A Brief History of Trauma and PTSD

The word trauma is widely known and its meaning is generally understood. However, it can oftentimes be misused to add dramatic effect to a situation; for example, using the phrase, “That was traumatizing,” when perhaps merely an embarrassing situation occurred. Was it traumatizing? What does it mean to be traumatized? As the American Psychological Association (2024) defines it, “Trauma is an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” When emotional responses such as shock, flashbacks, denial, and physical symptoms such as headaches or nausea persist well after the occurrence of an event, a person is likely suffering from trauma. 

What may be less commonly known is the history of the word trauma. Trauma is derived from the Greek word τραῦμᾰ, or traûma, meaning “wound,” with roots dating back to the mid-1600s (Kolaitis et al., 2017). Although the word was originally used in reference to a physical wound, it is now more commonly used to refer to an emotional wound. Let’s look at the year 1861, the beginning of the American Civil War when terms such as “soldier’s heart” and “nostalgia” were used when referring to a soldier’s response to traumatic stress. Fast forward 53 years to the beginning of World War I. During this time, the term “shell shock” was introduced to describe the physiological responses that soldiers were experiencing as a direct result of heavy explosives. As noted in Trauma-Informed Care in Behavioral Health Services (2014), “Even with a more physical explanation of traumatic stress (i.e., shell shock), a prevailing attitude remained that the traumatic stress response was due to a character flaw.” At this time, Charcot, Janet, and Freud were articulating that the symptoms that soldiers were experiencing were a direct result of psychological trauma. However, by the year 1939 and the next World War, this information was still falling on deaf ears, as military recruits were being screened to keep out any “who were afflicted with moral weakness.” However, advancements in treatment were being introduced, including allowing soldiers to rest from “battle fatigue.” Talk therapy emerged during the Korean and Vietnam wars, between the years of 1950 and 1975. 

Though it took longer than it should have to come to the realization, we now know that there is no single definition of trauma. “The ways we are exposed to trauma are vast, and the individual’s response to it is personal. Cultural differences, protective factors, and sense of self can all cause very different outcomes for two people witnessing the same event (Rousseau, 2024, Module 1: Introduction to Trauma).” As van der Kolk expresses in The Body Keeps The Score: Brain, Mind, and Body in The Healing of Trauma (2014, p. 19), it was not until 1980 that the formal diagnosis of PTSD was developed; an effort made by a group of Vietnam veterans and New York psychoanalysts, Chaim Shatan and Robert J. Lifton. Before this, individuals suffering from the symptoms of post-traumatic stress disorder, most of those war veterans, were being unsuccessfully diagnosed with alcoholism, substance abuse, depression, mood disorder, and schizophrenia. Subsequently, they were being treated with the wrong types of medications, and the wrong forms of therapy. Now, almost 45 years later, we also know that there are many different forms of care available for addressing the impact of trauma, including pharmacotherapy, cognitive behavioral therapy, exposure therapy, EMDR, neurofeedback approach, internal family systems therapy, yoga, mindfulness, theater, emotional freedom technique, service dogs, and gender-responsive approaches. We also understand that the symptoms of PTSD are very real, and are in no way due to “moral weakness.” 

References

American Psychological Association. (2024). Trauma. Retrieved from, https://www.apa.org/topics/trauma

Kolaitis, G., & Olff, M. (2017). Psychotraumatology in Greece. National Library of Medicine. Retrieved from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632764/

National Library of Medicine. (2014). Trauma-Informed Care in Behavioral Health Services: Appendix CHistorical Account of Trauma. Retrieved from, https://www.ncbi.nlm.nih.gov/books/NBK207202/

Rousseau, D. (2024). Boston University Metropolitan College, Module 1: Introduction to Trauma. https://onlinecampus.bu.edu/ultra/courses/_127887_1/cl/outline

Van der Kolk, B. A. (2014). The Body Keeps The Score: Brain, Mind, and Body in The Healing of Trauma. (1st edition). Viking Penguin.

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