The first result of the search for the hashtag #trauma on TikTok – the Chinese social network with over a billion users – made for this report shows a young woman, apparently in her mid-twenties, describing “reactions that people don’t realize come from trauma,” with melancholy music in the background. When she moves her head from side to side, the phrases appear on the screen: “being uncomfortable when people fight/scream”, “being afraid of intimacy/not liking physical touches”, “feeling emotionally connected to everyone because obliged to understand everyone’s emotions.”
The discomfort caused by physical touch, as well as the difficulty in establishing affective bonds can be – with emphasis on the indication of possibility –, in fact, behaviors resulting from from bad past experiences, from the most severe (such as cases of sexual abuse) to the most everyday (betrayals and disappointments in love). It is to be expected that the reader knows, however, one or another relative or close friend who, without having been through any of these situations, is simply not given to tight hugs. Getting uncomfortable in the midst of other people’s arguments, especially when those involved “turn it up,” on the other hand, is an almost universal reaction. Does it make sense that the first suspicion through this behavior is the existence of trauma?
The problem is that the definitions of trauma – word originating from the Greek “traumatos”, which means “wound” and , for hundreds of years, would remain restricted to physical damage – have been updated, giving rise to interpretations with little or no scientific support that, in practice, only deteriorate the mental health of an already weakened generation.
The term that was previously used to describe the strong reactions experienced by war veterans, especially after the Vietnam War – episodes of sudden and acute violence, frequent nightmares, loss of appetite, unbridled terror by loud noises, among others – , and which gave rise to the diagnosis of post-traumatic stress, extended to the point of covering any unpleasant experiences, as long as they are described by the victim as “traumatic” – or not even that.
In January of this year, the Minister of Foreign Affairs Canada’s Indians, Marc Miller, accused scientists who requested evidence that the 215 graves located in British Columbia even belonged to native peoples of “retraumatizing the survivors” . In American universities, activists are calling for the creation of “safe spaces”, spaces prepared to receive young people who felt violated when hearing from an eventual speaker that there are only two genders or that racism is not a “structural” problem. In the press, there is no shortage of articles addressing the “trauma” of Donald Trump’s election in 2016 or that of Jair Bolsonaro in 2018.
On the other hand, some of the greatest experts on post-traumatic stress in the world warn of the growing misuse of the term and of a truth hidden in common sense, increasingly supported by science: the being human is actually much more adaptable than we realize.
“Until recently, most of what we knew about trauma came from studying the most severe responses, such as post-traumatic stress disorder (…) The problem arises when we focus only on that goal and ignore the experiences of those who don’t show such extreme reactions”, writes psychologist George Bonanno, professor of clinical psychology at Columbia University and author of the recently released “The End of Trauma”, not yet translated into Portuguese.
“Not even post-traumatic stress is a static category , immutable. They are dynamic states with fuzzy boundaries that unfold and change over time. (…) In fact, not even a violent or life-threatening event is inherently traumatic. Such events are only ‘potentially traumatic’. Much of the rest is up to us. This ‘rest’ varies much more than the standard perspective on trauma assumes.”
From the Vietnam War to TikTok: The History of Trauma
Although there are records of the use of the word “trauma” in the English language in the mid-seventeenth century, according to the Oxford English Dictionary, it was only in the 19th century, in the midst of the Industrial Revolution, that doctors would turn their attention to workers who were victims of serious accidents at work who manifested inexplicable symptoms – memory failure, lack of appetite, excessive anxiety and irritability – , initially attributed to neurological problems.
It was only in 40 that the German neurologist Hermann Oppenheim proposed the hypothesis that some of these evils were, in fact, of psychological origin. Despite the little repercussion at the time, the book Die Traumatischen Neurosen (Traumatic neuroses) is the first to use the term “trauma” to describe a psychological phenomenon. Meanwhile, at the University of Vienna, the physician Sigmund Freud risked his first interpretations of harmful and involuntary behaviors by associating them with “sexual trauma”.
The two great wars would change the understanding of trauma, leading psychology to focus on the medium and long-term reactions caused by highly stressful experiences – even though, for some time, posthumous reactions were considered irrelevant or associated with cowardice. The end of World War II would mark the release of the first edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which would become the “bible” of psychiatrists. The version included a description of the “acute stress reaction”, still without a list of clear criteria for its description.
It was only after the Vietnam war, in
, that the terrifying reports of surviving soldiers, as well as their lingering symptoms years after returning home, would lead psychiatry to get serious about post-traumatic stress disorder (PTSD). ), which would be officially incorporated into the DSM-III in 1980.
“Trauma was treated as a reaction to situations that involve risk to life and this definition remains consistent to this day. It is a very narrow and evidence-based identification”, defends psychiatrist Michael Scheeringa, professor at Tulane University and author of the book “The Trouble with Trauma” (“O Problema com o Trauma”, not yet translated into Portuguese). ), in an interview with Gazeta do Povo.
