What are the Four Types of Trauma?

Mental health, problem and woman in studio psychology, trauma and schizophrenia on black background

The term trauma is bandied about quite often nowadays, whether on or offline and in various communities and settings.

All this is great since awareness of the detrimental effects of trauma and its lasting impact on survivors can only be a good thing. Unless the information you stumble upon is inaccurate, not very helpful, or, worst-case scenario, it leads to re-traumatisation.

Re-traumatisation is a keyword within the trauma community – mainly because survivors are at significant risk of becoming re-activated or re-traumatised, particularly when those around them are unaware or insensitive to their triggers or when treatment providers such as mental health professionals or those working in healthcare are not trauma-informed.

That said, it’s vital for everyone to be trauma aware and to live in a world where we view ourselves and those around us through a more trauma-informed lens.

To achieve this, we must first understand the different types of trauma, their impact, and the various treatments available in today’s climate.

Let’s start by exploring the theory of trauma, and remember, if you think you or a loved one might be suffering from the effects of trauma, you must consult a mental health professional or trauma specialist who can help.

Early treatment can help you avoid some of the long-term effects of trauma and will improve treatment outcomes for many.

The theory of trauma

For those hoping to understand more about trauma, you may have come across various definitions and explanations in your quest for information! 

Suppose you were to google ‘the theory of trauma’. 

In that case, you’ll likely come across the likes of Sigmund Freud, theories on the significance of trauma and the human brain, and literature on physical trauma resulting from brain injuries or car accidents (which isn’t the same as emotional trauma, although it’s worth noting that severe accidents and other forms of medical exposure can lead to psychological trauma).

Those wanting to become more trauma-savvy may find that the information they come across in articles, books, abstracts, and so on, is often perplexing or contradictory. In our experience, building knowledge on trauma usually requires much more than a quick Google search.

“Trauma theory” explores how trauma is manifested, processed, suppressed and expressed in various texts and contexts. (Trauma Theory, The Saylor Foundation.)

Trauma refers to the sudden intrusion of new and unexpected knowledge into someone’s psyche, usually due to a sudden confrontation with violence or death. 

This traumatic event leaves the survivor emotionally and intellectually divided between what they felt or believed in before the event and what they now know or believe in post-event, causing a psychic separation in identity and consciousness, often leaving the survivor confused, frightened, and disturbed. (Trauma Theory, The Saylor Foundation.)

According to Dr Jackie Parke, another way of explaining trauma is that it’s “too much, too soon, too fast”, in a way that our body, mind and soul cannot integrate. (Therapy for Trauma, Dr Jackie Parke.)

Traumatic events can involve extreme stress or shock that occurs once (acute) or is ongoing (chronic), interfering with an individual’s ability to experience safety, trust, and emotional stability. (Therapy for Trauma, Dr Jackie Parke.)

Trauma can deeply wound us, leaving us shattered, broken and in despair. Still, Parke explains this is also where the light gets in, suggesting that although often challenging, recovery from trauma is possible.

What are the four types of trauma?

It might be worth repeating that information and insight into the different types of trauma can be just as confusing and bewildering as the many definitions of trauma can be!

As mentioned above, a traumatic experience can be viewed as a single event, such as a car accident, mugging or physical assault (called acute trauma), or ongoing, such as long-term exposure to domestic violence or bullying (chronic trauma).

But whether acute or chronic, the effects of trauma can cause severe disruption and devastation to the individual, and according to Dr Jackie Parke, different people can respond differently to the same potentially traumatic event. 

Some people will not develop long-term difficulties due to a potentially traumatic event, whereas others will experience traumatisation. (Trauma Theory, The Saylor Foundation.)

For example, some trauma survivors will meet the full criteria for post-traumatic stress disorder (PTSD). Whereas other people will have various aspects of post-traumatic stress, other mental health diagnoses, such as panic disorder, social anxiety disorder, and major depression, more accurately capture their experience.

The four types of trauma

According to trauma specialists, there are four primary types of trauma:

  • Direct trauma
  • Vicarious trauma
  • Developmental trauma
  • Complex trauma

Let’s explore each of the trauma types in more detail.

1. Direct trauma

Trauma treatment at CFHH

Direct trauma is when an individual experiences a traumatic event first-hand or is physically present to witness it. 

These events may include all forms of abuse, accidents, neglect, war, natural disasters, and so on. (What Kind of Trauma Do I Have? Counselling Connections.) 

This type of trauma may be induced when a person experiences a threat to life or their bodily or psychic coherence, resulting in helplessness, intense fear, or horror.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) determines direct traumas as:

  • Threatened death
  • Actual or threatened serious injury
  • Actual or threatened sexual violence

Studies show that exposure to at least one traumatic event is required for a diagnosis of PTSD to be made.

