The Impact of Big T and little t Trauma

October 05, 2021

Written by Kevin Marra, MD, Director of Medical Services 

Trauma can describe a certain stressful or disturbing event. Trauma can also describe the effect such an event has on a person’s physical and emotional health.

Big T Trauma

Most of the time, when people think about a traumatic event, they think about a car accident, war, natural disaster or death. In the mental health field, these traumas are referred to as “big T” traumas, as they refer to events that are life-threatening.

Little t trauma

"Little t" traumas are events or circumstances that, in general, may not be viewed by society as traumatic or meet diagnostic criteria, but still have a profound negative effect on those who experience them.

Little t trauma examples include a divorce, a difficult move, a hard break-up or financial trouble.

How Trauma Affects the Brain

Experiencing any kind of trauma, whether it be a “big T” trauma or “little t” trauma can impact how the brain functions. Trauma conditions the brain to react to reminders and cues about the event as a way to stay safe. The hippocampus, amygdala and prefrontal cortex are specific areas of the brain that are impacted and can even experience prolonged change. In most people, the stress response shuts off when the trauma is over, but in some cases the stress response does not know when to quit. This leads to the repeated release of stress hormones and can cause symptoms of PTSD, like hypervigilance, anger and difficulty sleeping. These lasting changes in the brain in turn impact someone’s daily functioning, including their mental and physical health.

Trauma vs PTSD

The reality is many people will experience some kind of traumatic event during their life, but it is important to know that not everyone develops Post-Traumatic Stress Disorder (PTSD) simply because they experienced a trauma. When researchers look at traumatic events like 9/11 or the Oklahoma City bombing, usually around 1 in 4 people who experienced the same trauma are diagnosed with PTSD. The vast majority of people do not develop PTSD symptoms that rise to a level that doctors would consider to be a disorder.

Dealing With Trauma

“Big T” and “little t” traumas do change the way individuals view the world or see themselves in the world, and each person responds differently, a fact evident throughout the pandemic and other national and global turmoil since March of 2020.

Genetics and previous life experiences play a part in how people respond to trauma. Some people have innate traits that help them recover from trauma in ways others cannot, such as brain development and interpersonal relationships. Others have the ability and understanding to utilize their resources and acknowledge the impact a stressful event has had on their life, which subsequently helps them recover faster.

Regardless of the event, or if someone experiences a “big T” or “little t” trauma, any traumatic event makes a person feel powerless, out of control and like they have lost their sense of security. We have seen this time and time again with Covid-19. It has impacted jobs, housing, childcare, social relationships and countless other aspects of life. However, as we face the impact this period of time has had, it is vital to focus our attention on the things we can control, rather than ruminating on those things that are out of our control. The brain is also adaptable, so while trauma can change the functionality of the brain, there are ways to regain control of the brain after a traumatic event. 

How to Cope with Trauma

Talk About It

First and foremost, people need to talk about it. They should talk about the feelings and stress they are experiencing, while being cognizant to talk to someone who is supportive and someone who will decrease their anxiety. Connecting with a loved one or a mental health or medical professional can be beneficial.

Meditation and Mindfulness

Meditation and mindfulness help to slow the brain down and promote the use of higher parts of the brain, like the prefrontal cortex. This helps balance out other areas of the brain, like the amygdala that may have been impacted by the stress response.

Physical Health

Tend to your body. Physical health and mental health are inextricably linked. It is important to maintain good self-care: get quality sleep, exercise, eat healthy and get outside.

Covid-19 is indeed a novel disease, but humans have been experiencing traumatic events since the beginning of time, and we have proven, time and time again, our collective resiliency. While many things are out of our control, please remember how important it is to take care of yourself and your loved ones during this time and there are healthcare professionals, at HopeWay, available to help, if needed.

Dr. Kevin Marra, MD

Dr. Kevin Marra is a board-certified psychiatrist and serves as HopeWay’s Director of Medical Services. In addition to his practice as an inpatient psychiatrist at Mindy Ellen Levine Behavioral Health Center, Dr. Marra has served on several committees including the Medical Records Committee and Trauma Focused Therapy Committee, and was involved in coordinating projects related to optimization of the Behavioral Health Electronic Medical Record. Dr. Marra received his Bachelor’s in Biology from West Virginia University and Medical Degree from the West Virginia University School of Medicine. He went on to complete a Forensic Psychiatry Fellowship at UNC. He is also a member of the American Psychiatric Association and the American Academy of Psychiatry and the Law where he was selected as a Rappeport Fellow in 2011.