Written by Samantha Carter
Therapy Unboxed, a therapist-led podcast and YouTube series, was designed to “unbox” or illuminate some of the common themes explored throughout mental health treatment. Led by clinical psychologist Lana Seiler, the first episode of this series explores a brief history of trauma within the mental health field and how to best understand it today.
Throughout the episode, Lana offers hope to anyone who’s experienced trauma as well as some starting points for healing. To learn more about what an experienced therapist has to say about the matter, check out the full podcast episode or continue reading the article below.
What is Trauma?
Lana reiterates her preferred definition of trauma several times throughout episode one of Therapy Unboxed.
“I get asked a lot what the definition of trauma is,” Lana said. “While there are many out there, my favorite is anything that overwhelms our ability to cope.”
However, Lana explains why we first need to explore trauma from a historical context in order to better understand how it is thought of today.
“There’s a lot of information out there, and I encourage anybody who’s interested to get online and do some research because the journey to where we are now has been an interesting one,” Lana said.
A Brief History of Trauma in Mental Health Treatment
Diving into the history, Lana begins to illuminate some of the key points that have contributed to our modern understanding of trauma. These historical markers have been summarized in the sections below.
Freud Develops Psychoanalysis – 1890s-1930s
In the late 19th and early 20th centuries, Sigmund Freud revolutionized the field of psychology with his theory of psychoanalysis. Freud’s work was one of the earliest attempts to systematically understand the human mind, particularly how early life experiences involving trauma affect mental health throughout adulthood.
Freud believed that repressed memories and unconscious conflicts – often rooted in childhood – were the primary causes of psychological disorders. His focus was largely on early attachment relationships with caregivers and the psychological impact of disturbances from these formative bonds.
Freud’s theories laid the groundwork for understanding trauma in a psychological context, particularly how unresolved or unconscious trauma could manifest in symptoms like anxiety, hysteria, and depression.
Though we have moved beyond some of Freud’s more controversial ideas, his focus on early childhood trauma has had a lasting impact and continues to inform therapeutic approaches today.
The Evolution of Understanding the Trauma of War (Civil War – Present Day)
War has also been a historical catalyst in the understanding of trauma, as soldiers and civilians alike were exposed to extreme violence, loss, and psychological distress. However, war trauma has not always been understood or accepted.
During the U.S. Civil War (1861-1865), soldiers who experienced significant mental distress were often thought of as personally weak. Terms like “soldier’s heart” and “nostalgia” were used to describe what we now recognize as trauma-related conditions. At that time, mental health issues stemming from war were viewed as moral failings or frailties of character, rather than legitimate psychological conditions.
As warfare evolved and the violence of World War I introduced new forms of devastation, the understanding of war-related trauma began to shift. The term “shell shock” emerged to describe the psychological impact of exposure to heavy artillery and the horrors of trench warfare. This marked an important step in the recognition that trauma was not merely the result of individual weakness, but rather a reaction to external events. However, treatment options remained limited, and the understanding of trauma was still in its infancy.
By World War II, the term “combat fatigue” or “battle fatigue” was introduced, reflecting the growing awareness of the psychological toll of war. However, it wasn’t until the aftermath of the Vietnam War that the mental health field began to fully recognize trauma’s long-lasting effects on soldiers.
The unique challenges faced by returning veterans—such as flashbacks, nightmares, and emotional numbness—helped to shape the growing understanding of trauma as something that could severely impact a person’s ability to function even after the traumatic events had ended.
Attachment Theory – 1940s-1950s
In the 1940s and 1950s, British psychologist John Bowlby expanded the understanding of trauma with his development of attachment theory. Bowlby believed that the bonds formed between a child and their primary caregiver had profound effects on emotional and social development.
If these bonds were disrupted or insecure—due to neglect, abuse, or separation—the child would be at higher risk for emotional distress and difficulties later in life. Bowlby’s work emphasized that early attachment-related trauma could have lasting effects, mirroring Freud’s earlier ideas about the importance of early childhood experiences.
Mary Ainsworth, a developmental psychologist, further advanced attachment theory with her “Strange Situation” experiments in the 1970s, categorizing different types of attachment, including secure and insecure forms. These studies demonstrated how attachment patterns in infancy could influence emotional regulation and resilience in adulthood.
Bowlby and Ainsworth’s work deepened the understanding that trauma, particularly relational trauma, has far-reaching implications for mental health. The idea that disruptions in early attachment could lead to long-term psychological issues helped pave the way for trauma-focused therapies in the future.
1979 – NAMI Was Created
In 1979, the National Alliance on Mental Illness (NAMI) was founded in the U.S. This marked a significant shift in the approach to mental health, including trauma treatment. NAMI was created by a group of families affected by mental illness who advocated for better support and understanding of mental health conditions, including recognizing the role that trauma plays in mental health disorders.
One of NAMI’s key contributions was its emphasis on the biological components of mental illness. While earlier theories focused predominantly on environmental and psychological factors, NAMI pushed for a broader understanding that combined biology, environment, and trauma. Therefore, this organization played a significant role in breaking down stigma and advocating for more research and funding for conditions related to trauma.
