Know Your Trauma

Big “T” versus Little “t” Trauma

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Trauma is gaining some momentum in the world of healing chronic illness thanks to the works of Dr. Bessel Van der Kolk (“The Body Keeps the Score”), Dr. Gabor Maté (“When the Body Says No”), Dr. Peter Levine (“Waking the Tiger”), and Dr. Steven Porges (“Polyvagal Theory”), and many more. I couldn’t have been happier to understand this part of my own healing journey and how trauma played a leading role in my chronic illnesses.

There’s no shame in having trauma, however, knowing what kind of trauma will help you come to know it and name it so that ultimately you can then process it. There are two main categories of trauma commonly referred to as Big “T” and little “t” traumas. These refer to the kind of events that occur.

Before we dive in deeper, it’s important to recognize that people have unique capacities to handle stress, otherwise known as their resilience, which impacts their ability to cope with trauma. What’s highly distressing to one person, may not cause the same response in someone else. There is no “meter” of trauma, no badges to earn or share. Trauma is simply how you experienced an event and how it left an imprint on your psyche.

Big “T” Trauma
(Usually) one-time events with serious injury, sexual violence, or life-threatening experiences.

These are much easier to categorize and are easily recognized as traumatic experiences. Some examples include war, disasters, rape, childhood abuse, car wreck, crime victim, domestic violence, surgery. It’s where there was a moment in time that can be recalled where something big and hurtful happened.

Interestingly, Big “T” traumas have been found to be more easily treatable, and are especially receptive to psychedelic therapies because a person can go back and recall a single moment in time and the feelings associated with that event.

Little “t” Trauma
Repeated highly distressing personal events.

These are ongoing, repetitive, non-life-threatening injuries, emotional abuse, bullying or harassment, living with a chronic illness, and loss of significant relationships. Think of a verbally abusive caregiver or boss you might have had. Did you feel scared, shocked, or angry again and again? Depending on the severity, your age, and your resilience, these could have a significant impact on you.

While little “t” traumas may not meet the criteria for a PTSD diagnosis, these events can be extremely upsetting and cause significant emotional damage, particularly if an individual experiences more than one event or if these traumas occur during important periods of brain development like early childhood and adolescence.

Evidence now concludes that repeated exposure to little “t” traumas can cause more emotional harm than exposure to a single big “T” traumatic event. They cause distress and decreased quality of life.

Why is trauma important to know about?

It’s directedly related to chronic illness and autoimmune diseases. It affects the central nervous system, which in turn creates gut dysregulation, which creates brain disfunction. ⁠⁠Here’s how that happens:

When we are in a stressful event we trigger the “fight or flight” response in our sympathetic system. This immediately gives us a rush of adrenaline, cortisol, and norepinephrine to think and act fast. But these same systems also turn off our digestion. Our body is pretty sure we don’t need to eat a turkey sandwich right now. Instead, we need all bodily resources dedicated to getting ourselves out of whatever situation we find ourselves in.

Now imagine with repeated small “t” traumas that we’re turning off our digestive system over and over again, day in and day out. This looks like low stomach acid and food not moving through the intestines. And a lot of time as a stress-coping mechanism, we still dump food into it, whether it’s ready to receive food or not. We start to create a cascade of events that leads to gut dysbiosis. With a lack of stomach acid to break down food, and a slow or sluggish process because we’re still stuck in flight or fight, we end up with food not breaking down entirely and fermenting inside our own bellies. This overfeeds certain bacteria and fungus and we get bloat, brain fog, and much more.

In short, when the gut/brain axis is compromised, it sets up a lifetime of being stuck in a vicious cycle of hormone imbalance, bacteria and fungal overgrowth in the gut, elevated blood sugars, and more. ⁠⁠

When our hormones, bacteria, and sugars are off, the result is mental and physical distress and disorders.⁠⁠

Well, shit. Now what?

Know your trauma, know your treatment. Effective ways to purge trauma.

It is possible to heal a body that is stuck in trauma. There are different methodologies and modalities, but the ones proven to work best are bottom-up therapies, not top-down.

Bottom-up therapies include utilizing the physical body to process the trauma and help it re-regulate itself to a normal state. The reason this works so effectively is it’s tapping back into the central nervous system (the vagal nerve bundle) which is directly wired into our heart, lungs, guts, and organs so that we can get back to that pivotal “rest and digest” state. Top-down therapies are usually talk-therapies which have been shown to only have temporary effects when it comes to trauma. Our brain processes logic and understands it’s no longer in danger, however, the body didn’t get the memo and is stuck in a cycle of stress.