What Is Trauma?

This statement may sound surprising, but anyone who has experienced trauma understands its truth. Sometimes trauma is obvious and easy to recognize. Other times, its effects remain hidden in the unconscious, quietly shaping our relationships, sense of self, and daily interactions. It can appear in intimate partnerships, friendships, family dynamics, and even in the workplace. Trauma has a way of making us question our worth, our safety, and our place in the world.

The effects of trauma often persist long after the original event has passed—weeks, months, years, and sometimes even decades later. As trauma expert Dr. Janina Fisher notes, trauma becomes a “living legacy,” influencing how we think, feel, respond, and connect with others. Its legacy can emerge through intense physical, emotional, and psychological reactions to everyday experiences.

Trauma is defined as the result of an event, series of events, or set of circumstances that an individual experiences as physically or emotionally harmful or threatening. These experiences can have lasting effects on a person’s mental, emotional, physical, social, and spiritual well-being.

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes trauma through three dimensions, sometimes called the “three E’s”:

Event(s): Trauma may result from a single event or from repeated experiences over time. Examples include abuse, neglect, violence, loss, disasters, war, or other circumstances that overwhelm a person’s ability to cope.

Experience: Trauma is shaped not only by what happened, but by how the individual experiences and interprets the event.

Effect: Trauma can have long-term consequences, including difficulties with memory, attention, emotional regulation, relationships, and trust. It can also alter the nervous system, leading to chronic stress, hypervigilance, and heightened states of arousal.

When people hear the word trauma, they often think of major events such as war, abuse, violence, or natural disasters. These are sometimes referred to as Big “T” traumas—experiences that are dangerous, life-threatening, or overwhelming enough to exceed a person’s ability to cope.

However, trauma is not limited to catastrophic events. Psychoanalyst Ernst Kris (1956) proposed that trauma can take different forms. He described “shock trauma” as the result of a single, often sudden event in which reality forcefully intrudes into a child’s or adult’s life. He also identified what he called “strain trauma,” referring to the effects of prolonged and stressful circumstances that accumulate over time and produce traumatic effects.

Today, strain trauma is often understood as developmental trauma, cumulative trauma, complex trauma, or small “t” trauma. Unlike a single overwhelming event, these experiences involve ongoing emotional wounds.

Developmental trauma not only affects emotional well-being but can also disrupt healthy psychological and neurological development. As trauma researchers have noted, it can impair the brain’s ability to integrate sensory, emotional, and cognitive experiences into a cohesive sense of self. Over time, these disruptions can influence how individuals regulate emotions, form relationships, and navigate the world around them.

While small “t” traumas are often less visible than Big “T” traumas, their impact can be equally profound—particularly when they occur repeatedly, leaving lasting imprints that continue to influence a person’s life.

One of the most important things to understand is that trauma is not defined by the event itself, but by its impact on the individual experiencing it. An event that one person navigates without lasting effects may be deeply traumatic for another. Culture, personality, developmental stage, support systems, and previous life experiences all influence how an event is experienced.

Equally important is what happens after the event. How others respond to a person’s suffering can significantly shape the trauma’s impact. Was someone available to help? Was the experience taken seriously? Did the person feel believed, protected, or supported? For many individuals, the response—or lack of response—from others becomes a trauma in itself. Trauma, therefore, is not only about what happened. It is also about how the experience was understood, supported, and carried forward in the person’s life.

Often, people do not believe they have experienced trauma because nothing on the “Big T” list happened to them. Yet they may have grown up with an emotionally unavailable parent, experienced attachment disruptions, endured chronic criticism, or lived in an environment where they never felt safe, seen, or valued. These experiences can leave lasting wounds that later emerge as anxiety, perfectionism, low self-esteem, difficulty trusting others, or relationship challenges.

Whether the trauma is “Big T” or “small t,” the nervous system responds to perceived threat. Over time, trauma can leave a person stuck in survival patterns such as fight, flight, freeze, or fawn, making it difficult to feel safe, connected, and fully present in everyday life. Trauma is not necessarily what happened to us—it is what remains inside us, often unconsciously.

