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American Heritage Dictionary:
trau·ma |
[Greek.]
traumatic trau·mat'ic (-măt'ĭk) adj.|
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Fowler's Modern English Usage:
trauma |
Blair crashed on with his schedule, side-stepping the trauma of a strike by South African Airline's ground crew—Observer, 1996 (inconvenience or discomfort, the words wanted here, make less journalistic impact).The preferred pronunciation is traw-mǝ, but trou-mǝ is more common in American English.
| transsexual, transport, transportation, transpire | |
| travel, trek, trellis |
Injury to tissue by physical or chemical means. Mechanical injury includes abrasions, contusions, lacerations, and incisions, as well as stab, puncture, and bullet wounds. Trauma to bones and joints results in fractures, dislocations, and sprains. Head injuries are often serious because of the complications of hemorrhage, skull fracture, or concussion.
Thermal, electrical, and chemical burns produce severe damage partly because they coagulate tissue and seal off restorative blood flow. Asphyxiation, including that caused by drowning, produces rapid damage to the brain and respiratory centers, as well as to other organs.
Frequent complications of trauma are shock, the state of collapse precipitated by peripheral circulatory failure, and also hemorrhage, infection, and improper healing. See also Hemorrhage; Infection; Shock syndrome.
Roget's Thesaurus:
trauma |
noun
Antonyms by Answers.com:
trauma |
Definition: severe mental or physical pain
Antonyms: alleviation, healing, help, relief
1. Physical damage caused by a blow, often the result of an external force.
2. An event causing psychological shock that may have long-lasting effects and lead to a neurosis.
Gale Dictionary of Psychoanalysis:
Trauma |
In its psychoanalytical sense, trauma denotes an event of such violence and suddenness that it occasions an inflow of excitation sufficiently strong to defeat normally successful defense mechanisms; as a general rule trauma stuns the subject and, sooner or later, brings about a disorganization of the psychic economy.
Trauma (a wound), a term borrowed from ancient Greek, was at first used in surgery to denote a violent injury from an external cause that breached the body's integrity. (Traumatism is used occasionally as a synonym, and occasionally to refer to any condition resulting from trauma.) The term eventually made its way into common usage, its psychological sense coming to the fore as its employment spread from medicine to psychoanalysis.
In the context of late-nineteenth-century causation, the notion of trauma was inseparably linked to the ideas of shock and physical breach, and it was regularly invoked to explain a variety of syndromes, among them traumatic neurosis. Freud was part of this current of thought, and, following Charcot, assigned trauma a determining role in the etiology of hysteria; then, along with Breuer (1893a), he moved from the idea of real, physical trauma to that of a "psychical trauma" (pp. 5-6), with the stress laid no longer on the reality of the event but rather on its mental representation, experienced as an internal "foreign body," which is the source of the excitation. This was a radical shift relative to the theories of the time, and an epistemological leap of great import, for it was the foundation stone of psychoanalysis.
What made an experience traumatic for Freud was indeed the incapacity of the psychical apparatus to discharge the excessive excitation in accordance with the principle of constancy, whether that excitation arose from the pathogenic action of a single brutal event or of a series of incidents having a cumulative effect. This economic view of things was part of psychoanalysis from the beginning, and it is crucial to the understanding of the psychoanalytical notion of trauma. Even at this early period, Freud distinguished two models: the first, evidenced by hysteria, involved the absence of discharge, whereas in the second, operative in the actual neuroses, discharge took place but did so at the wrong time and place, and independently of the object. The economic perspective provided the connection and continuity between the successive theories proposed by Freud as he considered trauma in terms of a causal relationship: the first of these theories was modeled on Charcot's hystero-trauma, but this traumatic theory was very soon replaced by the theory of seduction. Founded on clinical observation, this theory led Freud to assert that the trauma was always of a sexual nature and that it had two moments: the first, the moment of fright, confronted the child prematurely with the sexual conduct of an adult seducer; this the child experienced uncomprehendingly, and its meaning and traumatic effect came into play only after puberty, on the occasion of a second scene that served to reactualize the repressed memory of the earlier one. When the frequency with which his patients produced accounts of such early events obliged Freud to question their reality and treat them instead as products of fantasy, the theory of seduction lost a good deal of its interest; at the same time, its temporal aspect—the process of "deferred action" (après coup) of which the case of Emma provided the archetypal instance—remained essential to Freud's explanation of the trauma, whose importance in the triggering of neuroses, however, he now qualified by taking into account such factors as individual predisposition, the trauma's place in the subject's history and mental organization, and the circumstances of the event.
