Moment 174: Trauma Doctor Reveals Every Type Of Trauma & It’s Effects In 10 Minutes

SPEAKER_1 (0:00)

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What are the different types of trauma? Are there different categorizations of trauma from small to big?

Paul Conti (1:00)

If we're using the definition that trauma is anything that overwhelms our coping mechanisms. There are changes in the brain when our coping mechanisms are overwhelmed and on the other side of that our brains are different. That's the biological definition. Then we would look at how do we get there?

It breaks down into three categories of acute, chronic, or vicarious. The acute trauma is how we've traditionally seen trauma. If you think about the idea that people were shell shocked after World War I, that was acute trauma, combat trauma. Our traditions of looking at trauma come from acute trauma and it's just more evident. After someone dies or there's an injury or there's a car accident, we can see that, oh, okay, gosh, that could make some difference in the person. We can get that and sometimes we can see the change in the person from before and after. We have tended to equate trauma and post-trauma syndromes, like what happens to us after those changes in the brain are now with us to acute trauma. But again, it's not a soft definition. It's based on, do those changes in the brain happen in other ways? And the answer to that is yes. That if a person is seen as less than, for example, in a society, for whatever reason, across time or even within a household, a person is being abused in a household, a child is being neglected or a child is being emotionally or physically abused.

SPEAKER_1 (2:30)

Bullied at school?

Paul Conti (2:31)

Sure, bullied at school. Absolutely.

So nothing happens all at once, but that brain changes just the same. So it's a scientific definition of traumatic change. And it is true in situations of chronic trauma, just as it is in acute trauma. Now, it doesn't mean all acute traumas or all chronic traumas make these changes in the brain. And then vicarious, so the third category, there would be vicarious trauma, which means human beings are empathic. I mean, thank goodness, right? That's how all goodness comes in the world, through our ability to have empathic connection. But that also means that our trauma can communicate from one to another. And again, it's not a soft concept. So people who are very much involved in other people's trauma, so in healthcare settings, sometimes in journalism settings, just in intimate home settings, in just spending a lot of time with the news, right? It can become traumatized and have the changes in the brain that look the same as the person who lost two family members in the car accident. So it is true that vicarious trauma can change us in just the same way. The modern field acknowledges that if it's in the context of professional endeavors, which really makes no sense, right? Like what we're talking about are brain changes, and brain changes can come through acute trauma, chronic trauma or vicarious trauma because of our ability to have empathic connection and compassion with other humans.

SPEAKER_1 (4:01)

I want to make sure that I've nailed this before we move on. So the acute trauma, I get it, it's the big events. It's the going to war. It's the car accident, the big events that happen typically in an instant, typically. Chronic trauma, this is things like racism, sexism, bullying that happen over a long period of time gradually that make you often feel less than other people. And the vicarious trauma is the trauma that, as you say, you get from empathy. So feeling someone else's pain, feeling someone else's trauma, and it becomes your own.

Paul Conti (4:32)

Yes.

Yes. And they can all lead us to the same brain changes, but people have different levels of susceptibility, right? So one person may have three big acute traumas and that person's brain is still doing okay, right? It's not changed towards greater vigilance, right? It's not changed towards greater inflammation in their blood vessels. Then, you know, another person could have one incident that might seem more mild than the other three, and that person can then have brain changes. So part of it is who are we genetically? How are we built? What kind of life experience have we had, especially early life experience? How susceptible are we to one thing versus another? And then this idea of the multiple hit hypothesis that I could have a number of traumas and then on a certain trauma that might be even mild compared to ones that came before it, now it makes the changes.