What do therapists mean when they talk about big ‘’T’’ trauma?

What do therapists mean when they talk about big T trauma

Trauma often gets associated with harrowing events like natural disasters, serious crimes, and even war. 

However, there are plenty of other life events that can induce trauma.

Trauma is, by definition – any traumatic event that falls beyond the normal realms of human experience – this means that distressing events that get deemed as deeply disturbing by an individual fit under the category of trauma.

Trauma and addiction

Unfortunately, people exposed to trauma are at significant risk of developing drug addictions and substance use disorders compared to those who haven’t.

Therefore, people must understand the different types of trauma and the general health implications that traumas can cause.

What causes trauma?

Emotional trauma occurs for many different reasons, and the impact that trauma has on an individual depends on several critical variables, such as:

  • The person’s ability to cope
  • Emotional functioning
  • What type of traumatic experiences a person has got exposed to
  • The co-occurrence of other mental health conditions such as depression, anxiety, and post-traumatic stress disorder

Risk Group

Trauma, big or small, can be detrimental to one’s health, and it would be unfair for anyone to dismiss the impact that any single event has had on a person.

Every one of us possesses a unique way of coping with events that cause distress; some people may take up avoidance behaviours such as drugs and alcohol, while others appear to be more in control of their feelings and emotions.

Trauma triggers

As unique as we are as individuals, the same rule applies when it comes to the type of events that trigger trauma – these events include:

  • Natural disasters
  • War
  • Serious illness
  • Domestic abuse
  • Witnessing a death
  • Physical pain, injury and sexual abuse
What does big T and little t trauma mean

What do Big “T” and little “t” trauma mean?

Therapists describe two main types of trauma: big ”T” and little ”t” trauma.

Large “t” trauma

Big ”T” traumas signify events that are most commonly linked to post-traumatic stress disorder and get triggered by the following situations:

  • Physical injury
  • Death
  • Sexual violence

Research shows that threats of serious injury, sexual violence, and death can also cause trauma even if the person hasn’t gotten physically harmed.

Witnessing events

Those who have witnessed big ”T” events are also at risk of developing post-traumatic stress disorder symptoms.

The same goes for people working and living with big ”T” trauma survivors, particularly people who encounter daily shocks, such as therapists, police officers, doctors, and paramedics.

Small ‘’t’’ trauma

Little ”t” traumas are highly distressing events that impact a person’s emotional well-being but, equally, are not regarded as big ”T” traumas.

Events that fall into the category of little ”t” trauma get deemed as non-life-threatening experiences such as:

  • Being bullied
  • Loss of a pet
  • Emotional abuse
  • Loss of significant relationship
  • Non-life-threatening injuries


People who handle adverse life experiences such as big ”T” and small ”’t ” traumas often go on to build resilience. Since we all have our unique capacities for managing stress, people’s coping mechanisms will ultimately be different.

What may get deemed as highly upsetting or distressing to one person may not cause the same response in another. Therefore, the key to understanding little ”t” trauma is to examine the impact it has on the individual rather than concentrating on the event.

The impact of little ”t” traumas

Although little ”t” traumas do not meet the criteria for a post-traumatic stress disorder diagnosis, the trauma associated with small ”t” traumas are by no means trivial.

Small ”t” traumas can cause significant emotional damage, especially when an individual gets exposed to multiple small ”t ” traumas or when the traumatic experience occurs during a critical developmental phase, like early childhood and adolescence.

The impact on those who experience trauma

Studies show that people who experience ongoing small ”t” traumas are at significant risk of developing mental health complications since the emotional repercussions of repeated trauma exposure do more harm than one big ”T” trauma event.

It is not about small ‘’t’’ versus large ”T.”

People who experience little ”t” trauma are more likely to get their feelings and emotions dismissed since empathy and compassion surrounding smaller life events tend to get overlooked within society.

Unfortunately, the common misconception is that smaller traumatic events are less upsetting than life-threatening emergencies. 

However, comparisons between small ”t” trauma and extensive ”t” trauma only add to the suffering already experienced by trauma survivor groups.

The process of avoidance

Platitudes like those experienced in little ”t” trauma often lead to adverse coping behaviours like repressing emotions or managing unpleasant symptoms without the relevant support and guidance.

Refusal to address emotional suffering may result in complications and severely impact a person’s mental and physical health.

Therefore, compassion and empathy are crucial when it comes to both little ”t” trauma and big ”T” trauma.

The link between substance abuse and trauma

There is plenty of research that illustrates the vital link between substance abuse and all types of trauma.

Impact on mental health

Data taken from studies of teenagers treated for addiction illustrated that over 70% of teens reported trauma histories. For instance, adolescents who have been assaulted or sexually abused are three times more likely to abuse substances than those without trauma histories.

All this is a clear indicator that traumatic experiences, especially those that occur earlier on in life, are a prevalent risk factor for developing substance use disorders.

Untreated trauma

When trauma remains untreated, it can profoundly impact the individuals’ emotional well-being, often without them even being aware.

There are plenty of psychology articles that describe how untreated trauma impacts people. Trauma impairs our sense of self and how we view the world, and it can even heighten our reaction to events that are not deemed life-threatening.

Fight or flight mode

Untreated trauma frequently results in a person’s ”fight or flight” responses to remain off-kilter since the danger button that gets switched on during times of extraordinary threat hasn’t quite turned off for trauma sufferers.

The button remains on even when there is no evidence of imminent threat or danger, which is why a person with repressed trauma may exhibit disproportionate reactions to any given event, such as intense anger, anxiety, and helplessness.

Trauma symptoms

Symptoms of trauma get categorized as being ”emotional” and ”physical”.


Emotional symptoms of trauma include (but are not limited to):

  • Denial
  • Anger
  • Sadness
  • Emotional outbursts
  • Numbness and dissociation
  • Flashbacks, intrusive thoughts, and reliving unpleasant memories (also associated with symptoms of PTSD)


The physical symptoms associated with trauma include (but are not limited to):

  • Lethargy
  • Fatigue
  • Poor concentration
  • Paleness
  • Rapid heartbeat

Short and long-term effects

Many victims of trauma experience the emotional and physical effects of trauma straight away – while others develop trauma symptoms much later on, often days, weeks, or even months after the subsidence of events.

People must seek trauma treatment early since it prevents the permanence of symptoms and their severity.

Trauma treatment

Trauma treatment

Research shows that undetected trauma can become trapped within the body, such as the brain and the central nervous system, resulting in many unpleasant symptoms that frequently cause distress.

Trauma-based therapy such as EMDR (eye movement desensitization reprocessing) is a highly effective trauma treatment. 

EMDR helps an individual reprocess any traumatic experiences by focusing on any single event, while at the same time, a therapist gently guides patients through the process of bilateral eye movements.

The EMDR approach is a widely recognized trauma treatment across all disciplines. 

It is an invaluable therapy for trauma sufferers since it helps to reprocess any distressing memories where people no longer view their experiences in a negative light.

An individual will never forget what happened to them, but the distressing symptoms no longer have a tight grip over their lives. 

As a result, people ultimately begin viewing their experiences through the lens of empowerment, rather than something that causes them shame and disgust.

Other treatments such as talk therapy and cognitive behavioural therapy are also incredibly effective when treating trauma.

Get in touch

If you feel that you or a loved one may be experiencing trauma symptoms, perhaps it’s time to get in touch with a trained specialist who can help.

No matter what form it gets expressed, trauma doesn’t have to be a way of life. No matter what your experiences are, support and recovery is available to all.

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