Abstract
he trauma that is the focus of the “After the Crisis: Healing from Trauma afterDisasters” initiative is not the trauma of emergency medicine – traumatic bodily injury,whether from accidents, beatings, or disasters – although it certainly intersects with suchinjury. A distinction is often made between a traumatic event and “psychological
trauma” (e.g., Herman, 1992b), the impact on the individual of experiencing a traumaticevent. Frequently, the word ‘trauma’ is used as a short-hand for both. Attention is paidin the literature to distinguishing between traumatic life events and stressful life events,with the line often drawn, in keeping with the
Diagnostic and Statistical Manual of Mental Disorders
(
DSM
), between those events that involve “threat of death or seriousinjury” and, according to the current edition of the
DSM
(DSM-IV-TR [Text Revision])(American Psychiatric Association [APA], 2000), also an “emotional response of fear,helplessness, or horror at the time of the precipitating event” and other “painful andstressful events that constitute the normal vicissitudes of life, such as divorce, loss,serious illness, and financial misfortune” (McHugo et al., 2005a, p. 114-115). Today’sworld is replete with examples of extreme life events, including war, ethnic cleansing, genocide, terrorist attacks, as well as tsunami, earthquakes, floods, tornadoes, andhurricanes – so-called “natural disasters” whose impact is frequently shaped by past and present human actions and inactions. Following SAMHSA’s Women, Co-Occurring Disorders, and Violence Study, weuse the word ‘trauma’ to mean interpersonal violence in the form of physical abuse andsexual abuse, including childhood sexual abuse, rape, and domestic or intimate partnerviolence. Such trauma may or may not entail trauma in the medical sense of traumatic bodily injury. We understand violence in the sense of violation, which may or may notentail physical violence against a person but
always
entails violation of that person. Inaddition, the term ‘trauma’ can designate neglect or verbal, emotional, or psychologicalabuse, which some consider even more damaging than interpersonal physical and sexualabuse (Dutton, Kaltman, Goodman, Weinfurt, & Vankos, 2005; Follingstad, Rutledge,Berg, Hause, & Polek, 1990; Savin-Williams, 1994), as well as stalking (Basile, Arias,Desai, & Thompson, 2004), and witnessing interpersonal violence (American PsychiatricAssociation, 2000). We also use the word ‘trauma’ to designate the impact of traumaticevents on individuals. Thus ‘trauma’ designates both events and their impact, in part because the actual experience of abuse and the assault that experience poses to sense ofself, safety, belonging, and connection are intertwined