Understanding Trauma and Finding a Path to Healing

What makes an experience traumatic?

“I am orange juice and thick soup gone sour. I am roses and lilies crawling with insect eggs. I am the North Star in a brilliantly lit city: clearly there, yet seen by no one and needed by no one.”

In Fang Si-Chi’s First Love Paradise, Fang Si-chi writes these words after being sexually assaulted by a teacher at a tutoring school. Her story eventually ends in psychological collapse and devastation. The novel draws on author Lin Yi-han’s own experiences; the account of her life connects that sexual trauma with the depression she developed and her eventual death by suicide. Sexual assault is among the most severe forms of trauma.

Trauma has long been a major concern in psychology and psychiatry because of the serious psychological difficulties it can bring. These include post-traumatic stress disorder, or PTSD, acute stress disorder and developmental trauma disorder.

For someone with PTSD, the past may intrude through unwanted images and memories that return repeatedly. Reminders of the event can cause distress and become things to avoid. Changes in thinking and mood may include depression, excessive self-blame, persistent negative expectations and ongoing negative emotions. Changes in arousal can include anxiety and heightened vigilance. Together, these symptoms can cause substantial physical and psychological suffering and impair relationships, work and other important parts of life.

But what kinds of events lead to trauma? The answer depends partly on the person experiencing them. The event alone does not tell us everything about its impact.

During the COVID-19 pandemic, for example, some people experienced intense loneliness, anxiety and panic that profoundly disrupted their lives. Others experienced the same broad circumstances mainly as an inconvenience, without marked physical or psychological changes.

Age also matters. Early experiences play a particularly important role in long-term health and development, and childhood trauma can have deeper, more enduring effects than trauma experienced later. The care a child receives helps shape adult patterns of relating to others. Children who experience abuse may even find themselves drawn toward abusive relationships later, making early intervention especially important.

The nature of the experience matters, too. Research cited in this discussion distinguishes war, non-interpersonal trauma such as natural disasters and serious accidents, and interpersonal trauma such as domestic violence, murder and sexual assault. It identifies interpersonal trauma as causing more severe psychological harm among these categories.

Perry describes trauma in terms familiar to most people: a terrible event or experience whose shadow does not lift. It is not forgotten, and its effects can continue long afterward.

Why the past can feel present

Understanding trauma’s lasting influence requires looking at both the individual and the surrounding social world.

A simplified physiological framework describes four interconnected brain regions: the brainstem, diencephalon, limbic system and cerebral cortex. Moving from the lower regions upward, their structures and functions become increasingly complex—a relationship that can be pictured as an inverted triangle.

Within this framework, traumatic experiences deeply imprint stress responses in lower brain regions. When something resembles an earlier danger, those responses can activate before the higher processing systems have had time to assess what is happening.

A soldier who survived gunfire may react to exploding firecrackers. Someone who survived a serious car crash may react to a car horn. Before the cerebral cortex has finished processing the sensory information and distinguishing the present situation from the earlier threat, the person may already have acted to protect themselves. A response that seems out of place now can begin as an attempt to avoid a danger learned in the past.

Another explanatory image is the “reward bucket.” Each day, we seek experiences that activate the brain’s reward pathways. In this model, that activation must reach a minimum level before we feel satisfied and at ease: our reward bucket needs to be filled. The account calls this threshold a stress-response baseline.

A healthy mix of rewards might include positive interactions with other people, a healthy daily rhythm, work that aligns with personal values and a satisfying sex life. When these sources of satisfaction are missing, unhealthy ways of seeking reward, such as substance dependence or binge eating, become more likely.

The model describes people who have experienced trauma as generally having a higher stress-response baseline, requiring more stimulation to feel pleasure and satisfaction. That can make unhealthy reward patterns more tempting. Without supportive relationships and social support, the pattern can become a vicious cycle.

Trauma also has a social context

The social environment affects vulnerability to trauma, especially in children. When a group faces entrenched stereotypes and prejudice, institutions can compound the harm its members experience.

The discussion points to North America, Australia and New Zealand, describing how Black, brown and Indigenous children are more likely to be overdiagnosed and medicated in mental health settings, removed from their homes into child welfare systems, and suspended or expelled from school. It links these experiences to substantially higher rates of juvenile offending. Reducing prejudice and creating opportunities for healing within social systems are therefore essential parts of supporting people who are vulnerable to trauma.

At the same time, as more of life moves onto electronic devices, direct interaction between people diminishes. We can become impoverished in our relationships, with fewer strong sources of support. When emotional connections are interrupted, we become more vulnerable. Isolation and loneliness have become an epidemic, making it harder to respond to trauma in healthy ways.

Finding a way toward healing

Trauma is painful, but experiencing it does not mean a person must remain trapped in that pain. The brain’s adaptability and plasticity leave room for change.

By exploring the question “What happened to you?”, many people have learned to distinguish their past experiences from who they are today. They have found resilience and reclaimed a sense of control over their lives. Oprah is one recognizable example among countless people making that journey.

Professional approaches to trauma include medication and psychological treatment, such as trauma-focused cognitive behavioral therapy, or TF-CBT, and eye movement desensitization and reprocessing, or EMDR. Other approaches include movement-based gaming interventions and animal-assisted therapy. These are among the answers offered by psychiatrists and therapists. Relationships and rhythm also have an important place in recovery.

Connection that helps carry stress

Our connections with others are central to buffering the pressures we face. Returning to the image of the reward bucket, positive relationships are an important part of building resilience.

Love can hold people together. Seeking out supportive family members and friends, and finding warm, inclusive groups where support is available, can be important parts of healing.

A rhythm the mind and body can return to

Rhythm matters to both physical and mental health throughout development. When we feel out of step, anxious or low, we each have ways of trying to regulate ourselves. Some people exercise; others immerse themselves in work. One element these activities can share is rhythm.

After trauma changes the stress-response system, finding equilibrium can become exhausting. A stable rhythm of daily life can help build the brain’s regulatory networks.

Persistent avoidance of conversations related to trauma does not remove its underlying effects. Controllable, predictable and moderate challenges can strengthen core regulatory networks—but the dose matters. The intensity of a challenge is an essential part of whether it can help.

Care for the person doing the healing

Everyone facing trauma has the possibility of healing. Whether you are recovering from your own experiences or supporting someone close to you, caring for yourself matters throughout the process.

You are the principal resource for making change in your own life. We have more strength than we often imagine.

Everything we have experienced helps shape how we live now. To some extent, even trauma and adversity can become a gift: hardship, challenge, despair, loss and trauma can deepen empathy and help a person grow wiser.

Asking what happened, recognizing the trauma and facing it is a first step toward healing. Every person’s existence carries its own meaning. What you have lived through will, in time, become part of your strength.