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THE THREE “E’S” OF TRAUMA: EVENT(S),
EXPERIENCE OF EVENT(S), AND EFFECT
shattering a person’s trust and leaving them feeling
alone. Often, abuse of children and domestic violence
Events
are accompanied by threats that lead to silencing and
and circumstances may include the actual
fear of reaching out for help.
or extreme threat of physical or psychological harm
(i.e. natural disasters, violence, etc.) or severe,
How the event is experienced may be linked to a
life-threatening neglect for a child that imperils healthy
range of factors including the individual’s cultural
development. These events and circumstances may
beliefs (e.g., the subjugation of women and the
occur as a single occurrence or repeatedly over
experience of domestic violence), availability of
time. This element of SAMHSA’s concept of trauma
social supports (e.g., whether isolated or embedded
is represented in the fth version of the Diagnostic
in a supportive family or community structure), or to
and Statistical Manual of Mental Disorders (DSM-5),
the developmental stage of the individual (i.e., an
which requires all conditions classied as “trauma and
individual may understand and experience events
stressor-related disorders” to include exposure to a
differently at age ve, fteen, or fty).
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traumatic or stressful event as a diagnostic criterion.
The long-lasting adverse effects of the event are a
The individual’s experience of these events or
critical component of trauma. These adverse effects
circumstances helps to determine whether it
may occur immediately or may have a delayed onset.
is a traumatic event. A particular event may be
The duration of the effects can be short to long term.
experienced as traumatic for one individual and not
In some situations, the individual may not recognize
for another (e.g., a child removed from an abusive
the connection between the traumatic events and
home experiences this differently than their sibling;
the effects. Examples of adverse effects include an
one refugee may experience eeing one’s country
individual’s inability to cope with the normal stresses
differently from another refugee; one military
and strains of daily living; to trust and benet from
veteran may experience deployment to a war zone
relationships; to manage cognitive processes, such
as traumatic while another veteran is not similarly
as memory, attention, thinking; to regulate behavior;
affected). How the individual labels, assigns meaning
or to control the expression of emotions. In addition
to, and is disrupted physically and psychologically
to these more visible effects, there may be an altering
by an event will contribute to whether or not it is
of one’s neurobiological make-up and ongoing
experienced as traumatic. Traumatic events by their
health and well-being. Advances in neuroscience
very nature set up a power differential where one
and an increased understanding of the interaction
entity (whether an individual, an event, or a force of
of neurobiological and environmental factors have
nature) has power over another. They elicit a profound
documented the effects of such threatening events.
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question of “why me?” The individual’s experience of
Traumatic effects, which may range from hyper-
these events or circumstances is shaped in the context
vigilance or a constant state of arousal, to numbing
of this powerlessness and questioning. Feelings of
or avoidance, can eventually wear a person down,
humiliation, guilt, shame, betrayal, or silencing often
physically, mentally, and emotionally. Survivors of
shape the experience of the event. When a person
trauma have also highlighted the impact of these
experiences physical or sexual abuse, it is often
events on spiritual beliefs and the capacity to make
accompanied by a sense of humiliation, which can
meaning of these experiences.
lead the person to feel as though they are bad or
dirty, leading to a sense of self blame, shame and
guilt. In cases of war or natural disasters, those who
survived the traumatic event may blame themselves
for surviving when others did not. Abuse by a trusted
caregiver frequently gives rise to feelings of betrayal,