2. Vicarious trauma

Vicarious trauma is when you are exposed to the traumatic stories or experiences of another person. 

For example, if you hear about a tragic story or event that happened to a friend, colleague or loved one, these events can become ingrained in your memory as if you experienced them first-hand.

Vicarious trauma is the accruing effect of being exposed to another person’s trauma. You may not have encountered this trauma yourself, but you’ve heard or learned about it from others. (What Is Vicarious Trauma? PsychCentral, Sonia Matejko, March 10, 2022.) 

Those who work in the helping professions, such as nurses, doctors and therapists, are at significant risk of vicarious trauma, as they often take on the stresses and experiences of the people they are looking after.

Research indicates that vicarious trauma is not well known. And despite available treatment options, many people do not seek treatment due to a lack of awareness or knowledge about the condition.

Although those in the mental health and medical professions are at increased risk of vicarious trauma, any one of us can be affected.

Learning about a loved one’s trauma can be extremely painful and upsetting, and our responses, whatever they may be, are natural and valid. However, despite similarities in symptoms, vicarious trauma and PTSD are not the same. 

For example, although vicarious trauma can lead to post-traumatic stress disorder and other mental health challenges such as depression and anxiety, PTSD typically affects those who have experienced or witnessed trauma directly. (What Is Vicarious Trauma? PsychCentral, Sonia Matejko, March 10, 2022.) 

Additional terms for vicarious trauma

You may come across other terms for vicarious trauma, including:

  • Secondary trauma
  • Secondary traumatisation
  • Secondary traumatic stress
  • Second-hand trauma

3. Developmental trauma

Sad little girl with a teddy bear

Developmental trauma is a term used to describe the impact of early, repeated trauma (and loss) that occurs within a child’s vital relationships, usually in early life. (Developmental Trauma Close Up, Beacon House.)

Within the first few years of life, infants and babies require safe, predictable, nurturing and accessible caregivers.

In this ideal environment, a child’s brain can develop healthily and in a normal sequence of growth.

This is where things can get quite scientific since developmental trauma often takes a profoundly scientific approach, particularly when understanding brain development and what can happen when normal healthy growth is disrupted or impaired by early trauma or parental detachment.

Research shows that the human brain develops from the bottom up. The lower parts of our brain, sometimes called the emotional brain, are responsible for ensuring survival and how we respond to stress. 

On the other hand, the upper brain, sometimes called the rational brain, is responsible for executive functioning, including linguistics, language and making sense of our experiences and moral compass.

According to researchers, how the upper brain develops depends upon the prior development of the lower parts. (What Is Developmental Trauma? Psychology Today, Odelya Gertel Kraybill PhD, August 15, 2018.)  

Sequential brain development is disrupted when a child’s stress responses are consistently activated (which often happens in cases of chronic abuse or neglect). 

Trauma specialist and psychotherapist Odelya Gertel Kraybill uses the ladder analogy when discussing early trauma and its significance in brain development.

Kraybill explains that the brain is meant to develop like a ladder (from the bottom up). 

However, in cases of chronic child abuse or neglect, the ladder develops, but foundational steps are missing, and many things that follow afterwards are out of kilter. (What Is Developmental Trauma? Psychology Today, Odelya Gertel Kraybill PhD, August 15, 2018.) 

Moreover, Kraybill reports that developmental trauma can present in various ways and pathologies, including bipolar disorder, borderline personality disorder, PTSD, cognitive impairment, speech delay, and learning difficulties, to name just a few. 

Successful treatment for developmental trauma often involves addressing the emotional brain, which includes exploring traumatic memories and experiences that a person may have forgotten or repressed, under the guidance and supervision of an experienced trauma clinician.

4. Complex trauma

Complex trauma involves exposure to multiple, often interrelated forms of traumatic experiences and the challenges of adapting to or surviving these experiences. (Complex Trauma: What is it and how does it affect people? Complex Trauma Resources.) 

This type of trauma is literal in that it is profoundly complex and varies from other trauma types.

Although the adverse experiences endured by trauma survivors often begin in early childhood and are usually perpetuated by an individual’s early attachments, there are variations to how and why complex trauma may develop.

For example, complex trauma often involves patterns of risk and dysfunction affecting generations of families. In addition, complex trauma intersects with structural and institutional forms of violence and oppression that impact specific people and communities, particularly those holding minority status within society. (Complex Trauma: What is it and how does it affect people? Complex Trauma Resources.) 

Complex trauma often results from exposure to varied, multiple traumatic events or experiences, often of an interpersonal or invasive nature. Such experiences can have persistent, severe and cumulative impacts on survivors, affecting their relationships and daily functioning. 

