When Trauma Is Ignored or Labelled

Peter Levine (clinical psychologist) states that: “Trauma is the most avoided, ignored, denied, misunderstood, and untreated cause of human suffering.” There are even theories that Sigmund Freud — the father of psychoanalysis — ignored the sexual abuse experienced by many of his patients, misinterpreting real experiences and explaining them with concepts like “hysteria,” “false memories,” and his theory of psychosexual development.

Janina Fisher, PhD (psychologist) talks about the legacy of trauma. By legacy, she means the natural responses trauma leaves survivors. It is the legacy of trauma itself that is not only ignored by society in general, but also in professional fields that should be supporting those who are traumatized. Psychiatry has a history of seeing people as just symptoms, all while not recognizing the symptomology of trauma. Therefore, they have tended to just throw labels at survivors, rather than looking at the history of a person. They have asked, “What’s wrong with you?” rather than, “What happened to you?” The approach hasn’t been one of empathy, and it hasn’t always been an accurate one either.

This approach can still be found in the field, and a lot of work needs to be done to change this. But with a slow increase in trauma awareness, new information, and more discussion, we can hope to see much-needed changes.

Trauma can cause the inability to self-sooth and self-regulate, yet some have been misdiagnosed with bipolar due to poorly regulated or dysregulated mood states, or the popular diagnoses that was thrown so easily to label survivors of abuse — BPD (borderline personality disorder). The names themselves tend to suggest a defect in a person. Trauma and emotional dysregulation are therefore easily labelled and can be easily misdiagnosed.

This is also why some of these conditions have been renamed: multiple personality disorder was renamed dissociative identity disorder because the new term accurately focuses on the fact that dissociation is what happens. Again, this dissociation is a natural survival response to extreme abuse and trauma in childhood that forms as a creative and ingenious way for the mind to protect itself and survive horrors that no human should ever have to endure, ones that would be too unbearable without this coping mechanism. It is evidence of trauma and of the adaptive brain and the ways symptoms and conditions form to protect our psyche. An extraordinary ability.

Another trauma response that gets misdiagnosed is ADHD — it is not rare for children who experience trauma earlier on in life to be diagnosed with ADHD. Again, psychological trauma is being labelled. These are traumatic reactions and not necessarily a mental illness, but because symptoms overlap this error is easily made. However, if we start asking the right questions and see people as individuals, it’s less likely we’ll make these kinds of mistakes. Seeing people as just their symptoms or ignoring the legacy of trauma is not an empathetic approach or useful at that.

Gabor Mate (physician and expert on trauma/addiction/stress/childhood development) states: “All of the diagnoses that you deal with — depression, anxiety, ADHD, bipolar illness, post-traumatic stress disorder, even psychosis, are significantly rooted in trauma. They are manifestations of trauma. Therefore, the diagnoses don’t explain anything. The problem in the medical world is that we diagnose somebody, and we think that is the explanation. He’s behaving that way because he is psychotic. She’s behaving that way because she has ADHD. Nobody has ADHD, nobody has psychosis — these are processes within the individual. It’s not a thing that you have. This is a process that expresses your life experience. It has meaning in every single case.” 

Society itself is based on a culture of toxic positivity or statements that silence, dismiss, or minimize the human sufferings of others and the human experience. No emotion is good or bad, all emotions are to be felt and heard and allowed the natural process of being released and healed, instead of the process interrupted, emotions denied, having to be repressed and remain unheard and unresolved and stuck in the process of healing. Emotions are road maps to what is hurting, to what needs to be addressed to the wounds caused to our psyche.

Symptoms manifest and are natural responses just as we would expect a bone to break, the skin to tear and bled in injury, a ligament to rupture, we wouldn’t think this is abnormal and that it says something about someone’s personality. How can we not see that mind, body, and soul are connected? That the mind and body is not separate but that what affects the mind will also affect the body? Research has shown from the Polyvagal Theory that all emotions and survival responses are experienced in our nervous system, and that when the back part of our brain is activated and in survival mode, our front part of the brain (logic/thinking) is offline. We automatically react to survive before we have time to think of our actions or thoughts because the brain part in control of logic and reasoning is offline when a threat is posed or felt. The fear response is activated to act and defend ourselves from danger (perceived or real). If we are in this hypoarousal (freeze/collapsed) state or hyperarousal (flight/fight) state, we will find it difficult to emotionally regulate ourselves. For those of us who grew up with parents who were absent, unattuned, or abusive themselves, nobody taught us these skills. Nobody is born with the ability to self-regulate themselves.

Traumatologist John Briere stated: “If C-PTSD (Complex post-traumatic stress disorder) were ever given its due, the DSM (The Diagnostic and Statistical Manual of Mental Disorders) used by all mental health professionals would shrink from its dictionary like size to the size of a thin pamphlet.” What this understands is that the role of traumatized childhoods in most adult psychological disorders is enormous.

Other misdiagnoses are those of depression and anxiety.

Trauma and its legacy can of course co-occur with mental conditions, but many can be accurately described as the natural survival responses found in trauma, for example ADHD and compulsive obsessive can be responses to the fight response, depression to the freeze/collapse response. Responses that were created to protect us at the time and served the role for our survival. It doesn’t mean our struggles are any less or real or that we can’t have biological conditions, but it means we need the right treatment and support and to accurately see these experiences for what they are.

This is such so important to always bear in mind and to know and I hope that others can find it helpful and useful.