The Trauma Continuum: Big T trauma, Little t trauma, and the Trauma Continuum

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Trauma: Frozen Moments, Frozen Lives

By Gaetano Vaccaro, Ph.D. and Joni Lavick, M.F.T.
From San Francisco AIDS Foundation, Summer 2008

Trauma can take many forms and occur at any life stage. The impact of trauma is especially pronounced in childhood. For children, even seemingly minor events — such as schoolyard bullying or an encounter with an aggressive dog — can have profound effects. Infancy and childhood are the most critical developmental periods; the human brain completes 75% of its total development within the first six years of life.

A child’s earliest experiences, even those beyond conscious recall, play a crucial role in his or her behaviors, attitude development, relationships, and sense of self in later life. A stable childhood can provide some protection against the effects of trauma, but no one is completely immune. Cataclysmic events, such as riots, natural disasters, and war, can traumatize entire groups of people, regardless of their past experience or current resilience. Diagnosis of a life-threatening illness can traumatize even the most self-confident individual.

Trauma must always be considered in the context of each person’s individual perception. What may be traumatic to one individual may not be traumatic to another; it is the subjective perception of “threat” that determines the intensity of each person’s reaction. In the field of trauma therapy, traumatic events are classified as degrees on a continuum: “big-T” trauma, “little-t” trauma, and cumulative trauma (also called chronic unremitting stress).

Big-T trauma is generally associated with discrete, identifiable events and usually involves distinct memories that the individual can recall. A person who has suffered rape, severe childhood abuse, or a catastrophic illness or injury; unexpectedly lost a relative or friend; or witnessed violence or war has experienced big-T trauma. In the short term, these traumas generally exert the most debilitating physical and psychological effects.

Little-t trauma and cumulative trauma, in contrast, are associated with continual or recurring situations and have more global and lasting effects on the individual. Little-t trauma stems from situations that may seem insignificant or only mildly distressing, but which can lead to extreme reactions. These may include physically uncomfortable experiences like dog bites, dental procedures, or minor automobile accidents, or emotionally painful experiences such as criticism or verbal abuse, repeated failures at school or work, intermittent childhood neglect or isolation, or being bullied or teased.

Write from the following prompts and questions. Post your replies in the “Comments” section below.

Common Symptoms of Unresolved Trauma

Anxiety Mood Fluctuations Headaches
Panic attacks Disorientations Dizziness, trembling, fainting
Intrusive thoughts Depression Chronic illness
Flashbacks Hypervigilance Sleep Disturbances, nightmares
Shame Avoidance behaviors Heart Palpitations
Exaggerated emotions Attraction to dangerous situations or high-risk behaviors Extreme sensitivity to heat or cold
Irritability Nausea

Answer this:

What symptom of trauma are you ignoring or not aware of?

Write about one experience and self–reflect on the cause of this silencing in your life.

Which belief(s) affect your daily life?


Common negative beliefs associated with Big T Trauma:

“I should have done something when____________.”
“I am powerless when____________.”
“I can’t protect myself when____________.”
“I am in danger when____________.”
“I am weak when____________.”

Answer this:

Write about a time you had no control over a crisis, trauma or catastrophic event.

How did this affect your courage, resilience and determination in life?


Common negative beliefs associated with little t trauma:

“I am insignificant because___________.”
“I am a failure because___________.”
“I am unlovable because___________.”
“I can’t trust anyone because___________.”
“I am broken because___________.”
“I don’t deserve to be happy because___________.”

Answer this:

Write about a time when your feelings were dismissed.

How did this affect your safety, trust and value in the world?


Common negative beliefs associated with cumulative trauma:

“The world is unsafe _____________.”
“I need to protect myself at all times _____________.”
“Nothing will ever change _____________.”
“There is no point in trying _____________.”

Answer this:

Write about a recurring situation where you felt emotionally abused and trapped.

How did this affect your self-image and self-esteem?

For young people, little-t traumas may also include “empathic failures” on the part of caregivers. Continual dismissal of a child’s feelings — for example, with words like “you aren’t hurt” or “don’t be sad” — represents a caregiver’s failure to empathize, or perceive and understand the child’s emotional state. When this occurs, there is no “relational home” for the child’s feelings, no sense of the safety or security required for the child to express emotions and learn to regulate them.

