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--:-- Sean Rameswaram: Support for Today Explained comes from BetterHelp. Let me tell you a true story. Last weekend, I got an email from a listener who wanted to discuss their problems with me. And I said, look, I don't think that this is about me personally. At least I hope it's not. Why don't you try BetterHelp.com slash Explained? Absolute truth. As the largest online therapy provider in the world, BetterHelp can provide access to mental health professionals with a diverse variety of expertise. Find the one with BetterHelp. The one is not me, guys. Our listeners get 10% off their first month at BetterHelp.com slash explain. That's BetterHelp.com slash explained.
--:-- Sean Rameswaram: Support for the show comes from Charles Schwab. At Schwab, how you invest is your choice, not theirs. That's why when it comes to managing your wealth, Schwab gives you more choices. You can invest and trade on your own. Plus, get advice and more comprehensive wealth solutions to help meet your unique needs. With award-winning service, low costs, and transparent advice, you can manage your wealth your way at Schwab. Visit schwab.com to learn more.
--:-- Sean Rameswaram: On the show today, we're going to talk about trauma. Lexi Pandell recently wrote about trauma for Vox. To start, it's important to say that trauma is real and PTSD is a real diagnosable disorder. But with that said, there's a huge appetite for trauma right now. There's this one book called The Body Keeps the Score, and it isn't light reading. It's a very serious book that discusses horrific traumatic events in great detail and argues essentially that trauma can change brain and bodily functions.
--:-- Sean Rameswaram: And so, a lot of people still think that trauma is something that happens to you. That is a story about the past. Trauma is that your brain gets changed, and you see the world differently, and you live in a different body, you live in a different world. So that book was published in 2014, but it has hovered around the number one spot on the New York Times bestseller list for paperback nonfiction since February 2021. And as of this conversation, it is currently back in the number one spot.
--:-- Sean Rameswaram: So, in addition to that, there's tons of podcasts about trauma, and there's television shows about it. I think particularly of shows like Yellow Jackets. I know what you want to hear, but the truth is the plane crashed, a bunch of my friends died, and the rest of us starved and scavenged and prayed for 19 months. I may destroy you in Station 11. So you ran away, and you let everyone believe that you died. The Matrix Resurrections features trauma therapy as a key plot point. You ever wonder why you have nightmares? Why your own brain tortures you? And trauma is all over social media.
--:-- Sean Rameswaram: So there's influencers talking about their trauma, and so-called trauma experts espousing what trauma responses may look like. Most overdoing anything is typically a trauma response from a deep fear of rejection or abandonment. Examples include over-explaining, over-achieving, over-preparing. And it's really become a word that's casually thrown around. Literally traumatizing. And in that way, the sort of true meaning of trauma has been watered down and kind of adopted as a cultural touchstone.
--:-- Sean Rameswaram: And in some cases, it's even kind of being used as a joke. Ooh, where are the trauma jokes? There's one trauma expert who I spoke to who said things like, you know, people refer to it like, I've run out of cookies. That's so traumatic. Or my favorite football team lost. That's so traumatic. Those aren't even funny jokes. They're not even funny.
--:-- Sean Rameswaram: And the language of trauma, too, has kind of been co-opted. I think we see that a lot with the word triggered, which has become pretty common. Hi, everybody, and welcome to our fantastic live book signing of already bestseller. Congratulations, Mr. Trump. Thank you, Princess. Yes, I'm triggered. All right. Thank you.
--:-- Sean Rameswaram: Well, I want to get more into the sort of language of trauma and how we ended up there. But why do you think this word is having such a sort of crescendo right now? It's the jokes, the popular culture. It sounds like it's on social media, the books. What's going on?
--:-- Sean Rameswaram: So there's been a lot of talk about trauma in connection to the COVID-19 pandemic and the lockdowns. You know, it has been a tough year, and the COVID-19 pandemic has provided potential sources of trauma, which can lead to post-traumatic stress disorder. And we've kind of reached this high point of trauma discussion, I think, because of that.
--:-- Sean Rameswaram: But what's surprising is that if you look at it over the years, trauma's really been on the rise since the 1980s. God, what is your childhood trauma? And that reflects kind of an expansion of the formal clinical understanding of trauma as well as cultural shifts. So that second point, we've really entered a point of overwhelm in our culture. People are incredibly stressed out, and there are social structures that are not working for everyone, and a lot of big, scary questions that we don't know how to deal with.