1980 – American Psychiatric Association Defines First PTSD Diagnosis
The inclusion of Post-Traumatic Stress Disorder (PTSD) in the DSM-III in 1980 was a groundbreaking moment in the history of trauma and mental health treatment. This was the first time that trauma-related disorders were formally recognized in a clinical setting, marking a shift in how both the medical and mental health communities understood trauma.
Prior to this, trauma was often seen as a result of individual vulnerability rather than something caused by external events. By defining PTSD, the American Psychiatric Association acknowledged that traumatic experiences, such as combat, natural disasters, or severe accidents, could have a profound and lasting impact on mental health. This was a major step forward, as it shifted the understanding of trauma from being seen as a character flaw or personal weakness to being recognized as a psychological wound caused by external circumstances.
The DSM-III’s definition of trauma was initially limited to “big” traumatic events, such as combat or disasters. However, the formal recognition of PTSD helped create a framework for studying trauma in more detail, leading to a deeper understanding of its prevalence and the development of effective treatments like cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR).
Today: DSM Recognizes Multiple Types of Trauma
Today, our understanding of trauma has evolved considerably, and the DSM now recognizes multiple types of trauma, not just the large-scale events that were originally the focus. Trauma is now defined more broadly, acknowledging that anything that overwhelms a person’s ability to cope can be classified as a traumatic experience. This expanded definition includes not only combat and disasters but also childhood abuse, neglect, sexual assault, domestic violence, and even chronic stressors like discrimination or poverty.
The field of trauma treatment has advanced significantly since the 1980s. Therapists now recognize that trauma can be either acute (from a single event) or complex (from repeated, prolonged exposure to traumatic situations). There is also a growing understanding of the impact of developmental trauma, which includes experiences like childhood neglect or parental abuse that can disrupt healthy emotional and psychological development.
Not an Exhaustive History
Lana explains how this is not an exhaustive history on the development of trauma within the mental health field. As such, she encourages anyone who is interested to do further research on the topic. While it can be helpful to take a look at the bigger picture, it’s important to recognize that it would be difficult to outline this sort of comprehensive history in a single podcast episode or blog post.
Three Common Misconceptions About Trauma Today
Another important topic of discussion when it comes to trauma is breaking down misconceptions. In episode one of Therapy Unboxed, Lana dives into three common misunderstandings when it comes to trauma.
Misconception #1: Trauma Occurs From Singular, Significant Events
Even though the mental health field is finally catching up to the idea that trauma can occur from a series of complex events, that doesn’t yet mean it’s common knowledge.
“One of my mentors uses a wonderful analogy about this,” Lana said. “If I was standing next to a wall and I wanted to do some damage to that wall, I could take a sledgehammer to it and there’d be this giant hole. But, if I wanted to do damage to that wall in a different way, I could also take sandpaper to it for five years and there would be a giant hole. And what that’s sort of illustrating is the things that we would describe as ‘little-t-traumas.’ I really don’t like that categorization. Little-t-traumas are relational and things that seem like smaller ruptures in relationships in our early life experiences. But, it’s the chronic quality of these experiences that makes it like the sandpaper to the wall.”
Misconception #2: You Can’t Heal From Trauma
Another misconception that Lana explores is this idea that you can’t heal from trauma.
“We really can do some pretty significant healing,” Lana said. “I like to use a wound analogy. If we get injured and we don’t treat the injury, it’s likely to get infected. Then, we have to deal with the secondary issue of the infection. But if we do treat it, the wound heals. Worst case scenario, we end up with a scar. And I think that’s really a good way to look at trauma therapy because you’re going to be potentially different – we’re changed by things that happen in our lives – and we can say that’s sort of like a scar, but we don’t have to live with secondary infections, so to speak. We don’t have to live with trauma really popping up in our lives and causing major havoc if we do the work to heal.”
Lana continues to challenge the way listeners choose to think about trauma while expanding on this point a bit. “Trauma’s something that we end up having a relationship with after it’s healed,” Lana said. “So similarly to the wound analogy, the scar would be our relationship to the trauma after it’s over. But those things are manageable.”
Misconception #3: “If I Open the Box, I’ll Never Be Able to Close It”
Finally, Lana speaks to a common misconception about trauma and mental health treatment that she engages with regularly throughout her practice.
“I hear a lot of people say, ‘If I open that box, I’m never going to be able to close it again; if I start to feel about something, I’m never going to be able to stop that feeling,’” Lana said. “People tend to be really fearful to talk about the difficult, painful things – to revisit this stuff – because there’s a fear that once we do, there’s no going back. And I completely can validate and understand how scary that feels. But as someone who does this all day every day, I can say that we certainly can close that box back up and we can learn how to feel safely.”
Shifting the Way We Think about Trauma
In addition to debunking some common misconceptions about trauma, Lana also goes over some frequent ways that people avoid discussing trauma or dismissing its existence altogether.
