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What are Adverse Life Experiences?

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

stressed manIn recent years, the phrase adverse life experience has entered the discussions about both trauma and stress. It's a term that helps us to distinguish between the ordinary stressors of daily life; from the stressors that can become traumatic for some people. In a sense, adverse life experiences fall somewhere in the middle of a severity range from the extreme, catastrophic events we usually associate with post-traumatic stress disorder (PTSD), to ordinary, everyday stress. As such, adverse life experiences may not meet the diagnostic criteria for post-traumatic stress disorder (the clinical diagnosis most commonly associated with trauma). This continuum of severity might look like this:

Severe----------moderate--------mild
Catastrophic trauma----adverse life experiences----ordinary stress

Francine Shapiro, Ph.D. is the creator of a highly effective trauma treatment called eye movement desensitization and reprocessing (EMDR).  Dr. Shapiro (1997) introduced the concept of Large-T trauma and small-t trauma. Small-t traumas represent these adverse life experiences that don't ordinarily qualify someone for a PTSD diagnosis; yet, they still merit clinical attention because they can be wounding, and therefore, traumatic. Some common examples of these adverse life experiences (small-t traumas) include racial or ethnic discrimination, verbal abuse, cyberbullying, surviving divorce, experiencing a medical crisis, spiritual abuse, emotional blackmail, or losing a pet. If left unhealed or unaddressed, a person may develop symptoms that are similar to PTSD. Large-T traumas are those we commonly associated with PTSD such as rape, witnessing a murder, natural disasters, and war-time atrocities.

By labeling these adverse life experiences as small-t traumas, Shapiro was not suggesting these experiences are any less significant than the Large-T traumas. According to one of Dr. Shapiro's (2001) models, these adverse life experiences can be just as valid and clinically significant as the kinds of trauma that we more commonly associate with PTSD. The significance of small-t trauma may be more evident if we return to our previous analogy to physical trauma. Large-T traumas that are consistent with a PTSD diagnosis (e.g., rape murder, torture) are analogous to a single, large, deep knife wound. Adverse life experiences (small-t traumas) are analogous to 15 shallow skin lacerations from a knife. You can bleed to death from both.

People tend to minimize the impact of small-t traumas. They seem to believe if they didn't survive a major disaster, then their trauma is somehow less legitimate or significant. Sadly, many professionals and family members further reinforce this harmful belief when they say things like, "Well, you didn't have it as bad as your brother. He fought in Iraq. You just had a couple of kids teasing you at school."

There will always be the critics who say these adverse life experiences are just that- a part of life; and therefore, should not be regarded as traumatic. Sure, many people can muster their own healing resources and support networks to heal these life wounds without professional care. However, many others cannot. The traumas themselves are usually not the problem. It's when the traumas go unresolved and unhealed that problems develop. People whose lives are affected by unhealed adverse life experiences have every right to access treatment. Just as beauty is in the eyes of the beholder, we might say that trauma is in the eyes of the beholder as well.