--:-- Sean Rameswaram: And trauma has become one way that we've tried to frame that narrative. Okay, and how does the understanding of trauma evolve over time? So trauma, let's go all the way back to the start. Trauma is derived from the Greek word for a physical wound, and we still see that today in hospital settings, for example.
--:-- Sean Rameswaram: But the emergence of our current understanding of trauma goes hand in hand with the rise of psychology in the late 1800s. Freud's work on, quote, hysteria was considered particularly foundational. Okay, everybody, that's it for today. Thanks. We'll see you Monday. We'll be talking about Freud, why he did enough cocaine to kill a small horse. Thank you.
--:-- Sean Rameswaram: And it was at this point that psychologists began really investigating how traumatic events could alter memory, change behavior, and cause lasting harm. Jumped forward to World War I. Soldiers began to be diagnosed with what was known as shell shock. I'm sorry. It's all right, Mr. Mark. I'm sorry. You're all right. Is it any wonder when he's been to hell and back? Symptoms included things like nightmares or impaired sight, but it was controversial and often considered a sign of cowardice.
--:-- Sean Rameswaram: And some soldiers were accused of simply trying to get out of fighting. Sir, I only meant to say that Lieutenant Courtney is depressed. I will not leave wounded soldiers freezing or sweating under canvas because one junior officer is depressed. A big turning point here was research on veterans of the Vietnam War. And that proved to be critical in our understanding of post-stress disorder or PTSD.
--:-- Sean Rameswaram: And studies on those veterans and of others who experienced horrific events around that time informed the definition of PTSD, which was added to the DSM in 1980. Hmm. Where does the term even come from? The sort of clinical definition, we can start from there, of the DSM-5, which is the standard in American psychiatric diagnosis, currently defines trauma as an actual or threatened death, serious injury, or sexual violence, something you've experienced either as the victim of it or as a witness of it.
--:-- Sean Rameswaram: Being a witness can either be a direct witness or if you're, say, the close family member of someone who experienced the trauma. You could also be traumatized if you are repeatedly exposed to details of traumatic events, like a police officer working with children who were victims of sexual abuse. Which is subjective, I guess? It can be subjective, yeah.
--:-- Sean Rameswaram: And that's actually something that's changed with the clinical definition, too, because a traumatic event to one person may not be traumatic to another person. So there's been more weight placed on sort of the person's experience of it. Okay, so it sounds like PTSD and before that trauma start to get really used because of the experience of war, which is one of the most grotesque human experiences around.
--:-- Sean Rameswaram: But how does trauma start to get associated with other experiences? So in the 1980s, Americans were emerging from the civil rights and women's movements of the 60s and 70s. And there was this push to think about trauma as it related to things like racial injustice, violence against women, and child abuse.
--:-- Sean Rameswaram: And at that point, a traumatic event was still considered to be something that was a singular event, a threat to life or limb. But soon researchers began looking at what effects long-lasting or systemic abuse might have. And that's where we started to see terms like cultural trauma and generational trauma, particularly as they described issues like genocide or enslavement.
--:-- Sean Rameswaram: And really, the casual use of trauma started happening around 2005. 2005? What happened in 2005? So trauma was better known at that point. That's one thing. But one expert I spoke to pointed to how our online lives were expanding at that time. So there was a huge rise in internet culture. We saw a lot of blogging and sharing of personal experiences on websites like MySpace and LiveJournal.
--:-- Sean Rameswaram: And this was really new and widespread like never before. People were posting candidly about their struggles, specifically with mental health. And trauma, which had been a pretty clinical term up until then, started to be used as a way to frame those hardships. So even for people who hadn't experienced what might be clinically considered trauma, the word provided a tidy narrative.
--:-- Sean Rameswaram: One where they were the victim to circumstances outside of their control. And one researcher I talked to said that she started seeing people essentially justify their suffering through the lens of trauma. So what are the issues with this transition of people assessing say an experience in war or with genocide or or with enslavement or rape as trauma to people online who are blogging saying I've experienced this and that trauma that isn't one of those things I just mentioned.
--:-- Sean Rameswaram: So in the same way that saying that the weather is bipolar or that you're so depressed because you missed the bus, it could minimize the experience of people who have experienced trauma and may have PTSD. I spoke with one expert who said that misrepresenting trauma could stop those who have suffered from trauma from getting the right type of treatment for them.