The thinking sparked by the war neuroses gave the notion of trauma a new lease on life, while so reinforcing the energetic point of view that in 1916 Freud did not hesitate to say that "the term 'traumatic' has no other sense than an economic one" (1916-17a [1915-17], p. 275). Thus a trauma, by its simple intensity, could produce an instinctual hypercathexis capable of breaching the protective shield against stimuli. In order to stem this influx, which the ego, not having been prepared by anxiety to confront the danger, was all the more incapable of neutralizing, the psychical apparatus would mobilize all available energy and establish countervailing charges. Should these defensive strategies be insufficient, the apparatus would have to bind the excitation compulsively, "beyond the pleasure principle," so as to lower it gradually to a tolerable threshold (1920g, p. 31).
In Beyond the Pleasure Principle, where the importance assigned to the compulsion to repeat led Freud into speculation about the death instinct, the question arose of what principle governed repetition. Was it Thanatos, striving for absolute discharge, as in certain behaviors analogous to the traumatophilia described by Karl Abraham in 1907? Or Eros, aiming to attain mastery through the gradual resolution of tension and thence accede to the power of symbolization, as well illustrated by repetitive dreams recounted in the analytic session and by reproductions in the transference? In fact, where the work of analysis made it possible for the subject to recover and work through repressed material, the binding function could triumph over death-oriented repetition. In that case, deferred effects, by making reorganizations possible, would have been the motor of change.
Finally, in the context of Freud's revised theory of anxiety (1926d), the stress fell on the state of helplessness: what the baby experiences, subjected without recourse to a state of tension in the absence of its mother, was taken as the prototype of all traumatic situations. In this instance with the signal function of anxiety as yet not developed, the ego is overwhelmed by an eruption of instinctual forces it is powerless to contain.
Freud's reflections of 1926 have given rise to the present-day notion of narcissistic trauma, which refers to the ego's inability to bind excitation resulting from a loss, whether the loss of an object or a loss of a narcissistic kind. This classification is justified in terms of the symptomatology often presented by patients (rumination, repetitive dreams), who may thus be thought to be expressing a pathological mourning under the influence of deferred effects (après coup).
This category has led to a questionable broadening of the concept, for it tends to water down the specificity assigned to trauma in Freud's early works: Systematically treating all and every physical or psychic injury as a trauma runs counter to the psychoanalytic view, for which a trauma cannot be reduced to the level of events alone; at the same time, this level should always be taken into account, precisely because not to do so is to court the danger of further pathological development in a traumatic mode.
Bibliography
Abraham, Karl. (1979). The experiencing of sexual traumas as a form of sexual activity. In Selected papers on psychoanalysis. New York: Brunner/Mazel. (Original work published 1907)
Brette, Françoise. (1988). Le traumatisme et ses théories. Revue française de psychanalyse, 52 (6), 1259-84.
Freud, Sigmund. (1916-17a [1915-17]). Introductory lectures on psycho-analysis. SE, 15-16.
——. (1920g). Beyond the pleasure principle. SE, 18: 1-64.
——. (1926d). Inhibitions, symptoms and anxiety. SE, 20: 87-172.
Freud, Sigmund, and Breuer, Josef. (1893a). On the psychical mechanism of hysterical phenomena: Preliminary communication. SE, 2: 1-17.
——. (1895d). Studies on hysteria. SE,2.
Further Reading
Levine, Howard (Ed.). (1990). Adult analysis and childhood sexual abuse. Hillsdale, NJ: Analytic Press.
Sandler, Joseph, et al. (1991). Conceptual research in psychoanalysis: Psychic trauma. International Review of Psychoanalysis, 18, 133-142.
Terr, Lenore. (1990). Too scared to cry: Psychic trauma in childhood. New York: Harper and Row.
Van Der Kolk, Bessel, et al. (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford.
—FRANÇOISE BRETTE
Dictionary of Cultural Literacy: Health:
trauma |
Wounds that result from sudden physical injury or violence.
Saunders Veterinary Dictionary:
trauma |
A wound or injury, especially damage produced by external force, e.g. surgical operation, impact, blunt instrument.
Mosby's Dental Dictionary:
trauma |
A hurt; a wound; an injury; damage; impairment; external violence producing bodily injury or degeneration.
Random House Word Menu:
categories related to 'trauma' |
Rhymes:
traumata |
Wikipedia on Answers.com:
Psychological trauma |
 |
This article needs attention from an expert on the subject. See the talk page for details. WikiProject Psychology or the Psychology Portal may be able to help recruit an expert. (December 2011) |
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. When that trauma leads to posttraumatic stress disorder, damage may involve physical changes inside the brain and to brain chemistry, which changes the person's response to future stress.
