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What is trauma?

The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V) defines a “traumatic event” as one in which a person experiences, witnesses, or is confronted with actual or threatened death or serious injury, or threat to the physical integrity of oneself or others.

Trauma is a costly public health problem which happens as a result of physical, sexual or emotional abuse, neglect, violence, war, loss, disaster, and other emotionally harmful experiences. Like individuals, communities can be traumatized as well.

While many people who experience a traumatic event are able to move on with their lives without lasting negative effects, others may have more difficulty managing their responses to trauma. Trauma can have a devastating impact on physical, emotional, and mental well-being.

Trauma affects the developing brain and body and alters the body’s stress response mechanisms. Emerging research documents the relationship among traumatic events, impaired brain function and immune system responses. Trauma induces powerlessness, fear, hopelessness and a constant state of alert, as well as feelings of shame, guilt, rage, isolation and disconnection.

Unresolved trauma can manifest in many ways, including anxiety disorders, panic attacks, intrusive memories (flashbacks), obsessive-compulsive behaviors, post-traumatic stress disorder, addictions, self-injury and a variety of physical symptoms. Trauma increases health-risk behaviors such as overeating, smoking, drinking and risky sex. Trauma survivors can become perpetrators themselves.

Unaddressed trauma can significantly increase the risk of mental and substance use disorders, suicide, chronic physical ailments, as well as premature death.

A New Understanding of Trauma

Until recently, trauma survivors were largely unrecognized by the formal treatment system. The costs of trauma and its aftermath to victims and society were not well documented. Inadvertently, treatment systems may have frequently re-traumatized individuals and failed to understand the impact of traumatic experiences on general and mental health. Today, the causes of trauma—sexual abuse, violence in families and neighborhoods, and the impact of war, for example—are matters of public concern. Trauma survivors have formed self-help groups to heal together. Researchers have learned how trauma changes the brain and alters behavior. A movement for trauma-informed care has emerged to ensure that trauma is recognized and treated and that survivors are not re-victimized when they seek care. Complementing these changes are programs to promote healthy development of children and healthy behaviors in families, schools and communities that reduce the likelihood of trauma.

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