Trauma Is Not a Diagnosis
5 myths and truths about PTSD.
Trauma symptoms have historically been diagnosed under various terms before PTSD emerged.
Misconceptions surrounding trauma and PTSD include the belief that emotional wounds equate to trauma.
C-PTSD, distinct from PTSD, is less common and lacks a unified diagnosis criteria.
The first recognized diagnosis for the effects of experiencing traumatic events was "hysteria." Historically, hysteria was predominantly associated with women and included a range of symptoms and psychological disturbances. It was believed to stem from the uterus and was often attributed to unmet sexual needs or subconscious conflicts.
The diagnosis of hysteria quickly fell out of favor. Some texts assume that the high correlation between sexual trauma and incest may have been one of the reasons why studying trauma became inconvenient.
"Shell shock" was the diagnosis that emerged during the World Wars, used to describe the psychological and emotional effects of combat on soldiers. It highlighted visible traumatization symptoms such as tremors, paralysis, and emotional instability experienced by soldiers exposed to the horrors of war. It was also shelved for decades.
The term "trauma" itself was not used to describe psychological issues until later. It’s important to clarify: the term “trauma” is not and has not been used as a diagnosis, despite common misconceptions. What became a diagnosis in the 1980s is post-traumatic stress disorder (PTSD), with the purpose of providing a framework for understanding the effects of traumatic stress, observed mainly in veterans and battered women.
Still, for many people, trauma seems to mean a verdict about an unwelcoming future. Let’s try to change that perception by debunking some of the myths about how to name the effects of experiencing traumatic events.
Myths About PTSD
Myth #1: Trauma and heartbreak are the same.
Going through emotionally challenging situations can certainly cause emotional pain and leave a mark, but not all emotional pain constitutes trauma. Trauma includes only those situations that make us feel as if we are confronting irredeemable danger.
For instance, feeling heartbroken after a breakup is painful, but it doesn't amount to trauma unless the person's life feels threatened, such as when the partner of a disabled person leaves. If livelihood doesn’t depend on the ex-partner, the person will carry some emotional pain but won’t be traumatized. Enduring emotional pain is a natural part of being human, and our resilience enables us to navigate it over time.
Myth #2: All emotional wounds cause trauma.
Trauma involves the activation of survival responses after experiencing distressing events that make us feel unsafe even after the event is over and the risk is gone. There are many experiences that can leave emotional marks without necessarily inducing such type of survival responses.
Grief and loss, for example, can be deeply painful without any connection to an immediate threat. Similarly, feelings of loneliness, disappointment, frustration, conflict in a relationship, identity issues, or even anger can be emotionally distressing without involving having to extremely protect our lives.
While uncomfortable memories and emotions may linger as residue of emotionally painful experiences, our innate capacity to adapt and recover helps us return to normalcy. It’s a matter of integrating those experiences into our lives without being overtaken by them.
Myth #3: Trauma and PTSD are synonymous.
While PTSD is the disorder commonly associated with the aftermath of experiencing traumatic events, not everyone who encounters adversity or suffers from stress after a traumatic event develops the disorder. Most individuals have resources—such as cognitive schemas and social connections—that promote feelings of safety and security. Using confidence as a guiding force helps to bring their system back to its pre-trauma state even after horrific experiences. Just a minority of those who experience traumatic events develop PTSD.
Myth #4: PTSD means dysfunction for life.
The diagnosis of PTSD is often stigmatized due to its association with war, rape, and violence. Unfortunately, it’s quite common to assign the PTSD diagnosis to people who experience events considered awful without investigating further.
Don’t take a diagnosis at face value. To assign a PTSD diagnosis to someone, multiple and persistent symptoms need to be present over time. Most importantly, even those with a severe PTSD presentation have the capacity to reduce symptoms and stop them from further developing, to return to an almost normal level of functioning. As adaptive beings, our experiences are registered to aid us in the future, allowing us to assign new meanings to past emotions as we move forward.
Myth #5: C-PTSD is just a more extreme version of PTSD.
While PTSD and C-PTSD—complex post-traumatic stress disorder—share similarities in terms of symptoms and underlying mechanisms, they are two different syndromes with important differences. C-PTSD typically unfolds after prolonged or repeated exposure to traumatic events or adverse circumstances, most often interpersonal in nature. Individuals who have experienced lasting abuse, exploitation, or severe circumstances are more likely to meet the criteria for C-PTSD. In contrast, PTSD typically results from a single, discrete traumatic event or a series of events that occur over a relatively short period.
Since C-PTSD develops gradually, it can lead to a different set of symptoms that may include disruptions in self-concept, difficulties in regulating emotional reactions and mood, impaired relationships, and pervasive feelings of shame, guilt, or worthlessness. In contrast, PTSD symptoms often revolve around re-experiencing the traumatic event and avoidance of reminders.
I’d like to leave you with an important concept. Both PTSD and C-PTSD share the common feature of becoming a lasting issue once the survival circuits disrupt the nervous system's balanced activity, leading to the development of trauma symptoms. Still, clinicians often diagnose PTSD more frequently because the symptoms of C-PTSD may overlap with other disorders such as BPD, making it more challenging to distinguish and diagnose (Herman, 1992).