--:-- Sean Rameswaram: And I talked to others who said that it could undercut human resilience, that essentially overusing the word trauma flattens every negative event into a catastrophe that leaves us helpless and unable to move on. I mean, who gets to decide? Who gets to decide what is a real trauma and what isn't? Is there like a bouncer at Club Trauma?
--:-- Sean Rameswaram: In terms of like, what is trauma? What isn't trauma? Researchers are really divided on this. There are some researchers who say, yes, like we should have this really widespread view of what trauma is. And if something bad has happened to you and there are lasting effects of that, then that's trauma.
--:-- Sean Rameswaram: There are other researchers who are much more conservative in their view, and they are essentially saying that trauma is something that happens to you in an incident that is a threat to you in some way. And then that is the only thing that can be considered clinically traumatic. So it's really to be decided.
--:-- Sean Rameswaram: And I think that there's some really interesting research being done on this exact topic. What do we gain if we tighten the definition of trauma? So to be clear, of course, this doesn't mean that we should stop talking about trauma, but taking care with language is always a good thing. And doing so could avoid some potentially harmful outcomes, like I mentioned earlier.
--:-- Sean Rameswaram: It's important, I think, too, to identify that there's something really beautiful that's happening and overdue for our culture, which is the recognition of mental health challenges, the recognition of trauma, and also the recognition that negative effects can have lasting harm. And that's huge, and it's an incredibly positive thing.
--:-- Sean Rameswaram: I think, too, we're dealing with world events that are incredibly overwhelming, which make us feel small and helpless. For example, the COVID-19 pandemic. For some, the pandemic has been traumatic. For example, those people working on the front lines as doctors. But many experts say that, by and large, the pandemic is not a collective trauma.
--:-- Sean Rameswaram: However, we are now dealing with these really extraordinary circumstances, which feel in many ways akin to trauma. So if what we're experiencing is not quote unquote clinical trauma, it's still really important to uncover what it is we are experiencing. I think that we have sort of encountered a limit of human language here, and we need to really look at that and see how we can broaden our understanding of the human experience.
--:-- Sean Rameswaram: Over-relying on trauma can really undercut this aspect of human resilience, which is to say that we may in fact be stronger than we think. And there's researchers I spoke to who basically said that flattening every bad experience into a trauma really takes that away from us. And that it's important to recognize that humans are incredibly resilient and that we don't have to be sort of necessarily bogged down by only viewing ourselves through the lens of being victims to situations outside of our control.
--:-- Sean Rameswaram: In a minute, the counter-argument. It's Today Explained. Getting paid up to two days early with direct deposit. So much more. Chime says with qualifying direct deposits, you can be eligible for free overdraft up to $200 on debit card purchases and cash withdrawals. Plus, they say you don't need to worry about monthly fees or maintenance fees.
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--:-- Sean Rameswaram: Support for this show comes from Macy's. It's almost fall, and that means it's time to cycle your wardrobe to the cold setting. Because while everyone loves a breezy summer outfit, let's be real. Layering is even more fun. That's why Macy's Fall Fashion Guide has everything you need to piece together the perfect look for you.
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--:-- Sean Rameswaram: You can even throw in some textural layers for contrast, like a faux fur bomber jacket from Karl Lagerfeld Paris. Whether your old favorite sweater or coat is on its last threads, or you're just craving a new vibe to switch things up, Macy's has got you covered this season.
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--:-- Sean Rameswaram: Ron is from, we're back. We just heard from Lexi Pandell. She wrote this piece for Vox all about how trauma became the word of the decade and especially of the pandemic. And she talked about the potential risk of the term trauma losing its meaning.
--:-- Sean Rameswaram: This got me thinking about my friend Stephanie Fu, who actually just wrote a whole book about trauma. So I sent her Lexi's Vox article and asked her what she thought about it. Let's just say she had some feelings. So I invited her on the show to talk about them.
--:-- Sean Rameswaram: We started where Lexi and I left off. I asked Stephanie what she thought about this expanding definition of trauma that some psychologists are worried about. I think it's great. Hmm. As a person who has experienced the more quote-unquote traditional textbook definitions of trauma, I think it's a good thing.
--:-- Sean Rameswaram: And I think trying to minimize that is pretty dangerous, actually. So you, as someone who has experienced more traditional forms of trauma, whatever that might be, aren't concerned that someone next to you on the subway or someone on the street while you're walking by might be saying, you know, I have trauma.
