I’m about to share what took me years of going to different doctors and therapists as well as starting a Masters in Psychology to figure out: it turns out that not all trauma is created equal. In fact, two people who present the same exact set of trauma symptoms (re-experiencing, avoiding, and scanning) can have wildly different root causes and, therefore, require significantly different treatments to get better.

The United Nations Beats The United States

Weirdly, the 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) only acknowledges one type of post-traumatic stress disorder (PTSD). I’m contrast, the 2018 International Classification of Diseases Manual recognizes two types (acute and complex). Several more types that have been observed by clinicians and regular people alike are described in this article https://traumapractice.co.uk/types-of-trauma. (Bravo to those authors!)

I’ll very briefly summarize the types I know about here but check out the link above for more details and examples:

• Little-t trauma is caused by a major life-altering event like entering into an arranged marriage, losing a job, or losing a beloved human or animal to divorce, custody, or death (including miscarriage, abortion, stillbirth, and death-after-birth). Most people have several little-t traumas in their lives.
• Acute PTSD is caused by a singular, significantly life-threatening event. Examples can include a violent car crash or an incidence of rape. People can have several acutely traumatic experiences.
• Secondary trauma is caused by watching or hearing about other people’s traumatic events. Examples include being a rape victim’s advocate or being in a military unit in America that conducts aerial reconnaissance in war.
• Complex PTSD is caused by a long period of life-threatening experiences. Examples include being a child of an addict or a child molester. Usually, people who have CPTSD also have other types of PTSD.
• Familial or ancestral trauma is inherited from one’s family members through epigenetics and affects how your DNA works, which affects how your brain and body is built. Examples include being a grandchild of slaves or of prisoners. Usually, people who have familial/ancestral trauma also have other types of PTSD.
• Historical, territorial, or generational trauma is inherited from one’s culture . Examples include being a grandchild of a generation that lost a war, or being a grandchild of a generation that committed mass-atrocities like slavery, genocide, or abortion.

Where it gets really complicated is when someone who is born with ancestral trauma grows up in a dysfunctional family and lives in a country with historical trauma, then joins a profession where she debriefs traumatized people, and then experiences several acute and little-t traumas in her own life. Oh—that’s me, by the way. It turns out I had every type of trauma known to man thus far. But I am healing, and you can, too!

When Pace-makers Can Kill

Although all types of trauma cause significant distress, it is conceptually (and scientifically) easier to treat the acute, little-t, and secondary kinds because the memories of the threatening experiences are isolated and the person has other healthy tools in their spiritual/mental/emotional/physical toolkit to heal themselves. In contrast, it is much more difficult to treat the complex, historical, and ancestral types because these affect the underlying mechanisms by which our brains and bodies operate. People with these types of trauma first need to build a set of resources that enable healing before they can address the trauma itself.

Unfortunately, this awareness is not very prevalent in America, since our DSM-5–the official standard for psychologic and psychiatric diagnosis—does not mention any of this. As a result, many of our mental health professionals offer the same set of trauma treatments (most designed only for acute PTSD) to everyone.

It’s like three people going to the doctor for heart problems (one from panic attacks, one from a congenital valve deformity, and one from hardened arteries). Yet, doctor only looks at the outward symptoms and gives everyone a pace maker. Two out of three people will still die early because that pace maker targeted the wrong root cause. Similarly, if you’ve been trying to get PTSD healing but nothing’s working, you are probably getting the wrong kind of treatment because you have a non-acute type of PTSD.

Stay tuned for my posts about the 20 or so different therapies I’ve undergone in the Health Resources category.