Healing from trauma is not about erasing the past. Rather, it is about helping the mind and body—including the conscious and unconscious memories that continue to linger—recognize that the danger has passed. Healing creates new pathways for safety, connection, growth, and the opportunity to reclaim agency over one’s life.

Therapy helps people move beyond survival toward a more meaningful and fulfilling life. There are many effective approaches to trauma treatment, including trauma-informed psychotherapy, EMDR, and Cognitive Processing Therapy (CPT). My own approach is psychodynamic psychotherapy, which can be a transformative tool for those who have felt “unseen and unheard.” Psychodynamic work helps a person gain deep insight and can restore a sense of identity that may have been fragmented by early emotional neglect.

This way of understanding trauma—as something carried in the mind and body, shaped by relationships, and capable of being understood rather than merely managed—sits at the heart of how we work at the Austen Riggs Center, both in our residential program and our online IOP for emerging adults in MA and VT. Rather than treating symptoms in isolation, we focus on understanding the whole person: the meaning of their experiences, the patterns that trauma has left behind, and the relationships through which healing becomes possible.

Our Online Intensive Outpatient Program (IOP) brings this relational, depth-oriented approach to emerging adults (18-30) who physically reside in MA or VT and who need more support than weekly therapy but want to remain connected to their own communities and daily lives.

Our online IOP features: 

Why not consider choosing a different legacy—transforming the unwelcome “gift” of trauma into the genuine gift of self-understanding and lasting healing?

To learn more about the Austen Riggs Online IOP for emerging adults in MA and VT, or to speak with our team about whether it might be right for you or someone you care about, contact us via phone, fax, or email.

Trauma is the result of an event, series of events, or set of circumstances that a person experiences as physically or emotionally harmful or threatening, and that can have lasting effects on their mental, emotional, physical, social, and spiritual well-being. Importantly, trauma is defined less by the event itself than by its lasting impact on the individual.

“Big T” trauma refers to major, often life-threatening events such as war, abuse, violence, or disasters. “Small t” trauma refers to ongoing or accumulating emotional wounds—such as growing up with an emotionally unavailable parent or enduring chronic criticism. Though less visible, repeated “small t” experiences can have an impact that is just as profound.

Yes. The same event can be deeply traumatic for one person and not for another, depending on culture, personality, developmental stage, support systems, and previous experiences. How others respond afterward—whether the person felt believed, protected, and supported—also shapes the lasting impact.

Healing is not about erasing the past. Therapy helps the mind and body recognize that the danger has passed and creates new pathways for safety, connection, growth, and a renewed sense of agency. Effective approaches include trauma-informed psychotherapy, EMDR, Cognitive Processing Therapy (CPT), and psychodynamic psychotherapy, which works to restore a sense of identity and meaning.

Fisher, J. (2021). Transforming the living legacy of trauma: A workbook for survivors and therapists. PESI.

Knight, R., & Miller, J. M. (2024). Developmental trauma: An introduction to the section. The Psychoanalytic Study of the Child, 77(1), 18–25. doi.org/10.1080/00797308.2024.2305592.

Kris, E. 1956. The recovery of childhood memories in psychoanalysis. The Psychoanalytic Study of the Child 11 (1):54–88. doi:10.1080/00797308.1956.11822782.

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). U.S. Department of Health and Human Services. https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884

Miriam Desgazon, MSW, LICSW, is a social worker in the Online Intensive Outpatient Program for College Students and Emerging Adults in Massachusetts at the Austen Riggs Center.

In addition, she is a dedicated clinical supervisor and family clinician at the Institute for Health and Recovery (IHR) where she passionately serves families grappling with dual diagnoses and Department of Children and Families (DCF) involvement. In addition to her impactful work with IHR, Miriam also runs a thriving small private practice based in Northampton, MA.