A traumatic event involves a single experience, or an enduring or repeating event or events, that completely overwhelm the individual's ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks, years or even decades, as the person struggles to cope with the immediate circumstances. Psychological trauma can lead to serious long-term negative consequences that are often overlooked even by mental health professionals: "If clinicians fail to look through a trauma lens and to conceptualize client problems as related possibly to current or past trauma, they may fail to see that trauma victims, young and old, organize much of their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects."[1]
Trauma can be caused by a wide variety of events, but there are a few common aspects. There is frequently a violation of the person's familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. This is also seen when people or institutions, depended on for survival, violate or betray or disillusion the person in some unforeseen way.[2]
Psychological trauma may accompany physical trauma or exist independently of it. Typical causes and dangers of psychological trauma are sexual abuse, bullying, domestic violence, indoctrination, being the victim of an alcoholic parent, the threat of either, or the witnessing of either, particularly in childhood. Catastrophic events such as earthquakes and volcanic eruptions, war or other mass violence can also cause psychological trauma. Long-term exposure to situations such as extreme poverty or milder forms of abuse, such as verbal abuse, can be traumatic (though verbal abuse can also potentially be traumatic as a single event).
However, different people will react differently to similar events. One person may experience an event as traumatic while another person would not suffer trauma as a result of the same event. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.[3]
Some theories suggest childhood trauma can lead to violent behavior, possibly as extreme as serial murder. For example, Hickey's Trauma-Control Model suggests that "childhood trauma for serial murderers may serve as a triggering mechanism resulting in an individual's inability to cope with the stress of certain events."[4]
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People who go through these types of extremely traumatic experiences often have certain symptoms and problems afterward. How severe these symptoms are depends on the person, the type of trauma involved, and the emotional support they receive from others. Reactions to and symptoms of trauma can be wide and varied, and differ in severity from person to person. A traumatized individual may experience one or several of them.[5]
After a traumatic experience, a person may re-experience the trauma mentally and physically, hence avoiding trauma reminders, also called triggers, as this can be uncomfortable and even painful. They may turn to psychoactive substances including alcohol to try to escape the feelings. Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience.[5]
Triggers and cues act as reminders of the trauma, and can cause anxiety and other associated emotions. Often the person can be completely unaware of what these triggers are. In many cases this may lead a person suffering from traumatic disorders to engage in disruptive or self-destructive coping mechanisms, often without being fully aware of the nature or causes of their own actions. Panic attacks are an example of a psychosomatic response to such emotional triggers.
Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present, as much as it is actually present and experienced from past events. Upsetting memories such as images, thoughts, or flashbacks may haunt the person, and nightmares may be frequent.[6] Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night.
The person may not remember what actually happened while emotions experienced during the trauma may be reexperienced without the person understanding why (see Repressed memory). This can lead to the traumatic events being constantly experienced as if they were happening in the present, preventing the subject from gaining perspective on the experience. This can produce a pattern of prolonged periods of acute arousal punctuated by periods of physical and mental exhaustion.[7]
In time, emotional exhaustion may set in, leading to distraction, and clear thinking may be difficult or impossible. Emotional detachment, as well as dissociation or "numbing out", can frequently occur. Dissociating from the painful emotion includes numbing all emotion, and the person may seem emotionally flat, preoccupied, distant, or cold. The person can become confused in ordinary situations and have memory problems.
Some traumatized people may feel permanently damaged when trauma symptoms do not go away and they do not believe their situation will improve. This can lead to feelings of despair, loss of self-esteem, and frequently depression. If important aspects of the person's self and world understanding have been violated, the person may call their own identity into question.[5] Often despite their best efforts, traumatized parents may have difficulty assisting their child with emotion regulation, attribution of meaning, and containment of post-traumatic fear in the wake of the child's traumatization, leading to adverse consequences for the child.[8][9] In such instances, it is in the interest of the parent(s) and child for the parent(s) to seek consultation as well as to have their child receive appropriate mental health services.
Self-medication is the use of drugs, alcohol, or other self-soothing forms of behavior to treat mental distress, stress, anxiety,[10] mental illnesses and/or other effects of psychological trauma.[11][12]
Trauma can be caused by man-made and natural disasters, including war, abuse, violence, earthquakes, mechanized accidents (car, train, or plane crashes, etc.) or medical emergencies.
