Marital rape, for example, was long not even acknowledged as an offence. Second, recognising the variety of behaviours that can cause trauma has allowed us to seek protection for people from these behaviours, which might not have been recognised as harmful in the past. It is difficult to understand and treat something that remains unacknowledged.
First is the recognition it provides trauma victims who might have hitherto found it difficult to name their experiences and acknowledge the impact. This work is not as simple as concluding: ‘You have anxiety after a difficult experience, ergo you must be traumatised’Ī broadened conception of trauma clearly has some key benefits. ‘When meaningful expansion occurs,’ they write, ‘a concept is altered in a thoughtful way to include new behaviours in new contexts,’ which ‘points toward constructive strategies for harm reduction.’ Michele Cascardi and Cathy Brown have provided a somewhat contrasting view, arguing that the broadening of our understanding of certain psychological concepts often constitutes a meaningful expansion. He notes that concepts that refer to negative aspects of human experience (such as bullying and prejudice) have expanded over time to capture less harmful variants of the same behaviour, as well as qualitatively new phenomena. The psychologist Nick Haslam suggests that the changing meaning of trauma is underpinned by what he calls ‘concept creep’, reflective of increasing liberalisation of society and a greater focus on moral harms. And with the expansion of ways in which the term ‘trauma’ is used, there are also concerns that it is now being overused. There are a number of potential reasons why the conception of trauma has widened. The concept of trauma has also been expanded such that witnessing a traumatic event as part of work might qualify one for a diagnosis of post-traumatic disorders, lending recognition to concepts such as the vicarious traumatisation experienced by professionals such as first responders. When traumas compound or occur at key developmental ages, a person may develop complex post-traumatic stress disorder (C-PTSD), which involves difficulties related to a person’s self-concept, emotional development, thinking and interpersonal functioning.
We now also know that events that are not directly life-threatening, including behaviours such as emotional abuse, financial abuse, bullying and neglect, can lead to post-traumatic reactions and responses. There has been easy recognition that a range of experiences, such as exposure to war, assault, rape and anything else that involves a disturbing and life-threatening event can lead to post-traumatic difficulties. Since the time PTSD first entered the diagnostic lexicon, our conception of trauma – including the causes of traumatisation and how it manifests – has grown more encompassing. PTSD is one of the most well-known mental health conditions arising after trauma, with symptom clusters of trauma intrusions (such as flashbacks and nightmares), avoidance (of memories of the trauma), emotional and cognitive changes (such as persistent negative emotions or distorted beliefs about oneself or others) and changes in arousal and reactivity (such as hypervigilance). Later, a collection of frequently observed after-effects of trauma were reconceptualised as post-traumatic stress disorder (PTSD). In the early 20th century, clinicians recognised manifestations of trauma in soldiers, using terms such as ‘shell shock’ and ‘war neurosis’. Historically, much of the clinical thinking about trauma has taken a narrow view, assuming that trauma (derived from the Greek for ‘wound’) necessitated the infliction of physical wounds and harms. The conceptualisation of trauma has changed significantly over time. Abuse and trauma can have far-reaching impacts, sometimes making life itself feel so painful as to be untenable. Like self-harm, skipping school, getting impulsive tattoos and all kinds of other unconscious, self-destructive, maladaptive coping mechanisms.’ Her statement will leave clinicians working in the field of trauma nodding, familiar as we are with the darker and more destructive impulses trauma can engender. As the sexual abuse survivor Grace Tame, winner of the 2021 Australian of the Year award, recently said, we must have an ‘open and honest discussion about trauma and what that can look like. The concept of trauma now permeates our zeitgeist like never before, with a growing awareness of both the range of events that can be considered traumatic and the tendrils of harm that trauma can send into the lives of victims.