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How trauma became the word of the decade

The very real psychiatric term has become so omnipresent in pop culture that some experts worry it’s losing its meaning.

The word trauma appears in numerous cartoon fonts and is repeated over and over on a yellow background. Bráulio Amado for Vox

Part of the Memory Issue of The Highlight, our home for ambitious stories that explain our world.

A preeminent book on trauma, The Body Keeps the Score, rocketed to the No. 1 spot on the New York Times nonfiction paperback bestseller list in February 2021, at the start of the second year of the pandemic.

The Body Keeps the Score wasn’t a newcomer to the NYT bestseller list — though it was published in 2014, it crept onto the list in 2017, where it has remained for 168 weeks, selling almost 2 million copies worldwide.

Though it’s occasionally been dethroned — recently by bell hooks’ All About Love and, later, Joan Didion’s The Year of Magical Thinking in the wake of their deaths — it keeps rallying back to the top. Men’s Health named Bessel van der Kolk’s opus one of the best mental health reads of 2021. The singer Phoebe Bridgers declared it her favorite book. Maybe you’ve seen influencers pose with their copies.

The Body Keeps the Score is a part of the zeitgeist. Trauma is everywhere.

The Listen Notes podcast search engine lists more than 5,500 podcasts with “trauma” in the title. Trauma is on our screens, too: Grey’s Anatomy, Succession, Fleabag, I May Destroy You, Yellowjackets, and Station Eleven are just a few examples of shows whose characters are haunted by the past. The Matrix Resurrections features trauma therapy as a key plot point. In an essay last month, The New Yorker’s Parul Sehgal criticized what she called “the trauma plot” trope — essentially, when trauma discovery or revelation acts as the story payoff. “Dress this story up or down: on the page and on the screen, one plot — the trauma plot — has arrived to rule them all,” she wrote.

In a GQ profile last spring, Justin Bieber alluded to “trauma stuff” affecting his first year of marriage. The internet’s favorite yogi, Adriene Mishler, has a “Yoga for Post Traumatic Stress” class on YouTube. Trauma “therapists” (accredited and not) are there for you on color-coordinated Instagram grids, espousing views on triggers and flashbacks, and trauma “experts” (accredited and not) are on TikTok, too, posting 60-second skits about what trauma responses look like. The TikTok hashtags #traumadump and #traumadumping, a trend where creators describe their various traumas via sound memes or “story time” retellings, have a collective 31 million views. #Trauma has 6.2 billion.

Trauma is real, and can result in real disorders, though its meaning is ever-evolving. The DSM-5, the standard in American psychiatric diagnosis, currently defines it as “actual or threatened death, serious injury, or sexual violence,” either as a victim or a witness. Growing attention to the term has pushed forth a larger acknowledgment of the indirect and long-lasting consequences of violence, certainly overdue in American culture.

Some who study trauma, however, say current cultural references to the word have become a mess of tongue-in-cheek and casual mentions, mixed with serious confessions and interrogations of the past — of definitional misunderstandings and the absurd and the trivial and the profound and the sincere.

“Trauma is one of those words that can mean anything,” says Michael Scheeringa, a medical doctor, professor at Tulane University, and author of the upcoming book The Trouble with Trauma. “I was stuck in traffic: That was traumatic. My football team lost: That was traumatic. That’s the way it’s used in our culture.”

The word hasn’t simply been watered down, but adopted widely as a kind of cultural touchstone.

“‘I have trauma,’ just becomes like, ‘I’m depressed’ or, ‘I’m addicted to cookies,’” says Pamela Rutledge, a media psychologist. “It has become a popular idiom tossed around without meaning.”

While it may be tempting to point to the Covid-19 pandemic as the source of our growing interest in trauma — and certainly, it has been traumatic for many — trauma has been on the tips of our tongues for years. Over the past 18 years, Google searches for “trauma” have steadily risen, peaking in 2021. Books have caught onto that trend, too, with a boom in references to trauma since the 1980s. Many invoked the word after the Trump election, during the height of the Me Too movement in 2017, and in connection with the long history of killings of Black people by police, along with other major world events.

“This is not a mere terminological fad,” University of Melbourne psychologist Nick Haslam wrote in a Washington Post op-ed a few years ago. “It reflects a steady expansion of the word’s meaning by psychiatrists and the culture at large. And its promiscuous use has worrying implications.”

Trauma is everywhere, and it’s worth asking why.

“We speak of trauma incessantly these days.”