War, rape and torture were considered in the category that, on the other hand, it gave little importance to events that today are understood to be severely impacting, such as family sexual abuse. Psychiatrist Bessel van der Kolk, author of the bestseller “The Body Keeps the Marks”, writes that the DSM version of 1980 still stated that “there is little agreement regarding the role of father-daughter incest as a source of serious subsequent psychopathology”.
The decade of 1975 would see the birth of movements to define trauma more broadly – according to Scheeringa, based on studies of questionable quality. “There have been many other attempts to define all kinds of stressful and non-life-threatening events as trauma, probably because PTSD has become so well accepted. Anyone trying to bring attention to their cause or publish an article could do a poorly designed study and find false positive PTSD cases for their stressful event,” says Scheeringa, for whom the concept of trauma has been politically hijacked.
“There is a very clear distinction between an adverse event, or stressful event, and trauma. Trauma is life threatening and stressful events are not. It’s not really a gray zone. Activists who are trying to broaden the definition of trauma to include non-life-threatening events are doing so to advance their agendas and get more attention and funding for their social programs,” says the expert.
The transformation was not restricted to a single term. According to a study published in 2016 by Australian psychologist Nick Haslam, other clinical and social psychology concepts such as “abuse”, “bullying” and “prejudice” have undergone major changes in the 40 years, the most important of which is absolute subjectivity. In other words, definitions of trauma, bullying or abuse no longer depend on objective criteria: it all depends on how the victim “felt”. With borders increasingly at the mercy of networks, it is not surprising that the hashtag #trauma has reached no less than 9.2 billion views on TikTok and that the coronavirus pandemic has foreshadowed a new “collective trauma”.
Where has resilience gone?
It is true that there is still much to be studied and understood about the psychological consequences of an event that not only claimed the lives of 6,27 millions of people around the world as it locked workers in their homes, drove children out of schools and drastically reduced the income of hundreds of millions of families. But, even so, in order to make an accurate diagnosis of the problem, it is necessary to differentiate the potentially traumatic events from the trauma itself.
“It is possible that a patient who developed sudden respiratory distress and unexpected and almost died because of it could have a life-threatening experience that causes post-traumatic stress disorder,” explains Scheeringa. “But all the other experiences caused by Covid – the mass lockdowns, working as a healthcare worker, etc – are not trauma. These are the stressors,” she explains.
“ Regardless of how the lockdowns played out, Covid undeniably disrupted our lives. But personally, I’m not going to equate this with a collective trauma. Collective trauma is much more serious. The Jewish Holocaust is the most recognized and researched collective trauma, and I feel that Covid and confinement do not equate to genocide, natural disasters or terrorist attacks.” interview with the report.
A striking example of how the impact of potentially traumatic events tends to be diluted over time for most people – without this implying that there are no victims with psychological sequelae severe – is extensively narrated by Bonanno in “The End of Trauma”: the terrorist attack on the World Trade Center on Sept. .
“The New York City Health Commissioner anticipated an imminent ‘public mental health crisis’. (…) City officials consulted trauma experts from across the country and ‘began to make preparations to train an army of volunteer therapists’ (…) But almost was everyone close to the attack doomed to suffer? Was post-traumatic stress disorder inevitable? For most mental health professionals at the time, the answers were a resounding yes”, reports the psychiatrist.
It turns out that the premeditated crisis never came. And, one year after the 11 in September, researcher Patricia Resick, director of the Center for Trauma Recovery at the University of Missouri, was one of the few voices to admit that the prophecies were “People’s expectations about the impact of the attack on the country’s mental health were wrong. The lesson? Strong emotions do not equate to psychopathology.”
“With so much attention to PTSD, it seems like we’ve over-corrected. (…) Trauma is no longer repressed. It now boldly asserts itself in the title of television series and video games, web pages and blogs. It is in the names of professional organizations and academic journals. (…) With all this trauma, what is or where has resilience gone?”, asks Bonnano.
The loss of faith in human resilience – already widely proven by science, as some of the world’s leading experts in the “psychology of happiness” attest in the praise of Bonanno’s book – this is perhaps the worst of the consequences of the unprecedented expansion of the concept of “trauma”, precisely because it makes access to adequate treatments difficult even for experiencing adverse experiences that do not fall into the category.
“If therapists and patients work on the assumption that some stressful events were traumas, when they are not, they mistakenly believe that patients’ symptoms were caused for these events. Many patients and therapists form a sort of collusion to find easy explanations for problems that don’t actually have simple solutions. When patients spend years with the wrong idea about the source of their problems, they may be wasting time in therapy”, explains Michael Scheeringa.
“In our brave new world overloaded with the indulgence of who play the poor thing, resilience is becoming less and less likely to be a genetic trait passed on to the next generation,” says Relojo-Howell, adding that there is also a lot of research indicating that whether the ability to face adversity is ” a trait influenced by a combination of genetics, personal history, environment and situational context”. So that there is no doubt, after all, that the praise of resilience is not a mere whim of those who have faced few bad weather, it is worth reminding the psychologist Viktor Frankl, who developed his therapeutic method while a prisoner in the Auschwitz concentration camp: “when we cannot change a situation, we are challenged to change ourselves.”
