performed unimaginable tasks…PTSD is a disorder of a good warrior.⁠3 A strong reaction to trauma is the normal response, and frequency and duration of trauma is the single greatest predictor of PTSD symptoms. 

A single terrifying event can be traumatic. How then can we understand the experience of multiple terrifying events? A car accident that lasts only 45 seconds can trigger all the symptoms of PTSD and require significant psychological treatment. So, what happens when trauma gets repeated relentlessly? What happens when it is not one frightening event, but a frightening event every night for years? When there is a one-time trauma, the system gets caught ‘off guard’ and overwhelmed. But imagine how exhausting it would be to get ‘caught off-guard’ and overwhelmed every night for most of a childhood, or ten years of war? For better or worse, the human body and brain are designed for efficiency and survival. And survival means finding the most efficient and protective way to cope.

    Understanding healing from trauma means respecting and honoring the ways we learned to cope—the ways we learned to protect ourselves. These were crucial and brilliant strategies that got us through the worst and gave us the chance to be in the position we are now—in a position to heal from it. Take some time today to reflect on the protections that you used to survive. Reflect on them and thank them for their loyal service to you.

© Gretchen L. Schmelzer, PhD 2014

1 Amy Banks, Stone Center Writing.


3 Eward Tick War and the Soul. p. 100.