So wrote Murray M. Schwartz in a review of Trauma: A Genealogy in 2003. Schwartz was referring to the Catholic church scandal of the early aughts, but also pulled in September 11, 2001, for additional context, writing that the terror attacks “exacerbated the stretch marks of linguistic usage, but the problem of locating sources and meanings of overwhelming experiences and psychic dangers was felt urgently long before that disruptive day.”

Schwartz’s analysis might seem harsh, a kind of bullying finger-wagging akin to conservative eye-rolling about sensitive “snowflakes.” But Schwartz hints at the “elastic uses of loaded terms,” in a prescient way.

As a term, trauma is slippery. It can indicate a physical injury, an experience, or an emotional response to a horrific event. Derived from the Greek for “wound,” it’s still used today to describe physical injury in medical settings. The idea of trauma as psyche damage didn’t emerge until the late 1880s.

That’s not to say trauma wasn’t discussed before, at least in some form. Aberrations in behavior — such as flashbacks or what was considered “hysteria” — were often attributed to spirits, magic, or evil. In Herodotus’s writings of the 490 BC Battle of Marathon, he described an Athenian spear-carrier who lost his sight without having been wounded, a physical manifestation of the psychological strain of war.

Eventually, the field of psychology began to secularize matters of the mind and soul. As scholar Jill L. Matus wrote of this revelation, “[W]e no longer look to the priest or turn to theories of external possession; instead, we employ the discourse of memory to explain how, having been transfixed by some experience so overwhelming that it cannot be properly remembered, we have hidden and buried memory and knowledge deep within ourselves.” In 1889, the French psychologist Pierre Janet published the first scientific account of traumatic stress, “L’automatisme psychologique,” a work which was cited in Sigmund Freud’s 1893 paper on hysteria, a foundational work of trauma study.

Fast forward to World War I, when the British diagnosed soldiers with “shell shock.” Though patients were initially given treatment and disability pensions, it was eventually deemed a character defect of “undisciplined and unwilling soldiers,” van der Kolk wrote in The Body Keeps the Score. By WWII, interest in shell shock was piqued again, and detractors returned, too. General George Patton infamously slapped several soldiers suffering from “battle fatigue,” threatening one with a gun and calling another a “gutless bastard.”

By the time van der Kolk began working with Vietnam veterans in the late 1970s, he wrote, “there was not a single book on war trauma in the library of the VA. … At the same time, interest in trauma was exploding in the general public.” After being identified in veterans and in those responding to disasters (such as those who identified dead bodies at the 1978 Jonestown Massacre), post-traumatic stress disorder was added to the DSM-III in 1980. Over the next 14 years, DSM revisions placed more emphasis on the patient’s degree of distress rather than the objective severity of an event. The definition of the disorder also expanded to include those who didn’t just experience a traumatic event, but witnessed or even just heard of it.

As Americans emerged from the civil rights and women’s movements of the 1960s and ’70s, racial injustice, violence against women, and child abuse began to be viewed as traumas in their own right.

By the 1990s, terms such as “cultural trauma,” “collective trauma,” “historical trauma,” and “intergenerational trauma” were on the rise, particularly in connection to genocide, enslavement, and war.

The expansion of the term had an unforeseen side effect, however. “Trauma started to become an easy go-to narrative for mental health challenges,” says Janis Whitlock, a research scientist at Cornell University who studies mental health in adolescents.

It didn’t take long after researchers began to grasp the concept of trauma for the nation to reach a flashpoint: trauma as trend.

“Trauma” in its current usage has created a tidy framework within which to understand our lives and roles. The word evokes a narrative in which one is stripped of agency: An event happens to us, an aggressor attacks us, we are born into generations of suffering. In this telling, we are powerless. Our minds protect us, or our memories get stuck, or our behavior changes — and it’s beyond our control.

“The trauma narrative became a very easy one to adopt, even for the people who didn’t have what we would call a lot of trauma,” Whitlock says. “It has currency, so people broker in it.”

Whitlock began hearing trauma used to describe more universal, upsetting experiences about 15 years ago, as she was conducting interviews for a self-injury study among youth. It was the heyday of Myspace and LiveJournal, when “for one of the first times, we went all in online,” she recalls. “People were sharing their lives, candidly.” That included posting about mental health and personal struggles. “One of my participants talked specifically about how she perceived a hierarchy of trauma,” Whitlock says. “There was a sense of, the worse your trauma is, the more justified your mental health challenges.”

Scheeringa also marked 2005 as a turning point — the dawn of a new, controversial understanding for trauma in the research realm. Complex PTSD — defined as a type of PTSD caused by repeated harmful events, such as childhood abuse — was being pursued by Scheeringa’s colleagues in a way he says he felt “wasn’t following the evidence.” Essentially, relying on ideas that trauma rewired the brain, “saying we think it not only causes PTSD, it can change your neurobiology permanently,” he says. “This is what I expected in Hollywood movies and in popular culture, but I didn’t really expect it from my colleagues.”