--:-- Sean Rameswaram: Last week, I couldn't find my keys in my apartment and it took me three hours and I missed all of my plans and I feel traumatized. You're not saying, bro, that isn't trauma. No, I think it's a little bit silly. As a person who goes out and lives in the world, I don't really hear people using trauma in that way that often.
--:-- Sean Rameswaram: Usually, it is something a little bit more serious. I mean, I suppose that can be mildly irritating if someone were to say like, I have actual PTSD from losing my keys. But the word trauma, no, not really. It is out there, though, Stephanie. I got to say, I mean, Miles and I, when we were preparing for this episode, we discovered that there's like there's a whole subculture of TikToks, trauma TikToks.
--:-- Sean Rameswaram: Oh, yeah. Like. Do you spend any amount of time on TikTok? Because they have people saying ridiculous opinions about everything. So, of course, if trauma is going to be part of the conversation, there's going to be some people saying ridiculous things about trauma as well.
--:-- Sean Rameswaram: There's also a lot of people on TikTok sharing their very vulnerable feelings about complex PTSD, about their very legit traumas, opening the conversation up to have people feel less insecure about revealing their own traumas. I see people on there talking about their sexual assaults, you know, openly and shamelessly.
--:-- Sean Rameswaram: How do you show love to a partner who has gone through sexual trauma? Talk about sex while you are both fully clothed. And I see people in the comments getting in there and being like, oh, me too, me too. Or people talking about, you know, their tendency to dissociate and making really funny jokes about it, actually.
--:-- Sean Rameswaram: What do you mean? You can just turn your brain off? How the hell do you do that? Oh, yeah, it's super easy. I just. turning something that could be really depressing and heavy into something that's really light and where you go oh me too.
--:-- Sean Rameswaram: You wrote a book called what my bones know, and it's a memoir about healing from complex PTSD. We didn't really talk about that much earlier in the show. Can you explain what complex PTSD means? I guess the quote-unquote traditional post-traumatic stress disorder, you can get PTSD from a single traumatic event.
--:-- Sean Rameswaram: Say, you know, you were hit by a car that and severely injured. Like that could make you have PTSD and be sort of anxious when crossing the street, for example. Complex PTSD is, let's say you were hit by the car three times a week for many years.
--:-- Sean Rameswaram: Complex PTSD is when the trauma happens over and over and over again over the course of years. So that could be people living in a war zone. That could be people surviving domestic abuse, child abuse. My complex PTSD comes specifically from extreme physical and verbal abuse and neglect.
--:-- Sean Rameswaram: And I didn't mention this at the top, but you were a reporter at This American Life for years. You were a radio reporter for years before that. And after that, since you've written for Vox before about your complex PTSD. You wrote about it around the beginning of the pandemic.
--:-- Sean Rameswaram: And while you said it was something you've been working on recovering from, you also called it a superpower. How come? Yeah, I mean, I don't want to minimize the effects of complex PTSD. Just to be totally clear, it can be excruciatingly painful. It's not super fun to have.
--:-- Sean Rameswaram: But I absolutely do have side effects from my trauma that are tremendously helpful. Having complex PTSD has made me really empathetic, very eager to help others. Like healing from trauma really is like walking through fire.
--:-- Sean Rameswaram: And you really learn how to help other people get through as well. I'm really good about working hard and staying on deadline. And I'm really good in a crisis because PTSD is essentially hypervigilance, right? It keeps you on your toes and ready for the absolute worst to happen.
--:-- Sean Rameswaram: And during the pandemic, the worst kind of did happen. And I felt so emotionally prepared for it. Like when I knew all of these other people who were sort of crippled and couldn't function because they were so fearful, I was really fine.
--:-- Sean Rameswaram: I was able to support others. I was helping keep our family safe. What might have been hypervigilance or paranoia before was me taking like proactive actions to keep our family safe. And I felt really like I could hold space for everyone around me who was feeling as anxious as they did because I felt so stable.
--:-- Sean Rameswaram: You know, there are a lot of people, and I think Lexi mentioned this earlier in the show, who refer to the pandemic itself at this point as a kind of trauma. I think part of this sort of cultural crescendo we're seeing around this word has to do with the fact that a lot of people have been through the emotional ringer in the past two years in any number of ways.
