What happens when a term that was once restricted to specialist therapy services becomes an everyday diagnosis? In the following piece I will be sharing my reflections on my own personal journey with a now ubiquitous therapy label: ‘trauma’.
The first time I learned about c-PTSD or complex trauma I was relieved. The diagnostic criteria for c-PTSD felt relatable enough to be mistaken for mind-reading, and it released me from the highly stigmatized label of Borderline Personality Disorder. Yet, I now had to cope with the revelation that my childhood had been “traumatic,” which was, itself, destabilizing. I was sickened with thoughts of what might have been – if only my parents had done better, if teachers had known, if therapy had been more ‘trauma-informed’ in the 90s. I angrily cut off my family, an estrangement that lasted for 5 years.
I first learned about c-PTSD and Borderline Personality Disorder not from clinicians but from internet strangers. I began “educating myself” by reading forums and articles and watching Youtube videos about the condition. Eventually I bought a few books, too: Childhood Disrupted by Donna Jackson Nakazawa, Thou Shalt Not Be Aware by Alice Miller, and The Body Keeps the Score by Bessel Van der Kolk. I was convinced this is what “I had.” Since therapists also use the internet, I had no trouble finding one to validate my self-diagnosis. From talking to hundreds of people in mental health online support forums, I can attest to this being a common path.
One year ago, I made the hard decision to put down my sword and reconnect with my family. I took the blame for everything. No mental health forum would have endorsed this. I apologized, which was a significant risk. If they gloated, I’d accept that and find a way to move on with my life.
That didn’t happen. My parents were happy to hear from me. It seemed to inspire my parents to finally start talking more openly about the past. They did admit to mistakes. My mom even asked if I wanted her to apologize for anything. I hadn’t planned to ask for it but since she offered I was able to make my case more clearly about what precipitated the estrangement and why I had interpreted my childhood as traumatic.
They had not really disagreed with me about the facts of the past. There were certainly problems. I grew up around frequent yelling and other types of emotional dysregulation. There were occasions of physical punishment. My parents did not do a particularly good job of teaching me how to maintain a daily routine. They did not model how to have healthy relationships with other people and I picked up many of their maladaptive habits, such as losing my temper over minor inconveniences, oversharing, and pining for the approval of others.
My mom told me that I’ve been afraid of my dad since I was pre-verbal. She admitted to having been unskilled at keeping my brother and I on a regular routine. I showed signs of emotional difficulties from infancy, and suffered from colic and insomnia. My mother attempted to use the “cry it out” method to help me “learn to self-soothe” but it seemed to make my anxiety and insomnia worse. My mother has anxiety, too, as well as anorexia and possibly bulimia. Currently, her eating disorder is managed enough where she is healthy but she retains many dysregulated eating behaviors. I developed issues around eating as well.
I have always struggled with anxiety and poor eye contact, and this made me “weird.” I hung out in fringe social cliques with all the other weirdos who were not bothered by these traits. The trouble with weirdos is that they were emotionally dysregulated, too, which had a multiplying effect. My struggles with relationships, as well as my health, continued through my 30s, where I passed from one dysfunctional social circle to the next before I reached a breaking point. I was no stranger to inpatient facilities either.
It is nearly impossible to confidently attribute any of these things from my background to my current issues. It is certainly tempting, as there’s a good chance a lot of these things did negatively impact me. However, babies are also born with a natural temperament and mine happened to be one of high sensitivity and low adaptability. It was unlucky for me and for my parents, who seemed ill equipped to raise a sensitive child. It doesn’t mean they didn’t love me or that they intended to hurt me. It also doesn’t mean it was my “fault” for “being too sensitive.” It was just my nature.
In my 20s I developed ulcerative colitis, and it was a bad enough case that after seven years of failed medical management and two intensive care hospitalizations, I had to have surgery to correct it. My sensitivity and poor adaptability meant that I did not handle having a chronic illness well. Not everyone with ulcerative colitis comes out of it with emotional scars, but I did. I don’t know if this was something I could have helped or not. These are just the facts of the situation.
I’ll conclude with a crucial question I’ve asked myself for several years: was all of this trauma?
Unlike my parents, my brother was not as excited to reconnect with me. We had never been close, and my emotional issues growing up were always bewildering to him. He had been deeply insulted by my description of our childhood as traumatic. My brother has PTSD from fighting twice in Afghanistan. He also works in emergency response and is steeped in the worst of human suffering on a daily basis. He thought I was an unbelievable brat for saying I had PTSD because he interpreted our childhood as “amazing” compared to the situations he enters on his emergency calls.
Certainly there is an objective difference between a child who is left unclothed, unbathed, and unfed by addict parents and a child who grows up around yelling and other dysregulation but is otherwise fed, clothed, and bathed. Yet, I’ve had people in my life who had grown up in substandard conditions such as what my brother responds to at work, and there was little substantive difference between their anxiety and mine in terms of its impact on our ability to thrive in life.
