Dear Therapist:

I really appreciate your weekly column. What happens if a someone goes through trauma at home and doesn't take care of it—meaning, go for help.  If they're fine, could they stay fine? I am worried because many people say it comes back in later years. Thank you!

Response:

The simple answer is yes; someone who experiences a “trauma” can be fine. However, this depends on a number of factors. These factors relate to the definition of the words: “trauma” and “fine.”

With regard to posttraumatic stress disorder, the DSM 5 (the manual of mental disorders) has a specific description of what constitutes a traumatic event. However, for the sake of this response I will define “traumatic event” as something that strongly affects a person emotionally. Notice that the emphasis is on the particular person in question. There is no universal trauma in the sense that it will necessarily cause a person to experience ongoing issues as a result of experiencing it.

With regard to how a traumatic event “affects” a person, no two people are alike. One person who experiences a traumatic event can be highly traumatized in the sense that they have recurring, intrusive memories of the event, experience nightmares and flashbacks, and often feel (physically and psychologically) as if they are reexperiencing the event. They tend to avoid situations that could remind them of the traumatic event. They might mentally block memories of the event or self-isolate. In some circumstances, their entire life perspective might change, leaving them distrustful, negative, detached, and depressed.

Another person, however, might experience the exact same event, yet deal with it quickly and relatively easily. They might feel on edge for a short while, then process the experience. They might have few or no lasting ill effects.

We all react differently. Some of us have preconceived notions about particular types of events. These can lead to increased or decreased trauma. We have different thoughts, feelings, and triggers.

We often categorize people. Good and bad; nice and nasty; interesting and bland; and many other descriptions. We may think of people as a simple amalgam of a finite number of characteristics. Therefore, there should be a finite number of personalities. Perhaps we assume that there are ten or twenty personality types. However, when we truly consider what contributes to each individual’s personality, it becomes impossibly complicated.

Imagine a newborn child who has their very first experience. On their particular level, they internalize this experience in their own very singular way. Their second experience is colored by their reactions and perceptions related to their first experience. Their third experience takes into account the combination of all the aspects of their first two experiences. This process continues in an exponential manner for a thousand experiences. Imagine the billions of possible combinations. And the infant hasn’t even completed their first day of life (never mind all their in-utero experiences).

Now consider a grown person (or even a young child). The number of possible permutations is not only immeasurable; it is incomprehensible. How are we to possibly truly understand ourselves and others? In an effort to do so, we categorize people. However, this is only a very primitive way of convincing ourselves that we understand the human mind and personality.

The human brain is unbelievable complex. The truth is that we know very little about its processes. I couldn’t possibly know how an unknown person will react to a particular event. I know nothing about the event to which you refer. Much more importantly, I know nothing about this person.

It is possible that someone could appear to be fine in the immediate aftermath of an event that is traumatic for them. They might repress thoughts and feelings or otherwise deal with them in an unhealthy way. This could cause a reaction even years later.

However, nothing occurs in a vacuum. There are almost always signs that something is negatively affecting the person on some level. I mentioned some of the signs, like self-isolation, and being distrustful, negative, detached, or depressed. Generally heightened emotions, like fear or anger, or a marked decrease in emotional reaction can indicate a problem as well.

Although there are outward signs that you might notice, this person likely has a sense as to whether they have been negatively affected by this event. If you have concerns, you can speak with them about it. If they are not willing to talk, or to consider professional help, your question is only academic. If they are willing to discuss the matter with a professional, one or two sessions might be enough to discover whether there is a “trauma” that should be addressed.

 -Yehuda Lieberman, LCSW

   psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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