What I mean when I say trauma

Specialist CBT therapy for anxiety, OCD, depression and more in West London

When I use the word trauma, I am not trying to rank people’s experiences or decide whether an event was “bad enough”. People can be deeply affected by events that others do not understand, and people can also have difficult experiences without identifying with the word trauma. The language should help a person make sense of what is happening, not pressure them into a label. A blog cannot determine whether someone has experienced trauma, whether a diagnosis is appropriate or whether a particular event explains what they feel now. Intrusive memories, sleep disturbance, strong reactions, avoidance, detachment, low mood, anxiety or a sense of disconnection can have many possible contributors. Health, grief, current relationships, work stress, neurodivergence, substance use, safety and practical pressures all need consideration. An assessment can begin with the present rather than a detailed account of the past. What is difficult now? What feels safe enough to discuss? What support is already in place? What does the person want to be different? These questions make space for an individual story without assuming that a memory must be revisited or that one explanation fits everything. Some people use the phrase trauma because it gives shape to an experience that felt overwhelming or prolonged. Others prefer words such as loss, adversity, betrayal, fear, instability or harm. The words matter less than the opportunity to be heard accurately and to consider what support fits the person’s needs. If trauma focused work is considered appropriate, it should be planned with informed consent, choice, pacing and review. It is not a self directed task and it should not require a person to ignore their boundaries, disclose beyond what feels safe or revisit difficult material alone. At times, a different focus, a medical review, practical support or specialist input may be more appropriate. Progress can be about having more language for an experience, feeling less blame, understanding a reaction in context, setting a boundary or finding a safer way to respond in the present. It cannot be guaranteed or reduced to a fixed sequence of stages. If someone is in immediate danger, cannot keep themselves safe or is at risk of harm from another person, they should call 999, attend A&E or contact urgent crisis support. For non immediate concerns, an assessment led conversation can help clarify what support may be appropriate. For related information, read about <a href="/therapy/ptsd/">CBT for PTSD and trauma related difficulties</a> and the <a href="/guides/ptsd comprehensive guide/">PTSD clinical guide</a>. The Lyceum Clinic offers assessment led CBT online and in West London. A first conversation can help decide whether this support is appropriate and what other care may be relevant.