I also had to consider that my brother has witnessed brutal killing of hundreds of people in his military deployments, and I have not witnessed any such thing. The rational part of me understands that not all negative experiences are equally bad. Trauma, to me, could be defined as a threat or apparent threat to your life. But trauma is not the only thing a person can be exposed to in life that may harm them psychologically. And to further complicate the discussion, not all combat veterans get PTSD. The ones that do tend to enter service with pre-existing risk.
In general, I have stopped calling my past traumatic and I have stopped using the term PTSD to describe my mental health issues. It muddies the conversation and makes understanding across value systems difficult to impossible, as I learned with my brother. If I must, I call it anxiety and explain I was raised in a dysregulated home and learned bad habits. For some reason, today’s online mental health communities seem to bristle at their issues being “just anxiety.” They want it to be autism, or c-PTSD, or ADHD, or some other fashionable diagnosis that absolves them of an assumed character flaw. Perhaps anxiety has been dismissed so often as trivial and normal that people want to call it something stronger in order to be heard. I understand this feeling.
Since changing the language I use to describe my emotional struggles, it has made the use of trauma language in mental health support forums more obvious. I ask myself the forbidden question: how many of these people “really” have experienced trauma, and how many of them have incorrectly labeled a dysfunctional childhood as ‘trauma’? Did they have an unpleasant life experience and find ‘trauma’ a compelling descriptor of their emotional experiences the way I did, and latch onto it to their ultimate detriment? Through a screen and a username, there’s no way to know.
Mental health online communities hook you in like a drug, because of the initial wave of intense validation that you feel when you find a group of people who share your internal experiences. The internet has a way of helping us find people who seem to speak our innermost thoughts, as though they were reading our diaries. But very quickly I became dragged downward into the vortex of personal revisionist history, recoloring and retouching every memory in the language of complex trauma. It seems to me to be another form of dopamine-fueled escalation that will be the legacy of Web 3.0.
My use of internet trauma language drove a wedge between my brother and I which will take decades to repair, if at all. We do talk sometimes now, but it is still a delicate situation. The estrangement cost me five years of life with my aging parents, and we are trying to make up for lost time. I still need to keep my distance because I’ve had to do a lot of work on myself to unlearn the bad habits they taught me. But they didn’t mean it. They were hurt by others, and were doing what they knew how to do. I want their older years to be happy.
Part of it is for me, too. I want to grow old with good memories of my family because I believe it is healthier than being angry. Soon I will be a parent myself, and I don’t want my child to grow up without grandparents, uncles, aunts, and cousins. I want them to have positive feelings about those people, to feel secure as they grow, and come to understand the flaws of their family members at age appropriate times when they can put them into context. It may be harmful to hang out with dysfunctional people, but it is also harmful to plod through life thinking you come from fatally damaged stock when you don’t.
This is not to say that every child of a dysfunctional home needs to do what I did. Many people do have to detach from their families for their own and their spouse and childrens’ safety because their families were not open to talking about the past and may even be imminently violent. My parents can be immature and in some ways haven’t changed that much, but I am grateful that they find it in themselves to be real with me in the way that they can.
The broader issue is, then, how do we as therapy clients think about our past? Calling something ‘trauma’ that isn’t trauma incidentally seems to make anxiety symptoms worse. But, calling something ‘trauma’ that actually IS trauma can be very helpful. I do volunteer work in my community as an advocate for victims of crimes, and I see that acknowledging their trauma can be a powerful way for them to heal.
I don’t know the answer. I do see two starkly different takes online and I find both of them wanting. One sees trauma everywhere and claims that trauma is more about how it affects you than the substance of the experience. If everything bad can be trauma, with regard to “little t” and “big T” traumas and the like, then it renders trauma meaningless. The other perspective says that focusing on trauma comes at the expense of your own resilience. Yes, there’s too much emphasis on childhood experiences as the root cause of psychological problems and talking too much about “your trauma” does suffer from the law of diminishing returns. But, our early life experiences aren’t psychologically neutral.
For a clinician to be truly trauma-informed, to me, would involve being able to tell when a client has or has not experienced trauma and guide them toward strategies that will help with the symptoms that are keeping them from thriving regardless of the cause. Some would call this approach ‘gatekeeping’ but I prefer to call it ‘triaging’. How do we get the right medicine to the right target as quickly and efficiently as possible? This requires abandoning the relativistic value system that seems to underpin a lot of fashionable viewpoints. Some people are so offended by having had their experiences denied as “not trauma,” that they forget that what really matters is focusing on the symptoms that are preventing them from thriving.
This is my hope for the future of therapy. Thankfully we’re a long way past dismissing mental illness as a character flaw or a sin, but perhaps the “trauma is everywhere” approach was a gross overcorrection. On the other hand, let’s not throw the baby out with the bathwater. There is value in acknowledging and naming trauma. Recovery, to me, is learning to exist in this narrow space of sanity.
By ‘Velma Olden’ ( read other posts by this author on conservative values, healing from feminist miseducation, rebelling against ‘woke’ feminism, and the hidden politics of DBT)
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