--:-- Sean Rameswaram: Have you noticed that in your life? Oh, absolutely. For me, I think there was a sense of before the pandemic, I had more shame almost about having complex PTSD. I was like, I'm a freak. I'm weird. I have these behaviors, these hypervigilant, fearful behaviors, and they make me like paranoid or strange.
--:-- Sean Rameswaram: And then after the pandemic, I'm like, oh, all of a sudden I am perfectly normal. If anything, I am kind of coping better than most people because I saw those behaviors I was very used to in myself with everyone around me in a way that was tremendously shocking. And that felt comforting? Yeah, it felt comforting.
--:-- Sean Rameswaram: So many of us lost people we loved, including myself. And like me, so many of us weren't able to properly say goodbye to our loved ones because of COVID. We weren't able to grieve in the same ways, not to mention the racial reckonings, not to mention the fear and loneliness that especially immunocompromised people had to endure or the fact that domestic violence was way up or that so many relationships fell apart.
--:-- Sean Rameswaram: Any teacher will tell you that their students have struggled so much and endured trauma during this time. And why does acknowledging this as a collective trauma help? Well, when we acknowledge that there's a real problem, we can get resources to solve those problems, like more mental health funding.
--:-- Sean Rameswaram: Being able to change our broken mental health care system so anyone can get quality help, like affordable health care, more support for kids who are struggling in school right now. So there's a difference between suffering versus pain, right? So pain is the legitimate pain that you should feel, the grief that you should feel like, let's say, somebody you love dies.
--:-- Sean Rameswaram: And suffering is when it's been whatever six months and you're saying why am I still grieving over this person why am I still unable to function why am I still upset I shouldn't be I should be fine so that suffering is actually really debilitating to our abilities to heal and minimizing trauma and saying it's not valid that increases suffering in everyone.
--:-- Sean Rameswaram: I think anyone listening to this can relate to the pain and loneliness and depression and paranoia and fear of this pandemic. And I guess what's unclear in the science or what's unclear to maybe people like me or Lexi or maybe even you is where those words lose their weight and trauma becomes the word we're sort of allowed to use to describe our experience.
--:-- Sean Rameswaram: Does anyone have a concrete answer for that? No, I don't think that they do. And I think that's the problem. Like, what is the definition of trauma that you're going by? And isn't our society one in which words can take new shape and evolve over time? Consider, like, racism, right?
--:-- Sean Rameswaram: So if someone says they've experienced racism, are you just going to say, okay, lay it out for me. Exactly what racism have you experienced? Justify it for me. So I, as an outsider, can judge whether this has hurt you or not. It's probably not that big a deal. You should be able to get over it.
--:-- Sean Rameswaram: Or are you going to say, hey, maybe I should listen and consider why this has hurt you so much. And maybe we should pay attention to it. Like, if there's this real pain in our society, right, what can we do to try and address that? For years, I thought this idea of, oh, my trauma isn't serious, whatever, I'm fine.
--:-- Sean Rameswaram: It's not like I'm a combat veteran, you know. I went through really extreme trauma. But because of this societal pull-yourself-up-from-your-bootstraps-it's-not-that-big-of-a-deal idea, I was like, well, you know, I didn't live through war. I didn't have a gun to my head. So it must not be that big of a deal.
--:-- Sean Rameswaram: So if my trauma is making me depressed or anxious, nope, forget about it, dissociate, be a workaholic. You don't get to feel these feelings, which really prevented me from acknowledging, hey, what I went through was serious and valid and I really need to take healing from it seriously.
--:-- Sean Rameswaram: Like I need to find the right therapist and work on self-soothing and boundaries so I'm not putting myself in the way of more abuse. So feeling that tendency to minimize what I was really going through, it really slowed the healing process down. And once you get rid of the suffering, it speeds up the process of grieving so you can be ready to do the work of healing.
--:-- Sean Rameswaram: Stephanie Fu has a book about trauma coming out on 2-22-22. That's a Tuesday. Let's call it Super Tuesday. It's called What My Bones Know, and you can preorder it now. Earlier in the show, you heard from Lexi Pandell. You can read her article, which inspired this episode, over at the highlight section of the Vox website. It's titled, How Trauma Became the Word of the Decade.
--:-- Sean Rameswaram: Our show today was produced by Miles Bryan, edited by Matthew Collette, mixed and mastered by Afim Shapiro, and fact-checked by Laura Bullard. It's Today Explained.