“Sometimes people have some pushback or resistance to looking at and working on their trauma,” Lana said. “One of the things I hear a lot is, ‘Well, whatever doesn’t kill me makes me stronger. We need stress in our lives. We need anxiety. If we never had any adversity, we wouldn’t grow.’ And that’s entirely true. We do need stress. We do need to have some adversity in our lives, even starting from a young age. If things are too easy, we don’t learn how to pick ourselves back up. So when people say that to me, I agree with them, 100%. However, I don’t necessarily agree with the statement that ‘what doesn’t kill us makes us stronger.’”
Lana goes on to explain how things are a lot more complex than this cliche phrase she so often interacts with.
“Whether or not things make us stronger depends heavily on our ability to cope,” Lana said. “The truth is, most of us don’t learn a ton of healthy coping skills from our family systems. When things happen that are adverse or challenging, we have to consider that person’s ability to navigate and manage the situation when we look at whether that thing is traumatic. So what’s traumatizing to a three-year-old is very different than what’s traumatizing to a 30-year-old and that goes both ways. If we’re three and our parents leave us for a couple of days, that’s incredibly traumatic. When we’re 30, it’s a very different experience. That’s why it’s not helpful to compare something that may be traumatic to me and overwhelm my ability to cope as it may not traumatize someone else or overwhelm their ability to cope.”
Dissecting Complex Trauma
Because trauma is so nuanced and particular to the individual involved, Lana highlights the importance of understanding complex trauma, a more recent term in the world of trauma development and understanding.
“So when we talk about these relational, sort of more chronic ways, that we can have trauma in our lives, there’s a term – ‘complex PTSD’ – that people use a lot to define it,” Lana said. “Sometimes we come into a world that’s not able to attend to our needs completely. We come into a world of parents who have their own trauma, their own struggles with substance use, or poverty—there’s many, many, many factors that go into a less than ideal early life environment. I’m not here to villainize anybody. Intentions are usually the best. But oftentimes, the impact can be challenging for little ones coming up in a scary and unpredictable world.”
Some people might think, Ok, so what? It already happened and I can’t change it. Why does it matter now? However, Lana makes an interesting point to consider.
“These things really set us up to experience the world and the rest of our lives with that same tape that’s outdated,” Lana said. “We may have a more developed understanding of ourself and safety, but those tapes continue to play. The, ‘I’m not good enough, I can’t ask for what I need, I’m going to fail,’ core-belief-tapes keep playing and that’s a big piece of complex PTSD and complex trauma.”
The Importance of Addressing Trauma and Early Life Experiences
Going back to Lana’s earlier misconception about how trauma can’t be healed, Lana explains how working to overcome this kind of trauma can greatly improve one’s life.
“People can significantly change the way they walk through the world, getting a handle on what these outdated tapes are and how to reprogram them. This really allows us to walk through the world without having what I call ‘landmines.’ When we don’t take care of these traumatic experiences, we can walk through the world potentially stepping on something that could trigger us and cause disruption in our lives. And the more we can really dismantle those landmines and defuse them, the safer we really are in our lives.”
Ultimately, Lana believes that looking at early life experiences is a crucial aspect of both understanding and treating trauma.
“We really have to go all the way back to the beginning, back to the Freud, Ainsworth, and Bowlby and the attachment theorists to really bring in attachment injury to the developmental trauma arena,” Lana said. “These things go hand-in-hand. I mean, attachment injury is essentially relational trauma, so we can’t really have this conversation without including that concept—looking at ruptures in our early life relationships and then subsequently ruptures in our primary adult relationships. We know from tons and tons of research that people are healthier, live longer, and have more fulfilling and productive lives if we can have safe, secure attachments with people. So, this is huge.”
Healing Is Possible
Having studied and treated trauma for many years, Lana wants her listeners to understand one important thing.
“Addressing trauma is something that I think can really make a significant difference in people’s mental and behavioral health,” Lana said. “And healing is possible.”
Not only is healing possible, but Lana points out how people can come out of traumatic experiences with a level of resilience that leads to deeper meaning and connection.
“Post-traumatic growth is real,” Lana said. “Whatever doesn’t kill us doesn’t necessarily make us stronger, but getting through it does. People who are able to make it through traumatic experiences and are brave enough to get the help they need can come out the other side with some strengths and viewpoints that are even more helpful and evolved than before. So I just want to also give people some hope. Yeah, trauma can really take us out at the knees, but working through it can build us into people who can be super resilient and compassionate and connect deeply with others in the world.”
To finish out the podcast episode, Lana offered some helpful information for anyone thinking about seeking trauma treatment.
“If you’re interested in doing some trauma work for yourself or for someone that you love, make sure that you find a clinician who has some post post-graduate training in trauma work,” Lana said. “Specifically, they should have experience with some type of reconsolidation method as well as a really good understanding of resourcing and the relational complications of dealing with trauma.”
If you’re interested in learning more about All Points North and our addiction, trauma, and mental health recovery programs (where Lana works), submit our confidential contact form or call us at 855.934.1178 today. You never know how good your life can get when you allow yourself to receive the gifts of healing.
More From Therapy Unboxed
Listen and watch the first episode of Therapy Unboxed below, and find more episodes on YouTube, Spotify, and Apple Podcasts.
