We Need to Talk About Little "t" Trauma-Here's What It Looks Like and How to Process It
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.