The effects of cumulative trauma result from recurring situations or experiences. The constant pressures that contribute to cumulative trauma make it extremely resistant to treatment; it cannot be easily alleviated or temporarily managed through common stress-reduction techniques. As with other trauma, pain inflicted over time can become “frozen” into physical symptoms. Cumulative trauma can lead to a state of apathy, hopelessness, and even rage. Examples of cumulative trauma include extended exposure to frightening or stressful situations, homophobia/heterosexism, racism, sexism, classism, poverty, and neglect.


Long-Term Effects of Unresolved Trauma

The brain is the central processing organ for all sensory information and the primary regulator of all mental and emotional functions. It is divided into two hemispheres that regulate different mental attributes. The right hemisphere (or “right brain”) regulates non-verbal information, visual-spatial perception, autobiographical details, abstract thinking, creativity, and intuition. The right brain deals with procedural memory, which is long-term memory of skills and procedures, such as driving a car or tying a shoe. The right brain is the locus of the unconscious, where self-awareness begins. The left hemisphere (or “left brain”) is associated with logical, linear, analytical thinking. It is the primary center for linguistic and verbal functions and declarative memory, which is the conscious recall of information and events.

An important feature of trauma is how traumatic experiences become encoded in the brain as memories and throughout the body as sensory information. Big-T trauma is usually associated with specific large-scale events that elicit strong “affective sensations” (sensations accompanied by a strong compulsion to respond, such as the reflex of withdrawing one’s hand from a hot object) as well as powerful visual images, called “snapshot memories.”

Being both sensory and visual, the memories of big-T traumas are stored in both hemispheres of the brain, but primarily in the right hemisphere. Conversely, “little-t” traumas are not discrete events or situations, but rather continual attitudes and sensations that a person experiences over time (such as ongoing criticism or neglect). Little-t traumas are primarily recorded in the right hemisphere as “memory imprints” (such as negative self-concepts, negative beliefs, or feelings of isolation).

In a simplistic sense, in order for any traumatic experience to be processed, it must be felt by the right brain, then analyzed, interpreted, and understood by the left brain. Otherwise, a traumatized person may relive an event over and over again without examining it and coming to terms with what it means.

Click on any of the links below to learn more about trauma:

Marta Luzim, MS

Marta Luzim, MS

I have been working with women, families, and couples from every walk of life for over forty years. I have a practice as a Psychospiritual Therapist, with an MS in Counseling Psychology and BS in Education.

I have studied with master teachers of depth and Jungian psychology, Kabbalah, mythology, and mysticism. I am a Next Level Practitioner as a member of NICABM, studying with experts in the field of trauma. I am certified as a Kaizen creative coach, Metaphysician through Lao Russell's Science of the Cosmos training, somatic body worker, emotional intuitive, breath worker, and intimacy trainer under the guidance of Doug and Naomi Moseley.

Maureen Murdock’s Heroine’s Journey, Linda Leonard’s Meeting the Madwoman, Clarissa Estes’ Women Who Run with the Wolves, Savina Teubal’s Sarah the Priestess and Lost Civilizations of the Matriarchs, and Charlotte Kasl’s Women, Sex and Addiction have had major influences on my work with women.

I am an expert in women’s issues, family issues, trauma, abuse, addiction, and recovery. As an artist, writer, and healer I advocate/pioneer work with feminine spiritual and creative processes to evoke women’s voices, visions, and healing. As a teacher, I taught children right hemispheric and creative processes to bring passion, heart, and soul into the learning process.

My signature process, Writing Like A Madwoman™, is a life changing, creative, and emotionally charged healing program. I use story, memoir, and truth telling as the container to evoke your voice, explore trauma and healing through deep, dark and daring writing.

I have written five books: The Calling, Heart of a Woman, Little Book of Consciousness, Conscious Companion, and Cry Kali, Voices From My Soul. I had two staged productions, Breathing Under Water in 2000 and Vows of Love in 2004. In addition, I produced a docudrama Primal Urgency. I've published articles on woman's issues and creativity. I am President and founder of Give Her A Voice, Inc, a 501c3 nonprofit producing multi-media plays called The Telling, showcasing woman’s gutty, gritty stories of recovery from abuse. Visit her website at
Marta Luzim, MS

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