Breaking down "Big T" and "little t"


When you hear the word trauma, what do you think of? 

Often, we think of catastrophes, tragedies, war, natural disasters.

And these certainly are traumatic events. 

Over the years trauma has often been divided up into two main categories: “Big T” and “little t”. 

“Big T” are those commonly associated with post-traumatic stress disorder (PTSD) and they are ones that are usually more “visible”. We think of things like life threatening experiences, serious injuries and illnesses, sexual assault, car and plane crashes, war, natural disasters, terrorist attacks etc.  Events that everyone would identify and openly agree are “traumatic”. The DSM-5 defines a PTSD trauma as, “any situation where one’s life or bodily integrity is threatened”

There is another category referred to as “small t”. This category stereotypically might include things such as infidelity, divorce, interpersonal conflict, financial difficulty, emotional abuse, bullying or harassment,  mental health challenges (anxiety, depression, stress), neglect, addiction etc. These traumas are often less visible, and while they may not lead to PTSD, they often cause a person a great degree of distress and decreased quality of life. 

While as humans we find it helpful to identify, organize and classify things into categories, we sometimes can cause harm by doing so. “Small t” traumas can be overlooked  by people, including some professionals and even by the individual who has experienced them. This may cause feelings of shame, weakness, and being dismissed.  Furthermore, while a “one time” incident of “small t’s” may not lead to significant distress, the accumulation of these “small t’s” may cause significant challenges in emotional functioning. 

By definition, trauma is the “response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, diminishes  their sense and their ability to feel the full range of emotions and experiences”. Trauma has more to do with the response: the impact and the reaction, than it does to the cause and the event. 

We should also note that responding in this way is not an indicator of psychological weakness or some type of deficiency. People do have unique predisposing factors, past experiences, beliefs, perceptions, expectations, values, morals and even different ways handing stress, different levels of resiliency, and different role models and supports. In addition,  how they process the experience also can impact the level of response that they have. 

While using the labels might be helpful for some to identify the type of trauma, is it not helpful to use the categories to dismiss some people’s trauma or to justify rationales such as  “others have it much worse” or “that is not considered a trauma” or “you are just being dramatic”. We need to be careful of the language we use and the message we send by using that language.

What matters most  about dealing with trauma is the impact the adversity had in YOUR life. While the same event could have no impact in one person’s life, on another person,  it can lead to trauma and impact everyday functioning. 

And that is what makes us all human. We all can have the exact same circumstances and come out of it all with different results. Our story is ours to tell. It is no better than another. We do not have to compare pain. We do not have to feel shame for struggling with adversity different than our neighbour. We do not have to “recover” at the speed and pace of another. We are on our own path and our own journey.

Regardless as to whether your trauma is classified as a “Big T” or a “little t”, your recovery is just as important, and just as possible.