Responses to psychological trauma: There are several behavioral responses common towards stressors including the proactive, reactive, and passive responses. Proactive responses include attempts to address and correct a stressor before it has a noticeable effect on lifestyle. Reactive responses occur after the stress and possible trauma has occurred, and are aimed more at correcting or minimizing the damage of a stressful event. A passive response is often characterized by an emotional numbness or ignorance of a stressor.
Those who are able to be proactive can often overcome stressors and are more likely to be able to cope well with unexpected situations. On the other hand, those who are more reactive will often experience more noticeable effects from an unexpected stressor. In the case of those who are passive, victims of a stressful event are more likely to suffer from long term traumatic effects and often enact no intentional coping actions. These observations may suggest that the level of trauma associated with a victim is related to such independent coping abilities.
There is also a distinction between trauma induced by recent situations and long-term trauma which may have been buried in the unconscious from past situations such as childhood abuse. Trauma is often overcome through healing; in some cases this can be achieved by recreating or revisiting the origin of the trauma under more psychologically safe circumstances, such as with a therapist.
The experience and outcomes of psychological trauma can be assessed in a number of ways. Within the context of a clinical interview, the risk for imminent danger to the self or others is the initial focus of assessment. That is, it is necessary to assess the physical safety of both the individual and others by considering the individual’s physical and mental functioning as well as immediate environment. In many cases, ensuring the individual’s safety may involve contacting emergency services (e.g., medical, psychiatric, law enforcement) as well as members of the individual’s social support network.
Before assessing an individual’s psychological symptoms, it is necessary to determine whether the individual has returned to a state of psychological stability. If an individual remains in a state of crisis (i.e., overwhelmed with emotion, experiencing cognitive disorganization), it may not be appropriate or possible to conduct a psychological assessment until intervention has been provided. If deemed appropriate, the assessing clinician may proceed by inquiring about both the traumatic event and the outcomes experienced (e.g., posttraumatic symptoms, dissociation, substance abuse, somatic symptoms, psychotic reactions). Such inquiry occurs within the context of established rapport and is completed in an empathic, sensitive, and supportive manner. The clinician may also inquire about possible relational disturbance, such as alertness to interpersonal danger, abandonment issues, and the need for self-protection via interpersonal control. Through discussion of interpersonal relationships, the clinician is better able to assess the individual’s ability to enter and sustain a clinical relationship.
During assessment, individuals may exhibit activation responses in which reminders of the traumatic event trigger sudden feelings (e.g., distress, anxiety, anger), memories, or thoughts relating to the event. Because individuals may not yet be capable of managing this distress, it is necessary to determine how the event can be discussed in such a way that will not “retraumatize” the individual. It is also important to take note of such responses, as these responses may aid the clinician in determining the intensity and severity of possible posttraumatic stress as well as the ease with which responses are triggered. Further, it is important to note the presence of possible avoidance responses. Avoidance responses may involve the absence of expected activation or emotional reactivity as well as the use of avoidance mechanisms (e.g., substance use, effortful avoidance of cues associated with the event, dissociation).
In addition to monitoring activation and avoidance responses, clinicians carefully observe the individual’s strengths or difficulties with affect regulation (i.e., affect tolerance and affect modulation). Such difficulties may be evidenced by mood swings, brief yet intense depressive episodes, or self-mutilation. The information gathered through observation of affect regulation will guide the clinician’s decisions regarding the individual’s readiness to partake in various therapeutic activities.
Though assessment of psychological trauma may be conducted in an unstructured manner, assessment may also involve the use of a structured interview. Such interviews might include the Clinician-Administered PTSD Scale (CAPS; Blake et al., 1995), Acute Stress Disorder Interview (ASDI; Bryant, Harvey, Dang, & Sackville, 1998), Structured Interview for Disorders of Extreme Stress (SIDES; Pelcovitz et al., 1997), Structured Clinical Interview for DSM-IV Dissociative Disorders- Revised (SCID-D; Steinberg, 1994), and Brief Interview for Posttraumatic Disorders (BIPD; Briere, 1998).
Lastly, assessment of psychological trauma might include the use of self-administered psychological tests. Individuals’ scores on such tests are compared to normative data in order to determine how the individual’s level of functioning compares to others in a sample representative of the general population. Psychological testing might include the use of generic tests (e.g., MMPI-2, MCMI-III, SCL-90-R) to assess non-trauma-specific symptoms as well as difficulties related to personality. In addition, psychological testing might include the use of trauma-specific tests to assess posttraumatic outcomes. Such tests might include the Posttraumatic Stress Diagnostic Scale (PDS; Foa, 1995), Davidson Trauma Scale (DTS: Davidson et al., 1997), Detailed Assessment of Posttraumatic Stress (DAPS; Briere, 2001), Trauma Symptom Inventory (TSI: Briere, 1995), and Trauma Symptom Checklist for Children (TSCC; Briere, 1996).
