There is nothing small about this type of trauma—here’s what it means and how it can affect you.

When we think of trauma, we often think of acute, catastrophic events: the loss of a loved one, a natural disaster, a terrible accident. "The concept came from classic constructs like PTSD - we were trained only to think about experiences that were life-threatening," says Christine Yu Moutier, MD, chief medical officer of the American Foundation for Suicide Prevention.

But as clinicians continued to practice, they realized that other events-events that may not have been traditionally defined as "trauma" in the past-were indeed having the same emotional and physical impact. "Some people were dealing with stressors that caused the same symptoms," she says, even if the stressors weren't as life-threatening as, say, a natural disaster, deadly illness, or an abusive relationship. 

Clinicians and mental health professionals came to understand the importance of recognizing and classifying these "smaller" distressing experiences as legitimate forms of trauma in their own right. They've come to understand and define traumatic experiences in two categories, big "T" trauma and little "t" trauma. 

Big "T" trauma (sometimes called large "T"), which can often lead to an official PTSD diagnosis, are catastrophic, life-threatening, and intensely distressing events you probably think of when you hear the word "trauma"-a plane crash, active military combat, a sexual assault, or witnessing others' trauma. Little "t" trauma (sometimes called small "t") refers to relatively smaller, more personal, distressing events that anyone can go through at some point in life, and they're often not life-threatening or as obviously scarring. These might include a stressful move, a job change (or layoff), an injury that's not life-threatening, chronic pain, working for a difficult boss, a financial emergency, or a complicated divorce. 

But don't let the wording convince you that one trauma is more or less important than another- the definitions are simply meant to help point clinicians toward the best method of treatment for different patients. What's often so tricky about little "t" events is their cumulative impact, wreaking havoc psychologically over time or with repetition.

Understand how you process and respond to trauma

Trauma is a very personal experience and not everyone may react to trauma in the same way. Take the pandemic as an example. COVID-19 shutting down the world was a collective global trauma, filled with both big "T" and little "t" traumas for many people, running the gamut: losing loved ones, working on the hospital frontlines, losing a job, and being cut off from their social sphere, adapting to a new work cadence, and a general lack of certainty and answers.  

Why were some people able to work through the trauma more easily than others? Dr. Moutier likens it to a patient with heart disease. The basic preventive "prescription" for anyone to take care of their heart may include getting regular exercise and watching what you eat, but for someone with heart disease, you may need to do all of those things plus implement some additional therapies.

"We're all predisposed to understand trauma," explains Haylie Yakrus, a mental health clinician from Berman Psychotherapy in Atlanta. "It may be genetic, [environmental] (i.e., [whether or not you felt] safe and protected), or a traumatic experience when we were [children]." 

But certain triggers may affect individuals completely differently-or not at all. Sometimes a little "t" trauma can immediately cause an individual to enter that fight-or-flight, high-stress, mode with real physiological symptoms, while it may barely phase the individual next to them. 

Much of how intensely you're affected by little "t" stressors depends on how resilient you are. "There is a direct correlation between the resilience reservoir and how we process the trauma," Dr. Moutier says. People who tend to have more emotional resilience (the capacity to cope and bounce back in the face of adversity)-or a bigger "resiliency reservoir," as Dr. Moutier puts it-are better equipped to deal with trauma, particularly those on a smaller, less life-threatening scale. And if you're exhausted and not taking care of yourself, the trauma may have an unintended bigger impact on you.

Some of it is genetic-certain people are born with the ability to recover more quickly or let things roll off their backs more easily-but there's a huge spectrum, and many are not as lucky. The promising news is that filling that resilience reservoir can sometimes be as simple as getting the sleep, hydration, nutrition, and exercise you need. 

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In order to heal from trauma, you have to validate it

Are you just tired from a long day, or is something more serious going on here? How do you know when your body is reacting to a little "t" trauma in a way you need to address? Look inward and validate what's happening. 

The physical manifestations of trauma come in many forms. It can be anything from losing your temper easily to having migraines, sweating, and increased heart rate, or obsessive-compulsive behaviors. Yakrus gives the example: "If you just went through a divorce or bad breakup and you refuse to date, that could actually be a reaction to the trauma." 

Coming out of the pandemic, if you notice you're incessantly cleaning until your fingers turn raw, that may be a direct correlation to the trauma of this past year.

Noticing patterns and acknowledging that they might stem from something deeper is important, and validating the need to prioritize your mental health is a huge first step. Whether it's talking with a friend, a therapist, or journaling about your experiences.

It's hard to put your finger on when you're in the midst of the fall-out of a smaller trauma, but "by putting it out there, you realize how it's truly significant," Dr. Moutier says. And before you write off self-care as an ineffective luxury-think again. Understand that a lack of taking care of yourself-whatever that means to you, your mind, and your body "can have dire ramifications for your physical and mental health," Dr. Moutier adds.

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The ways to cope with little "t" trauma

Follow a comforting, helpful routine.

Once you recognize the trauma, create self-care outlets that work for you and continue to use them. Consistent breaks, moments of self-compassion, and making small, healthy decisions for you are crucial for working through it. "Keeping up with a consistent routine is key, and so is a form of release," Yakrus says. This could be as simple as splurging on the better brand of coffee, taking a long, hot shower, and going for a leisurely walk with a friend to talk.

Schedule non-negotiable time on your calendar to do something that fills up that resiliency reservoir: things that make you happy, fulfilled, accomplished, satisfied, connected-things that give you something to wake up for and look forward to: a sewing class, a yoga session, a great book, or baking.

Know when you need a mental health day.

Yakrus insists we need to start normalizing mental health days from work in the same way we do for sick days. Coming out of a global pandemic, she reminds us that "we should normalize that what we just went through was a collective trauma. As life resumes, we need to take time to ground ourselves, to take a breath, and recognize there is added anxiety [leftover]."

Talk to a therapist.

You can practice all the self-care in the world, but there are still times when you need more than a bubble bath or a cup of tea. Sometimes you need someone (who knows what they're doing) to hold you accountable, who isn't yourself or a friend-and that's where therapy comes in. Cognitive behavioral therapy is a common starting point for working through trauma and a great step toward breaking free of trauma-triggered behaviors. 

Dr. Moutier also points to EMDR (eye movement desensitization and reprocessing) as another treatment option, which can be used to "help the brain file these memory files to a new place in the brain that isn't so charged up."

"In America, we [tend to] grow up thinking that things happen to us, but we aren't powerless," says Dr. Moutier. If we retrain our brain, we can actually start to work through the trauma and alleviate the physiological symptoms we feel. The good news is that with some work and consistency, trauma is something people can work through, and even come out stronger and more resilient on the other side.

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