How do we decide what counts as trauma – and have we got it all wrong?

What qualifies as trauma has become a hotly debated issue, with implications for treating people who experience PTSD – and the way we respond to things like the pandemic and police killings


30 March 2022

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Daniel Stolle

GIVING birth. A car accident. Racial abuse. Many of us feel we have experienced things we would describe as traumatic. Look no further than the past few years. Beyond the sickness and deaths wrought by covid-19, many psychologists warned that the pandemic was a mental health crisis in the making, with cases of post-traumatic stress disorder (PTSD) predicted to soar.

Consult the medical textbooks, however, and you find that such experiences don’t generally qualify as trauma. People who suddenly lost a loved one to covid-19, and those working in hospitals and care homes might meet the criteria. But relentless news updates about a mysterious deadly disease, job loss, social isolation and living under lockdown – none of these fits the bill. “People called the pandemic traumatic, and it’s not,” says George Bonanno at Columbia University in New York.

In our propensity to view things as traumatic, we may also be overplaying the impact, Bonanno argues. His research has shown that, given time, most of us will recover even from the most horrifying experiences. In light of this, says Bonanno, the word “trauma” has lost all meaning. But others believe the strict medical definition should be expanded to cover a wider set of human experiences.

This explosive debate – reignited by the pandemic and the Black Lives Matter movement, and continuing at a time when war is high on the news agenda – has big implications. Ultimately, our understanding of what trauma is, and which experiences qualify, determines whether people are being unnecessarily diagnosed and treated for PTSD, or are living with the symptoms unable to get the treatment they need.

The medical …

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