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The word “trauma” is widely used to refer to an event that is experienced as threatening (physically or psychologically) and is damaging to a person’s psychological health and wellbeing. The level to which an event is experienced as threatening and damaging is completely dependent on the individual and their personal experience of the event.  Most people will experience something as traumatic within their lifetime.


Whilst most people have heard of the word trauma, you might not have heard of the terms ‘Big T’ and ‘Little t’ which are often used within psychological professions to understand different types of traumatic experiences.


Generally, the term ‘Big T’ refers to a specific (usually) single traumatic event that a person experiences as threatening.  Experiences that might fall into the Big T category are car crashes, sexual assaults, violent attacks, work accidents, acts of war, natural disasters, and near-death experiences.  When the brain experiences events as threatening it might struggle to fully process the event and, in an attempt to try and keep you safe, the brain might develop safety behaviours that you might experience as symptoms such as:


  • Struggles with sleep and nightmares

  • Flashbacks including images or re-living the experience

  • Intrusive thoughts about the event or even future events

  • Avoidance – making going out or facing issues anxiety provoking

  • Avoidance of feelings – even using drink or substances to manage emotions

  • Feeling tense and ‘on edge’

  • Struggling with emotions including outbursts of ‘anger’ or extreme lows of mood

  • Trouble focussing, concentrating and / or remembering

  • Reduced mood and motivation

  • Negative thoughts and feelings about yourself / others


If you are experiencing these symptoms after a traumatic event you might benefit from talking to a mental health professional and being assessed for post-traumatic stress disorder, often called PTSD.


Little t refers to highly distressing and disruptive experiences that are traumatic without being experienced as physically life-threatening. They are adverse events and struggles that people deal with throughout life that wouldn’t be classed as a single event trauma (BIG T).  Little t events can be invalidation in childhood (when a person's thoughts and feelings are rejected, ignored, or judged), bullying, loss and bereavement, ruptures to your early attachments, violence within the household, types of abuse including physical and psychological, divorce, rejection, infidelity, financial hardship, or even moving home and other life changes. Whilst Little t events are often negative experiences, they can include the lack of positive experiences. 


Little t events can include both early and later life experiences.  Early life events are often known as Adverse Childhood Experiences (ACE’s). Research has demonstrated clear links between ACES’s and neurodevelopment, social-emotional-cognitive development, attachments difficulties, and negative health outcomes later in life.  The impact of Little t events is very individual, and can depend on factors such as personality, age and perceived level of support.  Studies report a significantly higher risk for substance abuse, mental health issues, intimate partner violence, and a host of health issues after Little t events.


Sadly, Little t events can often be minimised and played down by others and in some cases the person can even be made to feel that they are the problem or that they should not be experiencing intense feelings about the events.   Little t events often don’t have a specific diagnosis such as PTSD as seen in Big T trauma, but they do often lead to other mental health problems such as depression, anxiety, complex trauma presentations and in some cases even personality disorders.


I understand how both Big T and Little t trauma events can have detrimental effects on your wellbeing and that they can generate unhelpful thought patterns, emotional responding, and behaviours even decades later.  The first stage to coming to therapy for trauma is developing a shared understanding of events that you have been experienced as traumatic and to understand how the past has impacted you as an individual.  We can then discuss how best to work together on the impact of the trauma in your life.  I am trained in a number of trauma focussed therapies and I have worked in trauma informed services within the NHS, so I am equipped to help you process and overcome the impact of past traumatic events.

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