This question has sparked popular, scientific, philosophical, and political discourse for centuries. French neurologist, Jean Martin Charcot, is often credited with being the first physician to realize that hysterical symptoms (paralysis, sensory loss, convulsions, amnesia, volatile emotions) in women were psychologically and often associated with having experienced sexual violence. Until this time in the late 1800s, these symptoms were thought to be physiologically rooted in women’s uteruses. Treatment typically involved a hysterectomy.
If that sounds nonsensical and misogynistic, that’s because it is. Human history is littered with examples of the assumption that problems originate by or within women. The word “hysterical” comes from the Greek word “husterikos,” meaning “of the womb.” A full discussion of the implications of this is beyond the scope of this post, but it is important to remember that how we understand the world is shaped by our position and power within it.
What Experiences Might Be Traumatic?
Returning to trauma, the term comes from the Greek word of the same spelling meaning “wound.” Traumatic events are situations that overwhelm a person’s ability to adaptively cope with the situation. While not inclusive of all potentially traumatic experiences, some examples are:
Physical sexual, emotional, or psychological abuse (including human trafficking)
Homelessness and housing insecurity
Natural and human-caused disasters
Family, community, and mass violence
Sudden, violent, and/or unexpected loss of a loved one
Problematic substance use and exposure to problematic substance use
Refugee, asylee, and war experiences
Sudden, unexpected, and undesired separation from family
Serious accidents, medical events, and chronic illnesses
Military family-related stressors (such as deployment, death, or injury)
What are Symptoms of Trauma?
Trauma symptoms are behavioral, cognitive, physical, and emotional difficulties that are related to the traumatic experience. Again, this is not an exhaustive list, but here are some examples:
· Voluntary avoidance of trauma reminders (including internal reminders, like feelings)
· Maladaptive coping strategies
Problematic substance use
Problematic sexual behavior
Self-injurious behavior (including suicide)
Excessive physical risk-taking behavior
Trauma Bonding (Stockholm syndrome, for example)
· Inaccurate, distorted, or unhelpful beliefs about
Perpetrators of trauma
· Difficulty concentrating
· Racing thoughts
· Memory disturbances
· Poor executive functioning skills (like, decision-making, planning, and organization)
· Increased/decreased heart rate
· Increased/decreased respiration
· Increased/decreased blood pressure
· Decreased brain size
· Structural changes to the brain (such as a smaller connection between left and right hemispheres)
· Fear (including being chronically “on guard” and easily startled)
· Depression (including numbness and irritability)
· Anger (including having a short-temper or overreacting)
· Frequent Mood Changes
· Difficulty tolerating negative emotions
OK, So... Is there Hope?
Yes! While most people experience potentially traumatic events, most people who experience traumatic events do not go on to develop a trauma-related disorder. Although our capacity for predicting who will and will not develop a trauma-related disorder is limited, several factors have been identified that appear to lower the risk of this occurrence. These include: social support, community connection, familial support, stable family relationships, safe and structured home life, having (or having had) responsive caretakers, access to healthcare, and adequate housing. There is good news about treatment, too. We have come a long way since the late 19th century. There are several effective therapies for dealing with trauma symptoms (and ,thankfully, we no longer blame the uterus for their origin). The most efficacious interventions target multiple categories of trauma symptoms. More importantly, all effective treatments:
affirm the survivor's need to be respected, well-informed, connected, hopeful about outcomes
acknowledge that trauma symptoms overlap with other mental health issues, like depression and substance use
and work collaboratively with survivors and their various support systems
If you or someone you know needs emergency treatment, call 911 or go to your local emergency room. If you are or someone you know is seeking nonemergency treatment, there is national hotline that connects people to treatment and information, 24/7/365: 1-800-662-HELP (4357). An online mental health treatment facility locator can be accessed here.