A number of psychotherapy approaches have been designed with the treatment of trauma in mind—EMDR, Somatic Experiencing, Biofeedback, Internal Family Systems Therapy, and Sensorimotor psychotherapy.
French neurologist Jean-Martin Charcot argued[when?] that psychological trauma was the origin of all instances of the mental illness known as hysteria. Charcot's "traumatic hysteria" often manifested as a paralysis that followed a physical trauma, typically years later after what Charcot described as a period of "incubation". Sigmund Freud, Charcot's student and the father of psychoanalysis, examined the concept of psychological trauma throughout his career. Jean Laplanche has given a general description of Freud's understanding of trauma, which varied significantly over the course of Freud's career: "An event in the subject's life, defined by its intensity, by the subject's incapacity to respond adequately to it and by the upheaval and long-lasting effects that it brings about in the psychical organization".[14]
The French psychoanalyst Jacques Lacan claimed that what he called "The Real" had a traumatic quality external to symbolization. As an object of anxiety, Lacan maintained that The Real is "the essential object which isn't an object any longer, but this something faced with which all words cease and all categories fail, the object of anxiety par excellence".[15]
In times of war, psychological trauma has been known as shell shock or combat stress reaction. Psychological trauma may cause an acute stress reaction which may lead on to posttraumatic stress disorder (PTSD). PTSD emerged as the label for this condition after the Vietnam War in which many veterans returned to their respective countries demoralized, and sometimes, addicted to psychoactive substances. Psychological trauma is treated with therapy and, if indicated, psychotropic medications.
The term Continuous Post Traumatic Stress Disorder (CTSD) was introduced into the trauma literature by Gill Straker (1987).[16] It was originally used by South African clinicians to describe the effects of exposure to frequent, high levels of violence usually associated with civil conflict and political repression. The term is also applicable to the effects of exposure to contexts in which gang violence and crime are endemic as well as to the effects of ongoing exposure to life threats in high-risk occupations such as police, fire and emergency services.
Following traumatic events, persons involved are often asked to talk about the events soon after, sometimes even immediately after the event occurred in order to start a healing process. This practice may not garner the positive results needed to recover psychologically from a traumatic event.
Victims of traumatic occurrences who were debriefed immediately after the event in general do far better than others who received therapy at a later time, though there is also evidence to suggest forcing immediate debriefing may distort the natural psychological healing process.[17]
Specific:
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Physical:
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Translations:
Trauma |
Dansk (Danish)
n. - traume, læsion
Nederlands (Dutch)
trauma (psychologisch/ fysiek)
Français (French)
n. - (Méd, Psych) traumatisme, (fig) horreur
Deutsch (German)
n. - Trauma, Verletzung, Schock
Ελληνική (Greek)
n. - (ψυχολ., μτφ.) (ψυχικό) τραύμα
Português (Portuguese)
n. - trauma (m), traumatismo (m)
Svenska (Swedish)
n. - trauma, skada, sår, chock
中文（简体）(Chinese (Simplified))
外伤, 伤口, 创伤
中文（繁體）(Chinese (Traditional))
n. - 外傷, 傷口, 創傷
한국어 (Korean)
n. - 외상, (영구장애를 남기는) 충격
日本語 (Japanese)
n. - 外傷, 外傷性障害, 精神的外傷, ショック
العربيه (Arabic)
(الاسم) صدمه, أذى, جرح, رض
עברית (Hebrew)
n. - זעזוע נפשי, פגיעה או חבלה נפשית, חוויה לא-נעימה, פצע, חבלה, טראומה
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 | American Heritage Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved. Read more |
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Fowler's Modern English Usage. Oxford University Press. © 1999, 2004 All rights reserved. Read more | |
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| Oxford Dictionary of Sports Science & Medicine. The Oxford Dictionary of Sports Science & Medicine. Copyright © Michael Kent 1998, 2006, 2007. All rights reserved. Read more |
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| Gale Dictionary of Psychoanalysis. International Dictionary of Psychoanalysis. Copyright © 2005 by The Gale Group, Inc. All rights reserved. Read more |
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| Dictionary of Cultural Literacy: Health. The New Dictionary of Cultural Literacy, Third Edition Edited by E.D. Hirsch, Jr., Joseph F. Kett, and James Trefil. Copyright © 2002 by Houghton Mifflin Company. Published by Houghton Mifflin. All rights reserved. Read more |
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