Depending on the nature and severity of complex trauma, individuals may experience a range of physical and mental health outcomes, including:

The complex trauma framework recovery model operates from a strength-based survival-driven lens, shifting the focus from “What’s wrong with you?” to “What happened to you?”.

This dialectical shift in thinking is central to how survivors perceive and manage their traumatic experiences, putting them back into the driving seat of their lives and eventually allowing them to become empowered and in control.

Trauma symptoms

Shot of a young man sitting in the corner of a dark room with a scary figure on the wall

Although each trauma type may involve different symptoms and presentations, PTSD symptoms are generally grouped into four types:

  • Intrusive memories
  • Avoidance
  • Negative changes in mood or thinking
  • Changes in physical and emotional reactions

Individuals who have PTSD may:

  • Relive or re-experience the traumatic event as if it were happening again (flashbacks).
  • Experience disturbing or upsetting dreams or nightmares about the traumatic event.
  • Have recurrent, unwanted distressing memories related to the event.
  • Experience emotional distress or physical responses to something that reminds them of the traumatic event or experience.
  • Avoid people, places, objects or activities that remind them of the event.
  • Have trouble maintaining close relationships.
  • Feel detached or isolated from friends and family.
  • Have difficulty experiencing positive emotions.
  • Experience feelings of hopelessness about the future.
  • Have a profound sense of guilt or shame.
  • Experience negative thoughts or beliefs about themselves, others or the world.
  • Feel emotionally numb.
  • Get easily frightened or startled.
  • Engage in self-destructive behaviour, including substance abuse or reckless driving.
  • Experience severe agitation, angry outbursts or aggressive behaviour.

What are the risk factors?

Anyone exposed to trauma can develop PTSD; however, various risk factors may put you at increased risk for PTSD, including the following:

  • Genetics – A family history of PTSD can put individuals at a higher risk of developing the condition.
  • Societal or environmental influences – A lack of social support or those with limited options for a healthy support network are at higher risk for PTSD. 

    Those who experience a traumatic event require support and care from those around them. A reliable support network is vital to helping individuals recover in a healthy, secure way, allowing them to regain a sense of hope and joy through safe emotional connections; however, when a person doesn’t have a robust support network, this can hinder their recovery, putting them at higher risk for PTSD.
  • Co-occurring disorders – Individuals with existing mental health conditions (called co-occurring disorders), such as depression, anxiety or substance abuse, are at increased risk for PTSD. Studies show that existing mood disorders, conduct disorders and anxiety disorders can be influential risk factors in developing PTSD.

Trauma treatment options 

Group of smiling senior people applauding at mental health support group

Various trauma therapies can help treat trauma, allowing you to overcome trauma-related issues and manage your symptoms.

These treatments often involve an integrated approach to therapy and may include a combination of the following:

Research shows that cognitive processing therapy and prolonged exposure therapy are the recommended treatments for trauma, as research around the effectiveness of these therapies has been proven to be highly advantageous for those who have experienced trauma and the various trauma presentations and symptoms.

Trauma treatment at Centres for Health and Healing

Centres for Health and Healing provide personalised trauma treatment to clients in Ontario and surrounding regions.

Our professional, multi-disciplinary team and caring staff are here to support you in restoring balance to your mind, body and soul.

We offer a holistic treatment program for trauma disorders shaped by each person’s preferences and therapeutic needs. Throughout your treatment, we will also address and treat any co-occurring conditions you may be experiencing.

Combining psychiatric evaluation, intensive therapy, medical management, healthy eating, exercise options, and complementary therapies we help facilitate deep transformational healing and long-term recovery.

In addition, we also provide a wide range of complementary approaches designed to support the treatment of trauma, including; grief and loss group therapy, coping skills therapy, art therapy and relationship therapy.

We aim to help armour you with the necessary tools, resources and lifelong support to help you overcome your trauma and lead the empowered, joyous life you were born to live.

Trauma may wound us, but remember, the wound is where the light enters, paving the way for lasting healing and recovery. And we are here to support you every step of the way throughout your journey to lifelong wellness.

Contact our friendly team at our Ontario recovery centre to learn more about our trauma-informed treatment program. 

We are here and ready to help!

Additional resources

  1. Complex Trauma: What is it and how does it affect people? Complex Trauma Resources.
  2. What Is Developmental Trauma? Psychology Today, Odelya Gertel Kraybill PhD, August 15, 2018.
  3. What Is Vicarious Trauma? PsychCentral, Sonia Matejko, March 10, 2022.
  4. What Kind of Trauma Do I Have? Counselling Connections.
  5. Developmental Trauma Close Up Beacon House.
  6. Trauma Theory The Saylor Foundation.
  7. Therapy for Trauma Dr Jackie Parke.
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