Much of this research pointed to brain scans of traumatized people, which show abnormalities in the brain, including the amygdala, the part of the brain responsible for evaluating danger. Yet, to truly understand if trauma changes brain structures, longitudinal studies must prove that there weren’t pre-existing neurobiological differences. Scheeringa argues that there’s still way more research to be done.

Regardless, the idea has stuck among people who have endured hardships — or are just drawn to the idea. As Scheeringa says, “At the individual level, patients say, ‘I believe in complex PTSD because it helps me, that explains things for me.’”

Can an event be harmful and damaging, have consequences and even change the way we live, without also being traumatic? Some experts speak of “big-T” versus “little-t” trauma to differentiate, but that might not be going far enough.

I began reporting this story open to the idea that, perhaps, we are all traumatized. Then I read The Body Keeps the Score, which chronicles the stories of patients van der Kolk has seen in his decades of work. This includes, but is not limited to, survivors of child sexual abuse, perpetrators of war crimes, and a woman who woke up in the middle of surgery and couldn’t move but felt every incision. His examples are at turns sobering and horrifying, making it clear what constitutes trauma and what it looks like to be traumatized.

Van der Kolk also disagrees with the idea that all “traumatic” events are universally traumatizing. As he tells it in The Body Keeps the Score, the young son of his friend had just been dropped off for school on September 11, 2001, when the chaos broke out. The school looked directly on the Twin Towers and the students watched through the classroom window as the terrorist attacks unfolded. Witnessing September 11 certainly qualifies as a traumatic event: Frightening, life-threatening, shocking, and unexpected. Yet, van der Kolk wrote, the boy was not traumatized. His family supported him. He integrated the day into his larger story of himself, and of greater possibilities.

Twenty years later, plenty of headlines have suggested that we’re suffering from mass trauma from the Covid-19 pandemic. Isn’t the alienating isolation, uncertainty, and fear traumatizing? As van der Kolk told the Atlantic, “When people say the pandemic has been a collective trauma, I say, absolutely not.”

Excluding extraordinary circumstances, such as working on the frontlines as a doctor, “that speaks less to being victimized, more to the sense of overwhelm,” Whitlock says. “It’s more than we can process, it makes us feel small and helpless.” There’s a great difference, then, between feeling distress and being disordered. “What we’re lacking is a language nuanced enough to capture the experience we’ve collectively and individually had,” she says. “We need new glossaries to describe the human experience.”

To Scheeringa, trauma is strictly the result of a singular and unexpected life-threatening event. These days, however, many people are operating off the definition of trauma as laid out by Rutledge: “that your way of understanding the world has changed.”

By relying on trauma to understand our modern lives, we’re undercutting the very real impacts of stress and overwhelm. We’re flattening all hardships, conflating the horrific and life-shattering with the merely unpleasant. “Using the word ‘trauma’ turns every event into a catastrophe, leaving us helpless, broken and unable to move on,” Haslam wrote.

What of awareness? Doesn’t increased visibility push the traumatized to seek help? Perhaps. “It does mean that, in some capacity, people are aware that an experience can have negative consequences beyond just feeling bad in the moment,” Rutledge says, though it might be unhealthy for those suffering from trauma to meme-ify their experiences. “You’re not processing it,” she says, “you’re just advertising it.”

Misrepresenting trauma could also “stop a good portion of people from getting the right type of treatment for PTSD,” Scheeringa says. And, he says, signal-boosting unproven or bunk research “harms our science — when people think that scientists aren’t speaking truth, they stop respecting and listening to them.”

Our inclination to generalize trauma speaks to a commendable desire to recognize the complexity of the human experience. “There’s a golden opportunity for our own self-awareness and awareness of others and how humans work,” Whitlock says. Tightening the definition of trauma doesn’t take anything away from terrible personal experiences, the horrors of history, or the difficulty of being alive within our current social structures. It doesn’t limit our capacity for empathy or undercut the need to recover from tragedy, crises, or challenges. It doesn’t ignore the truth of violence and existential horror — though it does recognize that there can be consequences without there necessarily being trauma.

Perhaps, as Scheeringa says, “we’re not as fragile as we think.”

Lexi Pandell is a writer from Oakland, California. Her nonfiction work has been published in the Atlantic, the New York Times, Wired, and elsewhere. She last wrote about our brains and obsession for the Highlight.

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