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What It's Like to Have Lived Through Trauma but Not Have PTSD

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This may sound strange at first, but I believe I’ve experienced trauma, but yet I don’t have PTSD. Does that even make any sense? Is there a firm dividing line between the two, or is it more of a continuum?

• What is PTSD?

According to the Sidran Institute, psychological trauma occurs when an individual is faced with a highly distressing event or events that overwhelm their ability to integrate their emotional experience, or threatens life, limb or sanity. The traumatic event often involves “abuse of power, betrayal of trust, entrapment, helplessness, pain, confusion and/or loss.” The traumatized individual is left feeling helpless in a dangerous world.

It is not the event itself that determines trauma but rather the individual’s subjective response to it — so not everyone who experiences the same potentially traumatizing event will have the same response. Responses to stressors may be proactive, reactive or passive. Proactive responses are taken before the stressor can have a large impact, reactive responses occur after the stressor, and passive responses include emotional numbness or avoidance. An individual’s response can vary depending on the nature of the event, the person’s background (including childhood trauma), personality, coping resources and level available support.  

The Sidran Institute states that severe psychological trauma is most likely to occur with human-caused stressors that are repeated, unpredictable, sadistic, occurring in childhood and carried out by a caregiver. Protective temperamental and environmental factors can improve coping in response to stressors. Such factors included limited early life stress, resiliency and active help-seeking behavior.

Having some trauma-related symptoms is a normal reaction to major stressors, and represents part of the process of making sense of what happened and gaining perspective. These responses may last anywhere from a few days to a few weeks or even months, although there may be recurring responses to triggers. PTSD develops when the mind is left in a state of psychological shock and unable to process the trauma, and the person’s overall functioning is impacted.  Trauma symptoms may be forms of adaptation that were helpful while the trauma was occurring (such as dissociation) that become problematic when they instinctively continue after the stressor is removed.

So what does this all mean? If there are a group of people who are subjected to a particular stressor, a certain subset of those exposed will have a trauma reaction. Among that group, some will be able to process the trauma and move forward, while others will remain stuck and develop PTSD. Those who access therapy for PTSD will work on finally processing and integrating the trauma memories.  These diverse responses happen because trauma is more about what happens inside than what happens outside.

The trauma that I experienced was related to workplace bullying. I have major depressive disorder, and that likely made me more susceptible to being traumatized by the events that occurred. I had a range of trauma effects, particularly around avoidance. Yet I was never diagnosed with PTSD, and I don’t believe that I meet the diagnostic criteria. The way I conceptualize it is that I experienced trauma, but my mind’s processing of the trauma-related events was slowed down rather than stuck, and as a result it didn’t progress to PTSD.

Do you think there’s a difference between trauma and PTSD? How do we separate the two?

Getty Images photo via ANNA ISMAGILOVA

Originally published: July 6, 2019
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