According to Gabor Mate, trauma can be understood as a wound that hardens a person psychologically and interferes with the ability to grow and develop. It creates pain and out of the pain a person acts out. Trauma is not what happens to you but it is about what happens inside of you as a result of what happened to you. Trauma scars a person, making the person more rigid and defensive and less flexible and capable of feeling.

Bessel Van Der Kolk describes trauma as an event or experience that has a significant impact on the ‘survival’ or animal part of the brain. When trauma happens our danger signals become disturbed and we become ‘hypo’ (low) or hyper (high) aroused or numbed. We can regress into fear, aggression, or paralysis, resorting to primitive survival responses. Trauma changes the nervous system and alters how we assimilate memory and leaves us reactive anything that resembles the original experience. Symptoms of post-traumatic stress include severe anxiety, irritation and agitation, depression, hostility and distrust, fear and aggression, hypervigilance, numbness, lack of impulse control, self-destructive behaviours and risk-seeking, emotional detachment, avoidance, isolation, flashbacks and disturbed sleep. Repetitive and pervasive traumatic stressors that do not pose a risk to life impair a child’s development. Trauma is the inability to be in one’s body without being possessed by defences; it is the use of numbing to shut down experience, including the ability to feel pleasure and satisfaction. Resma Menakem describes trauma as anything that happens “too much, too fast, too soon, for too long”, coupled with an absence of what should have happened that didn’t.

Trauma is like a virus (Conti, 2021). As it harms one person, ‘it replicates and jumps to another’ p329). The impact of trauma can be similar to the impact of a virus like Covid-19: we wear masks to deal with people, keep emotional distance and avoid people who suffer its effects; we keep conversation shallow and brief. In responding to a virus, it is wise to become closed until a vaccine is available; in responding to a trauma pandemic, it is wise to become more open so that we become the vaccine. Trauma alters our brains – meanings, memories and thoughts – which makes it much harder to see the damage it causes. Trauma imposes isolation, which fosters more trauma.

Trauma can be understood as the sudden rupture of attachment bonds (De Zuleta, 2006). Abuse can be seen as a specialised form of rejection. Our need for others to sustain us physically and emotionally means that in their absence we become ill and depressed. At the root of our experience of early loss of the attachment figure is deprivation or ‘self-object loss’ and the resulting failure in attunement. In infancy the disruption or absence of this interactive experience is a key factor in creating neurophysiological changes that make us and other primates more vulnerable to aggressive or violent behaviour. This is the outcome of a damaged attachment system – a failure of attunement and deficiency in psychobiological regulation.

Post-traumatic stress disorder is a social disease that ripples across and down through generations (Bloom, 2013). The key to treating it is other people. Fragmentation is the hallmark of trauma and so integration is the essence of health. Traumatised people cannot put themselves back together again but with the help of others they can heal.