Language is our primary tool for expression and communication. It allows us to share thoughts, feelings, needs and information with one another and yet language is often inexact, communication is misconstrued, taken too literally or contributes to stereotypes.
I have had many conversations lately about nuance in language, and how this can have a profound impact on the way we and our experiences are understood, how we feel, our ability to help others and to personally work through mental illness.
Whilst awareness of, and conversations around, mental health have come a long way in the last few years, we should be clear and specific in the language we use, particularly around trauma. Our choice of words can unintentionally exclude people, invalidate their experiences, and sadly prevent people seeking help.
Trauma survivor - what we say versus what we hear.
The word trauma is frequently used interchangeably to mean traumatic event(s) and the impact those events have had. This can be confusing as these are two different things.
A traumatic experience may lead a person to suffer psychological trauma, a network of emotional and physical responses following a traumatic experience, that overwhelms our ability to cope.
Gabor Mate describes trauma eloquently in his recent book, The Myth Of Normal. Trauma “is not what happens to you; it is what happens inside you as a result of what happens to you … It is not the blow on the head, but the concussion I get”.
Most people who experience a traumatic event or events will not develop overwhelming traumatic syndrome, and some will experience post-traumatic growth.
Similarly, terms associated with those who have suffered traumatic experiences, such as ‘trauma survivor’ can have different meanings to different people.
The label ‘survivor’ is often understood to describe someone who has survived an event, especially a person remaining alive after an event in which others have died, and as such is commonly connected with PTSD.
The term ‘trauma survivor’ is often used with the intention of being a positive term and many identify with it in that way. Unlike the term ‘victim’, being called a ‘survivor’ can be empowering, “you survived, you’re still here”e.
For others, it may be disempowering, potentially making people feel like their experiences are not valid, or are not ‘traumatic enough’, or simply feel they don’t deserve to get help. This was true of my personal experience and I am uncomfortable identifying with the term. For me, ‘survivor’ also suggests that the experience has ended, when actually it is often ongoing and you can still feel like you’re struggling to survive. There can also be external judgement that comes with the word - others may say - ‘you didn’t literally nearly die though, how can you call yourself a survivor?’
The word ‘survivor’ can, however, have a different definition as provided by the National Crime Victim Law Institute which states a survivor is “a person who endures adversity, moves through it, and perseveres, or a person with resiliency who remains undefeated.” GoodTherapy | Stages of Trauma Recovery: What It Means to Be a ‘Survivor’
For me, this definition is a lot more resonant in relation t
o someone who has been through or is living with psychological trauma although of course, for some both meanings of the word may resonate..
But is it really possible to change the general understanding of the word survivor, so that it is understood in multiple contexts rather than having a single definition. 1. To describe someone who has survived an event. 2. Describing someone who has survived overwhelming suffering and 3. Describing someone who is surviving trauma - ongoing rather than past tense. Or would it be better to find more suitable language, something more straightforward and less open to interpretation - something different entirely?
Conversations
The language we choose to use in conversations matters too - around trauma and related experiences, as well as our casual day to day use of related words.
Sometimes, when sharing what you’re going through people may say things like “get over it” or “forget about it”, which feels dismissive of your experie
nces and from my point of view honestly there’s nothing I’d have loved more than to forget about it. Unfortunately it doesn’t work like that because of the way trauma leaves its imprint on the body and mind - the body keeps the score, as Bessel van der Kolk’s book is so aptly titled.
We should be clearer and more sensitive in the language we use when we casually talk about conditions such as trauma in everyday life.
Not only do people downplay the seriousness of trauma symptoms and time it can take to heal, they often use words incorrectly or causally such as “depressed” or “traumatised”, for example, something relatively mundane was so “dep
ressing” or was “so traumatic”. This use of this language can be demeaning to those who are struggling.
Stereotypes around trauma and PTSD such as only veterans have PTSD or only life threatening events cause trauma, exist due to a lack of awareness and understanding. They can cause more harm by adding to misconceptions and stigma, meaning people find it hard to open up and seek help.
Labels
Getting a label in the form of a diagnosis, can be helpful to give a general understanding to others of what someone is suffering from without them having to explain in detail. Having a label can also be vital for receiving the correct care and support, for example, labels are needed for treatment pathways within the NHS.
However, this can be a double edged sword, when too many labels are attached to a person and they are given multiple diagnoses their condition can be deemed too complex and it is unclear how care should be given resulting in people being passed from one service to another.
On the other hand, in today’s society everyone and everything seems to be given a label. Labels such as anxiety, depression, and OCD are now used so widely in casual conversation that they lose nuance of the individual’s experience and therefore do not have enough meaning when an individual needs them to. Labels can be also unhelpful, because when we are labelled we lose resolution, we lose all of the detail of a person and their experience, no two people have the same experience even if caused by similar events.
Losing nuance in individual experiences
Because of stereotypes and labels, and any preconceived notions that go with them, we can fail to grasp a full understanding of an individual's experience.
It's important to be aware and understand that there are many types of events that can be traumatic from childbirth or bereavement to road traffic accidents, war and terrorism.
Furthermore trauma does not cause a couple of symptoms, instead it can present itself in many different ways making each individual's experience of trauma very different. Trauma symptoms are grouped into four main categories. Re-experiencing symptoms such as flashbacks and nightmares. Avoidance of memories, thoughts or feelings. Cognition and mood symptoms such as loss of interest in activities you use to enjoy or negative beliefs about yourself and hyperarousal symptoms such as feeling jumpy or being ‘superalert’ watchful or on guard. There are additional symptoms of complex trauma, around emotional regulation, interpersonal relationships and suicidal feelings.
So what is the answer?
It not only takes a lot of courage and acceptance of vulnerability to share one’s experience of trauma, it can also be difficult to listen to because it may bring up complex feelings. From my experience we need to better educate ourselves on trauma and mental illnesses so that when a family member, friend, or perhaps a complete stranger reaches out to talk or to ask for help, we have a greater understanding and ability to empathise. We need to enable people to use nuanced language to describe their experiences to connect on a more human level and support each other better.
With this knowledge we can also start to recognise symptoms in others when they may not even realise what they are going through, and help them understand that with the appropriate support they may be able to start a journey to recovery. In those situations the advice of an acquaintance or loved one could be invaluable.
With regards to support and especially digital support for trauma, it is even more important to know that despite diagnoses one size does not fit all. Each individual’s experience of trauma and needs may be different. Better understanding these nuances means we can design digital interventions that subsequently provide better support for individuals on their unique recovery journeys.